Psychotic-Like Experiences: A Challenge in Definition and Assessment

Abstract

Assuming a continuum between psychotic experiences and psychotic symptoms aligned between healthy individuals and patients with non-psychotic and psychotic disorders, recent research has focused on subclinical psychotic experiences. The wide variety of definitions, assessment tools, and concepts of psychotic-like experiences (PLEs) might contribute to the mixed findings concerning prevalence and persistence rates and clinical impact. In this narrative review, we address the panoply of terminology, definitions, and assessment tools of PLEs and associated concerns with this multitude. Moreover, the ambiguous results of previous studies regarding the clinical relevance of PLEs are described. In conclusion, we address clinical implications and highly suggest conceptual clarity and consensus concerning the terminology and definition of PLEs. The development of an agreed upon use of a “gold standard” assessment tool seems essential for more comparable findings in future research.

'Feeling' or 'sensing' the future? Testing for anomalous cognitions in clinical versus healthy populations

“…The continuum model is valid, clinically useful, and widely accepted, but some of its disadvantages have not yet been resolved ( David, 2010 ; Sommer, 2010 ; Feyaerts et al., 2021 ). Particularly, a major limitation is that not all types of anomalous experiences can be included or are represented within this framework ( Hinterbuchinger and Mossaheb, 2021 ; Laythe et al., 2021 ; Woollacott et al., 2021 ).…”

The Persian version of the Psychotic‐Like Experiences Questionnaire for Children (PLEQ‐C): Psychometric properties in Iranian school students

“…It is essential to highlight that new perspectives are looking for more signs of reality in the definition of PLEs, leading to a new term known as "exceptional experiences" (EEs). All subtle signs of the existence of distortion can be categorized as EEs (Hinterbuchinger & Mossaheb, 2021;Unterrassner, 2018) Validated self-report questionnaires about psychosis and schizotypy are limited; nonetheless, they have been used extensively to learn more about delusion and hallucination thoughts in childhood. One of the potential limitations of these studies is the lack of multiple informants and the application of limited tools.…”

A Latent Profile Analysis of Psychotic Experiences, Non-psychotic Symptoms, Suicidal Ideation and Underlying Mechanisms in a Sample of Adolescents From the General Population

“…Although PEs have been suggested as predictors of mental disorders in the general population (17) and psychotic symptoms in youth at clinical high risk for psychosis (18), recent studies in the general population have highlighted that what makes such experiences psychopathologically relevant is not the experiences per se, but rather their co-occurrence with other domains of non-psychotic comorbidity (e.g., depression, anxiety and PTSD) (9,19) as well as the presence of other vulnerability factors such as a history of adverse childhood events (20). In addition, as different subdimensions of PEs seem to be differentially associated with concurrent psychiatric comorbidity (21)(22)(23), and because some PEs might be healthy coping mechanisms helping to maintain mental functioning (24), these associations should be assessed according to specific PE dimensions (18).…”

“…Taking a more transdiagnostic perspective to psychopathology ( 26 ), we identified different subgroups of adolescents based on their profile on multiple psychopathological domains and several transdiagnostic emotional/cognitive processes that underlie multiple psychiatric disorders. In line with the literature ( 24 ), we analyzed different sub-dimensions of PEs. We hypothesized that the LPA would reveal latent classes with different symptom profiles, mostly differentiated by the severity of symptoms, the intensity of PEs and by different levels of underlying transdiagnostic processes.…”