Association of Positive, Negative, and Disorganized Schizotypy With the Temporal Dynamics of Schizotypic Experiences in Daily Life

BACKGROUND AND HYPOTHESIS

Schizotypy is a useful and unifying construct for examining the etiology, development, and expression of schizophrenia-spectrum psychopathology. The positive, negative, and disorganized schizotypy dimensions are associated with distinct patterns of schizophrenia-spectrum symptoms and impairment. Furthermore, they are differentiated by mean levels of psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, and by temporal dynamics of affect. The schizotypy dimensions were thus hypothesized to be differentiated by the temporal dynamics of schizotypic experiences in daily life.

STUDY DESIGN

The present study employed experience sampling methodology in a large nonclinically ascertained sample (n = 693) to examine the associations of multidimensional schizotypy with psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, as well as with their temporal dynamics (variability, reactivity, inertia, and instability).

STUDY RESULTS

We replicated the mean-level associations between multidimensional schizotypy and schizotypic experiences in daily life. Furthermore, positive, negative, and disorganized schizotypy demonstrated hypothesized, differential patterns of temporal dynamics of schizotypic experiences. Disorganized schizotypy demonstrated the most robust associations, including intensity, variability, and inertia of disorganized schizotypic experiences. Disorganized schizotypy also moderated reactivity of psychotic-like and disorganized schizotypic experiences following previously reported stress. Positive schizotypy was associated with intensity and variability of psychotic-like experiences. Negative schizotypy was associated with intensity and variability of negative schizotypic experiences.

CONCLUSIONS

The findings indicate that schizotypy dimensions can be differentiated by both mean levels and temporal patterns of psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, with disorganized schizotypy uniquely characterized by stress reactivity.

A longitudinal study of the impact of childhood adversity dimensions on social and psychological factors and symptoms of psychosis, depression, and anxiety

The present study examined three empirically-derived childhood adversity dimensions as predictors of social, psychological, and symptom outcomes across three prospective assessments of a young adult sample. Participants were assessed five times over eight years with semi-structured interviews and questionnaires. The analyses used the dimensions underlying multiple subscales from well-established childhood adversity measures administered at the first two assessment waves (described in a previous report). Outcome data pertain to the last three assessment waves, with sample sizes ranging from 89 to 169. As hypothesized, the childhood adversity dimensions demonstrated overlapping and differential longitudinal associations with the outcomes. Deprivation predicted the negative (deficit-like) dimension of psychosis, while Threat and Intrafamilial Adversity predicted the positive (psychotic-like) dimension. Depression and anxiety symptoms were predicted by different childhood adversity dimensions over time. Furthermore, Threat predicted a smaller and less diverse social network, Intrafamilial Adversity predicted anxious attachment, and Deprivation predicted a smaller social network, anxious and avoidant attachment, perceived social support, and loneliness. The three adversity dimensions combined accounted for moderate to large proportions of variance in several outcomes. These results extend prior work by identifying associations of three meaningful dimensions of childhood adversity with different risk profiles across psychological, social, and psychopathological domains. The findings enhance our understanding of the impact of childhood adversity across young adulthood.

Exploring phenotypic overlap across schizotypy and autism spectrum conditions in American and Chinese young adults

Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed.

Differential Risk: Gender and Racial Differences in the Relationship between Trauma, Discrimination, and Schizotypy

Traumatic experiences are associated with increased experiences of positive schizotypy. This may be especially important for People of Color, who experience higher rates of trauma and racial discrimination. No study to date has examined how racial disparities in traumatic experiences may impact schizotypy. Furthermore, of the studies that have examined the relationship between trauma and schizotypy, none have examined racial discrimination as a potential moderator. The present study examined if racial discrimination moderates the relationship between trauma and multidimensional (positive, negative, and disorganized) schizotypy. In a sample of 770 college students, we conducted chi-squared analyses, analyses of variance, and stepwise regressions. We found that Black students experienced significantly higher racial discrimination and trauma than Latinx and Asian students. Furthermore, Black and Latinx students experienced significantly more multidimensional schizotypy items than Asian students. Trauma and racial discrimination explained 8 to 23% of the variance in each dimension of schizotypy. Racial discrimination did not moderate the relationships between trauma and multidimensional schizotypy. Our findings suggest that we need to examine risk factors that may prevent recovery from psychotic disorders. Additionally, disorganized schizotypy showed the most robust associations and may be a critical site of intervention.

Schizophrenia polygenic risk score in psychosis proneness

Schizophrenia (SZ) is a complex disorder with a highly polygenic inheritance. It can be conceived as the extreme expression of a continuum of traits that are present in the general population often broadly referred to as schizotypy. However, it is still poorly understood how these traits overlap genetically with the disorder. We investigated whether polygenic risk for SZ is associated with these disorder-related phenotypes (schizotypy, psychotic-like experiences, and subclinical psychopathology) in a sample of 253 non-clinically identified participants. Polygenic risk scores (PRSs) were constructed based on the latest SZ genome-wide association study using the PRS-CS method. Their association with self-report and interview measures of SZ-related traits was tested. No association with either schizotypy or psychotic-like experiences was found. However, we identified a significant association with the Motor Change subscale of the Comprehensive Assessment of At-Risk Mental States (CAARMS) interview. Our results indicate that the genetic overlap of SZ with schizotypy and psychotic-like experiences is less robust than previously hypothesized. The relationship between high PRS for SZ and motor abnormalities could reflect neurodevelopmental processes associated with psychosis proneness and SZ.

I don't understand how I feel: mediating role of impaired self-mentalizing in the relationship between childhood adversity and psychosis spectrum experiences

Introduction

Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood.

Methods

Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in n = 1,156 nonclinically ascertained young adults.

Results

Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested.

Conclusion

Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing.

Mnemonic discrimination deficits in multidimensional schizotypy

Current developmental psychopathology models indicate that schizophrenia can be understood as the most extreme expression of a multidimensional continuum of symptoms and impairment referred to as schizotypy. In nondisordered adults, schizotypy predicts risk for developing schizophrenia-spectrum psychopathology. Schizophrenia is associated with disruptions in detecting subtle differences between objects, which is linked to hippocampal dysfunction. These disruptions have been shown in the Mnemonic Similarity Task (MST) when patients are less likely to reject lures that are similar but not identical to studied objects, and instead mistake them for studied items. This pattern of errors may be a behavioral manifestation of impaired pattern separation, a key episodic memory ability associated with hippocampal integrity and overreliance on pattern completion. We examined whether multidimensional schizotypy is associated with such deficits in nondisordered young adults. Participants (n = 230) were assessed for positive, negative, and disorganized schizotypy and completed the MST and a perceptual discrimination task. MST performance showed that a combination of elevated negative and disorganized schizotypy was associated with decreased rejections of similar lures because they were mistakenly identified as studied items. These deficits were not observed in traditional recognition measures within the same task, nor in perceptual discrimination, suggesting that mnemonic discrimination deficits assessed by MST were selective and did not reflect generalized deficits. These findings extend the results obtained in schizophrenia patients and support a multidimensional model of schizophrenia-spectrum psychopathology.

Replication of the associations of positive, negative, and disorganized schizotypy with interview-assessed symptoms and impairment: Convergence with previous studies

Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impairment, psychopathology, and personality pathology in a sample of 161 young adults. Consistent with past studies, positive, negative, and disorganized schizotypy had distinct and hypothesized associations with symptoms and impairment. Positive schizotypy was associated with prodromal symptoms and schizotypal, paranoid, and borderline personality traits. Negative schizotypy was associated with impaired functioning, negative symptoms, and schizoid, schizotypal, and paranoid traits, as well as any broad personality disorder diagnosis; it was also associated with never having dated. Disorganized schizotypy was associated with impaired functioning, disorganized schizotypic experiences, attentional deficits, and schizotypal, paranoid, borderline, and avoidant personality traits, as well as depression. Overall, we successfully replicated findings from five previous schizotypy interview studies, supporting the construct validity of the multidimensional model of schizotypy and the Multidimensional Schizotypy Scale. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trait schizotypy and the psychosis prodrome: Current standard assessment of extended psychosis spectrum phenotypes

Schizotypy has become an increasingly important construct for elaborating psychotic disorders that vary along the schizophrenic spectrum. However, different schizotypy inventories vary in conceptual approach and measurement. In addition, commonly used schizotypy scales have been seen as qualitatively different from screening instruments for prodromal schizophrenia like the Prodromal Questionnaire-16 (PQ-16). Our study investigated the psychometric properties of three schizotypy questionnaires (the Schizotypal Personality Questionnaire-Brief, Oxford-Liverpool Inventory of Feelings and Experiences, and the Multidimensional Schizotypy Scale) as well as the PQ-16 in a cohort of 383 non-clinical subjects. We initially evaluated their factor structure using Principal Component Analysis (PCA) and used Confirmatory Factor Analysis (CFA) to test a newly proposed composition of factors. PCA results support a three-factor structure of schizotypy that accounts for 71 % of the total variance, but also shows cross-loadings of some schizotypy subscales. CFA of the newly composed schizotypy factors (together with an added neuroticism factor) shows good fit. Analyses including the PQ-16 indicate considerable overlap with measures of trait schizotypy, suggesting that the PQ-16 might not be quantitatively or qualitatively different from schizotypy measurements. Taken together, results indicate that there is good support for a three-factor structure of schizotypy but also that different schizotypy measurements grasp facets of schizotypy differently. This points towards the need for an integrative approach for assessing the construct of schizotypy.

A psychosocial pathway to paranoia: The interplay between social connectedness and self-esteem

The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness to perceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis.

Empirically-derived dimensions of childhood adversity and cumulative risk: associations with measures of depression, anxiety, and psychosis-spectrum psychopathology

Background: Investigating different approaches to operationalizing childhood adversity and how they relate to transdiagnostic psychopathology is relevant to advance research on mechanistic processes and to inform intervention efforts. To our knowledge, previous studies have not used questionnaire and interview measures of childhood adversity to examine factor-analytic and cumulative-risk approaches in a complementary manner.Objective: The first aim of this study was to identify the dimensions underlying multiple subscales from three well-established childhood adversity measures (the Childhood Trauma Questionnaire, the Childhood Experience of Care and Abuse Interview, and the Interview for Traumatic Events in Childhood) and to create a cumulative risk index based on the resulting dimensions. The second aim of the study was to examine the childhood adversity dimensions and the cumulative risk index as predictors of measures of depression, anxiety, and psychosis-spectrum psychopathology.Method: Participants were 214 nonclinically ascertained young adults who were administered questionnaire and interview measures of depression, anxiety, psychosis-spectrum phenomena, and childhood adversity.Results: Four childhood adversity dimensions were identified that captured experiences in the domains of Intrafamilial Adversity, Deprivation, Threat, and Sexual Abuse. As hypothesized, the adversity dimensions demonstrated some specificity in their associations with psychopathology symptoms. Deprivation was uniquely associated with the negative symptom dimension of psychosis (negative schizotypy and schizoid symptoms), Intrafamilial Adversity with schizotypal symptoms, and Threat with depression, anxiety, and psychosis-spectrum symptoms. No associations were found with the Sexual Abuse dimension. Finally, the cumulative risk index was associated with all the outcome measures.Conclusions: The findings support the use of both the empirically-derived adversity dimensions and the cumulative risk index and suggest that these approaches may facilitate different research objectives. This study contributes to our understanding of the complexity of childhood adversity and its links to different expressions of psychopathology.

Affective dynamics in daily life are differentially expressed in positive, negative, and disorganized schizotypy

Schizotypy and schizophrenia are associated with disruptions in the experience of affect. Temporal patterns of affect, or affective dynamics, offer unique information about the expression of multidimensional schizophrenia-spectrum psychopathology. The present study employed experience sampling methodology to examine affective intensity, inertia, variability, reactivity, and instability in positive, negative, and disorganized schizotypy in nonclinically ascertained young adults (n = 275). As hypothesized, disorganized schizotypy demonstrated the most robust associations with affective dynamics and was characterized by elevated intensity, reactivity, and variability of negative affect. Disorganized schizotypy was also associated with instability of negative affect, but this relation was better accounted for by mean negative affect, which was elevated in disorganized schizotypy. Negative schizotypy was characterized by diminished intensity and variability of positive affect as expected, but was unassociated with affective inertia. Finally, as hypothesized, positive schizotypy was associated with elevated intensity and variability of negative affect at the bivariate level, but was unassociated with affective dynamics when including disorganized schizotypy in the model. These findings indicate that the schizotypy dimensions are differentiated by both mean levels and dynamics of affect, and that affective dynamics convey unique information about multidimensional schizotypy beyond mean levels of affect. The findings provide further support for the multidimensional model of schizotypy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A "Goldilocks zone" for mind-wandering reports? A secondary data analysis of how few thought probes are enough for reliable and valid measurement

Mind-wandering assessment relies heavily on the thought probe technique as a reliable and valid method to assess momentary task-unrelated thought (TUT), but there is little guidance available to help researchers decide how many probes to include within a task. Too few probes may lead to unreliable measurement, but too many probes might artificially disrupt normal thought flow and produce reactive effects. Is there a "Goldilocks zone" for how few thought probes can be used to reliably and validly assess individual differences in mind-wandering propensity? We address this question by reanalyzing two published datasets (Study 1, n = 541; Study 2, ns ≈ 260 per condition) in which thought probes were presented in multiple tasks. Our primary analyses randomly sampled probes in increments of two for each subject in each task. A series of confirmatory factor analyses for each probe "bin" size tested whether the latent correlations between TUT rate and theoretically relevant constructs like working memory capacity, attention-control ability, disorganized schizotypy, and retrospective self-reported mind wandering changed as more probes assessed the TUT rate. TUT rates were remarkably similar across increasing probe-bin sizes and zero-order correlations within and between tasks stabilized at 8-10 probes; moreover, TUT-rate correlations with other latent variables stabilized at about 8 thought probes. Our provisional recommendation (with caveats) is that researchers may use as few as 8 thought probes in prototypical cognitive tasks to gain reliable and valid information about individual differences in TUT rate.

Association of Multidimensional Schizotypy with PID-5 Domains and Facets

The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.

Psychological Pathways to Paranoia and Psychotic-Like Experiences in Daily-Life: The Mediating Role of Distinct Affective Disturbances

BACKGROUND AND HYPOTHESIS

Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype.

STUDY DESIGN

Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions.

STUDY RESULTS

Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found.

CONCLUSIONS

This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.

A critical examination of multidimensionality within the Hypomanic Personality Scale

BACKGROUND

The Hypomanic Personality Scale (HPS) assesses bipolar spectrum psychopathology and risk for bipolar disorders. Despite the developers' intent to create a scale that provides a unitary score, several studies have examined whether the HPS has a multidimensional structure. These models have been unable to identify a replicable multidimensional structure, with models varying from fairly similar to entirely dissimilar, and have suffered from theoretical and methodological concerns.

PROCEDURES

We therefore examined the multidimensional structure of the HPS in a large undergraduate and adult sample (n = 5002).

MAIN FINDINGS

We failed to reproduce factors with equal congruence to those of previously published models.

PRINCIPLE CONCLUSIONS

We concluded that the HPS lacks factorial validity in previous research as a multidimensional measure of bipolar spectrum psychopathology. We further recommend the creation of a novel multidimensional assessment of bipolar spectrum psychopathology developed from a theoretically driven, comprehensive model, rather than examining a multidimensional model of a pre-existing measure, such as the HPS.

The association of multidimensional schizotypy with symptoms and impairment across racial groups

The assessment of schizotypy and schizophrenia-spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However, studies have not examined the validity of the measurement across different racial groups. The present study examined whether the associations of MSS positive, negative, and disorganized schizotypy subscales with interview-assessed ratings of functioning, schizophrenia-spectrum personality traits, and depressive disorders were generally comparable across nonclinically ascertained samples of Black (n = 46), Asian (n = 87), and White (n = 116) young adults. Consistent with previous findings, all three schizotypy subscales were associated with impairment and schizotypal and paranoid traits. Negative schizotypy was associated with schizoid traits, and disorganized schizotypy was associated with depressive disorders. These associations were comparable across the racial groups, supporting the use of the MSS in these groups. Culturally and empirically valid assessments are essential for providing accurate assessments across racial/ethnic groups and reducing the risk of overpathologizing people of color. The present findings support the cross-cultural validity of the MSS; however, future studies should expand upon these findings by including more diverse samples and longitudinal designs.

Variability in Sleep Is Associated with Trait-Based and Daily Measures of Bipolar Spectrum Psychopathology

INTRODUCTION

Although sleep disturbances are well documented in bipolar spectrum disorders (BSDs), significantly less research has examined whether these disturbances are present in those at risk for developing BSDs or with subsyndromal symptoms. The present study examined associations between risk for BSDs, as measured by the Hypomanic Personality Scale (HPS), and sleep assessed using experience sampling. We assessed whether intraindividual variability in sleep was associated with affect, cognition, and behavior in daily life and potential directionality of these relationships.

METHODS

233 young adults oversampled for high scores on the HPS completed 14 days of experience sampling assessing total sleep time (TST), bed/rise time, sleep quality, affect (negative and positive affect), cognition (difficulty concentrating, racing thoughts), and behavior (impulsivity) in daily life. We used Dynamic Structural Equation Modeling (DSEM) to assess within-person links between sleep and bipolar spectrum psychopathology.

RESULTS

HPS scores were associated with less TST, later bedtime, and more variable TST and bedtime. Variability in TST was associated with negative affect, difficulty concentrating/racing thoughts, and impulsivity. Within-person decreases in sleep were associated with next day increases in negative affect, stress, difficulty concentrating, and racing thoughts.

LIMITATIONS

Measurement of sleep was limited. Future studies should examine both objective measures of sleep (e.g., actigraphy) and fragmentation in sleep.

CONCLUSIONS

Risk for BSD was associated with similar patterns of sleep disruptions as seen in BSDs. Important dynamic links between sleep and bipolar spectrum psychopathology emerged indicating that sleep is an important target for improving symptoms of BSDs in daily life.

The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis

Objective

To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis.

Methods

265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes.

Results

Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis.

Conclusions

In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.

Associations of Multiple Measures of Openness to Experience with a Brief Questionnaire of Positive, Negative, and Disorganized Schizotypy

Abstract. The vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment known as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Openness to experience offers a useful personality domain for exploring multidimensional schizotypy. This study examined the factor structure of openness and its relation to schizotypy using the Multidimensional Schizotypy Scale-Brief (MSS-B) in a sample of 2,236 adults. Positive schizotypy was broadly associated with elevated openness and negative schizotypy was generally associated with diminished openness. Principal components analysis of 15 openness facets replicated the four-factor structure of openness including Fantasy/Feelings, Eccentricity, Nontraditionalism, and Ideas factors. All three schizotypy dimensions were associated with Eccentricity. Positive schizotypy was associated with Fantasy/Feelings, whereas negative schizotypy was inversely associated with Fantasy/Feelings. Results support the construct validity of the MSS-B, use of alternative openness measures in examining schizotypy, and the multidimensional structures of schizotypy and openness.

A time-lagged study of predictors of paranoia and psychotic-like experiences in daily life across the schizotypy continuum

Leading theoretical models of psychosis implicate a wide range of psychological factors in the development of positive symptoms. Ambulatory assessment allows us to repeatedly assess people's mental experiences within and across days to explore putative moment-to-moment prospective relationships that impact the onset and exacerbation of positive symptoms. This study used experience sampling methodology to examine the putative temporal associations of both risk and protective factors (negative emotional states, stress, self-esteem, and social appraisals) with the experience of paranoia and other positive psychotic-like experiences (PLE) in daily-life. A combined sample of 178 participants including 65 high-schizotypy, 74 at-risk mental states for psychosis, and 39 first-episode psychosis individuals was assessed repeatedly over seven consecutive days. Sadness, anxiety, stress, and negative social appraisals predicted higher levels of subsequent paranoia and PLE. In contrast, self-esteem and subjective appraisals of social support and social closeness predicted lower levels of paranoia and PLE. Most findings did not vary across subclinical, at-risk, and clinical levels of psychosis expression. Results support psychological models of psychosis and provide new evidence to disentangle psychological factors involved in the mechanistic pathways to positive symptoms. The findings can help the design of ecological momentary interventions delivered in real-time aimed at buffering psychological mechanisms that promote psychotic symptoms and strengthening causal mechanisms that protect from the development of positive symptoms. Finally, findings suggest that highly similar psychological mechanisms are implicated in the development of psychotic experiences across nonclinical, subclinical, and clinical expressions of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Self-Report Measures of Anhedonia and Approach Motivation Weakly Correspond to Anhedonia and Depression Assessed via Clinical Interviews

Self-report scales are popular tools for measuring anhedonic experiences and motivational deficits, but how well do they reflect clinically significant anhedonia? Seventy-eight adults participated in face-to-face structured diagnostic interviews: 22 showed clinically significant anhedonia, and 18 met criteria for depression. Analyses of effect sizes comparing the anhedonia and depression groups to their respective controls found large effects, as expected, for measures of depressive symptoms, but surprisingly weak effect sizes (all less than d=.50) for measures of general, social, or physical anhedonia, behavioral activation, and anticipatory and consummatory pleasure. Measures of Neuroticism and Extraversion distinguished the anhedonic and depressed groups from the controls at least as well as measures of anhedonia and motivation. Taken together, the findings suggest that caution is necessary when extending self-report findings to populations with clinically significant symptoms.

Association of positive, negative, and disorganized schizotypy with cluster a, borderline, and avoidant personality disorders and traits

The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy was associated with schizotypal and borderline personality traits; negative schizotypy was associated with schizotypal, schizoid, paranoid, and avoidant personality traits; and disorganized schizotypy was associated with paranoid, borderline, and avoidant personality disorder traits. Negative schizotypy predicted broad diagnoses of Cluster A personality disorders. Both negative and disorganized schizotypy predicted the broad diagnosis of any of the 5 personality disorders. The study further examined the association of the schizotypy dimensions with the individual personality disorder criteria to better understand the overall associations. Given the common origins and high comorbidity, we examined whether the schizotypy dimensions explained the association of borderline and schizotypal personality disorder traits. Positive and disorganized schizotypy fully mediated the association between borderline and schizotypal traits. In summary, the study replicated and extended previous findings that the schizotypy dimensions are uniquely associated with personality disorders and traits, as well as impaired functioning, in young adults. The study also provided additional support for the construct validity of the Multidimensional Schizotypy Scale and for the use of psychometric assessment of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The impact of family environment on self-esteem and symptoms in early psychosis

Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients’ SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients’ SE mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia; (2) patients’ perceived EE mediated the effect of relatives’ EE on patients’ SE; (3) patients’ SE mediated between patients’ perceived EE and patients’ symptomatology; and (4) patients’ perceived EE and patients’ SE serially mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients’ perceived EE mediated the link between relatives’ EE and patients’ negative, but not positive, SE; (2) patients’ negative SE mediated the effect of patients’ perceived EE on positive symptoms and paranoia; (3) the association of relatives’ EE with positive symptoms and paranoia was serially mediated by an increased level of patients’ perceived EE leading to increases in negative SE; (4) high levels of patients’ distress moderated the effect of relatives’ EE on symptoms through patients’ perceived EE and negative SE. Findings emphasize that patients’ SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients’ negative SE and symptoms.