Psychotic Experiences and Related Distress: A Cross-national Comparison and Network Analysis Based on 7141 Participants From 13 Countries

Abstract

Psychotic experiences (PEs) are common in the general population but do not necessarily reflect a risk status if they occur in relative isolation or are not distressing. Emerging evidence suggests that PEs might be experienced as more benign for individuals from collectivistic low- and middle-income countries (LAMIC) compared with individualistic high-income countries (HIC). The aim of this study was to determine whether: (1) self-reported PEs are less distressing in community samples from LAMIC than from HIC; (2) the network of PEs is significantly less connected in a sample from LAMIC than from HIC. Adults from 8 HIC (n = 4669) and 5 LAMIC (n = 2472) were compared. The lifetime frequency of PEs and related distress were assessed with the Community Assessment of Psychic Experiences. We analyzed the associations of PEs with distress and country type. The interconnection of PEs was visualized by a network analysis and tested for differences in global connection strengths. The average endorsement rates of PEs were significantly higher in LAMIC than in HIC (χ2 = 1772.87, P < .01, Φcramer = 0.50). There was a universal positive correlation between higher frequency of PEs and more distress, but the distress levels controlled for frequency were significantly higher in HIC (R2 = 0.11; b = 0.26; SE = 0.01; T = 17.68; P < .001). Moreover, the network of PEs was significantly less connected in LAMIC (S = 0.40, P < .05). The findings indicate that PEs are of less clinical relevance in LAMIC compared with HIC. The universal use of current high-risk criteria might thus not be adequate without consideration of associated distress and cultural values.

Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning

“…To improve our understanding of the dynamics between co-occurring autistic traits, psychotic traits, and functioning in PD, it would therefore be of great interest to study the strength of relations on a subdomain level and determine centrality measures within a network approach (van Rooijen et al, 2018;Wigman et al, 2015;Wüsten et al, 2018). Social cognitive functioning was also negatively associated with autistic traits in line with previous findings Vaskinn & Abu-Akel, 2019) but, contrary to expectations, the effect was small and comparable across groups.…”

Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway

“…Similar findings have been reported with regard to the prevalence of positive symptom clusters across different ethnic groups within certain countries: disparity in symptom prevalence between ethnic groups exceeds disparity in prevalence of psychotic disorder [37–39]. This seems to be especially true for perceptual anomalies and paranoia [40–42]. Moreover, discrepancies between positive symptom prevalence and prevalence of a diagnosis of psychosis have been shown to be more pronounced in some ethnic groups than in others [10, 37, 39, 43], pointing towards a complex interplay of cultural and social factors (e.g.…”

“…Although this meta-analysis [25] included samples from different parts of the world, the focus was mainly on identifying general underlying symptom structures, rather than comparing symptom prevalence across cultural groups or study samples. Moreover, the reviewed samples were from the so-called Western World, and to date CAPE-42 psychotic experiences have been rarely investigated in African study samples [22, 42].…”

Beyond Clinical High-Risk State for Psychosis: The Network Structure of Multidimensional Psychosis Liability in Adolescents

“…These results are also congruent with previous studies. Network models have also been used to analyze, amongst others, schizotypal personality traits in a multinational sample (54), psychotic like-experiences in crosscultural study (64), and psychotic-like experiences in a large U.S. sample (65). For instance, Fonseca-Pedrero et al, (54), using the Schizotypal Personality Questionnaire (66), indicated that schizotypal traits were strongly interconnected in the domainlevel network.…”