Risk of violent behaviour in young people at clinical high risk for psychosis from the North American Prodrome Longitudinal Studies consortium

Abstract

AimAlthough violent behaviour has been studied in schizophrenia, violence risk has received little attention in individuals at clinical high risk for psychosis (CHR). This manuscript aims to report and discuss the overall results of the Structured Assessment for Violence Risk in Youth (SAVRY) from the NAPLS‐3 project to explore the risk of violence in CHR youth and to determine the relationship between SAVRY violence risk scores, psychosis risk symptoms, and global functioning. We hypothesized that CHR young people are at higher risk of violence as compared to healthy comparison participants due to a similarity between risk factors for psychosis and risk factors for violence, and that this risk is associated with greater severity of symptoms, poor functioning, and risk for conversion to psychosis.MethodsParticipants from the North American Prodrome Longitudinal Study consortium phase 3 (NAPLS‐3) included 684 CHR and 96 HC. Assessments included the Structural Assessment of Violence Risk in Youth (SAVRY), clinical and functional measures.ResultsThe majority of participants across groups were deemed to be at low risk for violence. There were significantly more CHR participants (29.8%) who had moderate or high scores on the SAVRY Summary Risk Rating compared to HC participants (3.1%). Low versus moderate‐high SAVRY scores were associated with better social (p < .005) and role (p < .002) functioning and fewer positive (p < .002), negative (p < .002), disorganized (p < .01) and general symptoms (p < .002). CHR participants with higher SAVRY scores were more likely to be diagnosed with borderline personality disorder, ADHD and substance misuse. Among CHR, overall violence risk was not associated with conversion to psychosis. However, those who converted to psychosis scored lower on the protective factors index, primarily driven by less prosocial involvement and fewer resilient personality traits.ConclusionsThis is the first study to assess violence risk in CHR adolescents. Violence risk factors overlap with risk factors for psychosis in general, perhaps accounting for the association. These findings have implications for intervention efforts to reduce violence risk and bolster resiliency in CHR youth.

Harmonizing early intervention strategies: scoping review of clinical high risk for psychosis and borderline personality disorder

“…20 studies ( Schultze-Lutter et al, 2012 ; Thompson et al, 2012 ; Byars, 2013 ; Nelson et al, 2013 ; Barrantes-Vidal et al, 2014 ; Rutigliano et al, 2016 ; Fusar-Poli et al, 2017 ; Ryan et al, 2017 ; Kotlicka-Antczak et al, 2018 ; Madsen et al, 2018 ; Sevilla-Llewellyn-Jones et al, 2018 ; O’Connor et al, 2019 ; Paust et al, 2019 ; Hadar et al, 2020 ; Boldrini et al, 2020b ; DaBreo-Otero, 2021 ; West et al, 2022 ; Ceccolini et al, 2023 ; Pelizza et al, 2023 ; Tronick et al, 2023 ) focused on early detection and intervention within the framework of the CHR-P paradigm. Overall, the clinical population comprised CHR-P patients and, in some studies, control patients, accessing CHR-P clinics or mental health services.…”

“… Pelizza et al (2023) highlighted the need to overcome the barriers between adult and child/adolescent mental health services, reduce antipsychotic dosage and delivering psychosocial interventions, and establish cultural mediation services within early intervention clinics. Other clinical recommendations included providing non-stigmatizing settings ( Kotlicka-Antczak et al, 2018 ), fostering protective factors [e.g., social support Tronick et al, 2023 ], planning psychological treatments focused on underlying personality traits ( Schultze-Lutter et al, 2012 ), and improving non-psychotic disorders and general functioning beyond preventive aims ( Rutigliano et al, 2016 ).…”

Impulsivity: Features of Fоrmatiоn and Infl uence on Mental Pathоlоgy

“…Установлены прямые корреляционные связи между степенью выраженности импульсивности, особенно ее моторного компонента, и агрессивным поведением [46], что свидетельствует об общности биологических механизмов их развития. Это открывает возможность для исследования предикторной роли агрессии у больных из группы риска манифестации психоза [47].…”