Psychosis-like experiences and distress among adolescents using mental health services

Kline, Emily; Thompson, Elizabeth; Bussell, Kristin; Pitts, Steven C.; Reeves, Gloria; Schiffman, Jason

doi:10.1016/j.schres.2013.12.012

Cited by 51 publications

(43 citation statements)

References 20 publications

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“…Although it slightly lost sensitivity (62%), its specificity went up to 75%, with the best performances in terms of PPV (84%) and J (0.409). These diagnostic accuracy measures of the iPQ-B are substantially comparable to those of the Italian version of the PQ-92 (sensitivity = 62%, specificity = 82%) [34], but slightly lower than those reported in other PQ-B validation studies, in which sensitivity values varied between 73 and 88% and specificity between 68% and 83% [11,22,23,33].…”

Section: Concurrent Validity and Diagnostic Accuracy Measuressupporting

confidence: 54%

“…In their recent systematic review on psychosis risk screening using the PQ, Savill et al [2] examined 8 diagnostic accuracy studies using the PQ-B. Of these, one evaluated the number of distressing symptoms endorsed in a UHR/psychosis-enriched sample and found a threshold of ≥4 distressing items as optimal cut-off [22]. Six studies examined the total distress score for screening: in samples with a very high prevalence (∼80%) of UHR/psychosis individuals, a total distress score of ≥6 was supported [11], whereas in similar settings with a much lower prevalence (< 40%), a total distress score ≥18 was recommended [22,23].…”

Section: Methodsmentioning

confidence: 99%

“…Of these, one evaluated the number of distressing symptoms endorsed in a UHR/psychosis-enriched sample and found a threshold of ≥4 distressing items as optimal cut-off [22]. Six studies examined the total distress score for screening: in samples with a very high prevalence (∼80%) of UHR/psychosis individuals, a total distress score of ≥6 was supported [11], whereas in similar settings with a much lower prevalence (< 40%), a total distress score ≥18 was recommended [22,23]. Finally, 4 studies adopted the total number of symptoms endorsed as cut-off: in a sample with a very high proportion of UHR/psychotic participants, a cut-off score of ≥3 symptoms endorsed was supported [11], whereas in a lower prevalence sample from a similar setting, a higher threshold of ≥9 was identified (albeit below 75% sensitivity) [22].…”

Section: Methodsmentioning

confidence: 99%

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The Italian Version of the Brief 21-Item Prodromal Questionnaire: Field Test, Psychometric Properties and Age-Sensitive Cut-Offs

et al. 2018

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Background: The Brief, 21-item version of the Prodromal Questionnaire (PQ-B) is a promising screener for psychosis-risk states that could be implemented in routine clinical practice. In this study, we assessed psychometric properties of the Italian version of the PQ-B (iPQ-B) in a sample of 243 help-seekers, aged 13–35 years. Sampling and Methods: After completing the iPQ-B, participants were assessed with the Comprehensive Assessment of At-Risk Mental States (CAARMS). Diagnostic accuracy (sensitivity, specificity, positive and negative predictive values [PPV and NPV], positive and negative likelihood ratios) and concurrent validity between PQ-B and CAARMS were determined using Cronbach’s alpha and Cohen’s kappa. We also tested the validity of the adopted PQ-B cut-offs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses and the predictive validity of the iPQ-B at 1-year follow-up. Results: The iPQ-B showed high internal consistency (Cronbach’s alpha = 0.868), acceptable diagnostic accuracy and concurrent validity (70% sensitivity, 67% specificity, 81% PPV, Cohen’s kappa = 0.335). ROC analyses pointed to threshold of ≥20 on the PQ-B total distress score as best cut-off. After 12 months of follow-up, 11% of participants who scored ≥4 on the PQ-B distressing item total score and did not meet CAARMS psychosis criteria at baseline, developed a psychotic disorder. Interestingly, age had significant negative correlations with iPQ-B scores and adolescents (aged < 18 years) showed higher iPQ-B scores than young adults. Conclusions: Overall, the psychometric properties of the iPQ-B were satisfactory. As iPQ-B scores appeared inversely associated to age, age-tailored cut-off scores are recommended for screening purposes in child-adolescent cohorts.

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Section: Concurrent Validity and Diagnostic Accuracy Measuressupporting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The Italian Version of the Brief 21-Item Prodromal Questionnaire: Field Test, Psychometric Properties and Age-Sensitive Cut-Offs

et al. 2018

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“…Previous literature showed that it might be better to focus only on positive psychotic experiences that are associated with a range of distress, to avoid the stigmatization or pathologizing of normative experiences [33,36]. Introducing a high cut off for follow up could already avoid stigmatization.…”

Section: Resultsmentioning

confidence: 99%

The Occurrence of Positive Psychotic Experiences in an Outpatient Clinic in Flanders

Gaul¹,

Loore²,

West³

2017

J Child Adolesc Behav

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Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and transient. They occur numerously in clinical and non-clinical samples and have a peak incidence in adolescence. PLEs can be linked to psychopathology and, in the presence of risk factors, PLEs can make a transition to psychotic symptoms and psychosis. The aim of this study was to measure the occurrence of PLEs in a Flemish clinical sample of adolescents using the CAPE (Community Assessment of Psychic Experiences). Gender, age, IQ differences and possible links with psychopathology, distress and impairment have been investigated.Method: 1176 adolescents between 12 and 17 years old were referred to a child and adolescent psychiatric outpatient clinic for psychiatric assessment. PLEs were measured using the CAPE, more precisely the CAPE positive experiences scale (CAPE-P, 20 questions). PLEs were divided into 5 subdimensions: Hallucination, Paranoia, Delusion, Grandiosity and Paranormal Belief.Results: 734 CAPEs were valid for research. 94.2% of adolescents in the clinical sample reported at least one PLE at least 'sometimes'. 62.3% of our population reported at least one PLE at least 'often', which was a higher rate than found in the general population. 83.2% of the population reported at least 'a bit distress' for at least one PLE, whereas 51% reported to be 'quite or very distressed' about at least one PLE. Girls reported more PLEs than boys and reported higher levels of distress. There was no significant general trend in PLEs found when looked at age or IQ distribution. PLEs with distress could be linked to psychopathology in general, but not to specific diagnoses. Conclusion:In comparison to the general population, adolescents in a clinical population experience PLEs more often and with a higher degree of distress. The CAPE can be used in a clinical population for follow up and identification in the risk of transition. Higher risk can be defined by a higher score of frequency and distress on the CAPE and the persistence of this score over time. Risk of transition increases with a certain degree of impairment (that might be caused by comorbid psychopathology) and the combination with specific risk factors for psychosis.

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“…These strategies are increasingly focused on the early detection of subjects showing subthreshold symptoms comprising positive and negative symptoms, and functional difficulties developed in the period preceding the onset of psychosis [2]. The role of these attenuated psychotic symptoms–also termed psychotic-like experiences (PLEs)–as specific predictors of psychosis remains unclear [3,4]. However, cumulative evidence shows associations between persisting PLEs and suicidality [5], higher risk of psychiatric disorders [6], and functional impairments in ultra-high- risk (UHR) populations [7,8], general adolescent populations [9], and help-seeking adolescent subjects [10].…”

Section: Introductionmentioning

confidence: 99%

The Reliability and Validity of Liu´s Self-Report Questionnaire for Screening Putative Pre-Psychotic States (BQSPS) in Adolescents

2016

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The usage of rigorous analyses based on contemporary methods to enhance psychometric properties of screening questionnaires aimed to address psychotic-like experiences (PLE) is currently being encouraged. The Brief Self-Report Questionnaire for Screening Putative Pre-psychotic States (BQSPS) is a recently created tool addressing PLE beyond attenuated positive symptoms (APS). Its psychometric properties as a screening tool for first step assessment seems to be adequate, but further research is needed to evaluate certain validity aspects, particularly its dimensionality, internal structure, and psychometric properties in different populations. We assessed the reliability, construct validity, and criterion validity of BQSPS in two samples: 727 adolescents aged 13–18 years, and 245 young adults aged 18–33 years. We used exploratory structural equation modeling (ESEM), confirmatory factor analysis (CFA), and Structural Equation Modeling (SEM). The original four-factor structure was not replicated. The best fit in adolescents was obtained by a structure of three-correlated factors: social anxiety (SA), negative symptoms (NS), and positive symptoms (PS). This structure was confirmed in young adult subjects. The three-factor model reached a predictive capability with suicidality as external criterion. PLE are represented by a three-factor structure, which is highly stable between adolescent and young-adult samples. Although the BQSPS seems to be a valid tool for screening PLE, its psychometric properties should be improved to obtain a more accurate measurement.

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Psychosis-like experiences and distress among adolescents using mental health services

Cited by 51 publications

References 20 publications

The Italian Version of the Brief 21-Item Prodromal Questionnaire: Field Test, Psychometric Properties and Age-Sensitive Cut-Offs

The Italian Version of the Brief 21-Item Prodromal Questionnaire: Field Test, Psychometric Properties and Age-Sensitive Cut-Offs

The Occurrence of Positive Psychotic Experiences in an Outpatient Clinic in Flanders

The Reliability and Validity of Liu´s Self-Report Questionnaire for Screening Putative Pre-Psychotic States (BQSPS) in Adolescents

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