Subclinical psychotic symptoms in Indian adults: Application of the Community Assessment of Psychic Experiences (CAPE)

A cross-national investigation of psychosis-like experiences in five European countries included in the E-CLECTIC study: Psychometric challenges in studying their measurement

BACKGROUND

Psychotic-like experiences (PLEs) are subtle, subclinical perturbations of perceptions and thoughts and are common in the general population. Their characterisation and unidimensionality are still debated.

METHODS

This study was conducted by the Electronic-halluCinations-Like Experiences Cross-culTural International Consortium (E-CLECTIC) and aimed at measuring the Community Assessment of Psychic Experiences (CAPE) factorial structure across five European countries (Belgium; Czech Republic, Germany; Greece, and Spain) and testing the adequacy of the unidimensional polytomous Rasch model of the tool via Partial Credit Model (PCM) of the CAPE to detect people with a high risk for developing psychosis.

RESULTS

The sample included 1461 participants from the general population. The factorial analysis confirmed the best fit for the bifactor implementation of the three-factor model, including the positive, negative and depressive dimensions and a general factor. Moreover, the unidimensional polytomous Rasch analysis confirmed that CAPE responses reflected one underlying psychosis proneness.

CONCLUSIONS

The study proved that the CAPE measures a single latent dimension of psychosis-proneness. The CAPE might help locate and estimate psychosis risk and can be used as a screening tool in primary care settings/education settings.

Internal consistency and temporal stability of the Community Assessment of Psychic Experiences (CAPE): A reliability generalization meta-analysis

Psychotic experiences (PE) are prevalent in general and clinical populations and can increase the risk for mental disorders in young people. The Community Assessment of Psychic Experiences (CAPE) is a widely used measure to assess PE in different populations and settings. However, the current knowledge on their overall reliability is limited. We examined the reliability of the CAPE-42 and later versions, testing the role of age, sex, test scores, and clinical status as moderators. A systematic search was conducted on the Scopus, Web of Science, PubMed, EBSCOhost, ProQuest, and GoogleScholar databases. Internal consistency and temporal stability indices were examined through reliability generalization meta-analysis (RGMA). Moderators were tested through meta-regression analysis. From a pool of 1,015 records, 90 independent samples were extracted from 71 studies. Four versions showed quantitative evidence for inclusion: CAPE-42, CAPE-20, CAPE-P15, and CAPE-P8. Internal consistency indices were good (α/ω≈.725-0.917). Temporal stability was only analyzed for the CAPE-P15, yielding a moderate but not-significant effect (r=0.672). The evidence for temporal stability is scant due to the limited literature, and definitive conclusions cannot be drawn. Further evidence on other potential moderators such as adverse experiences or psychosocial functioning is required.

Cross-cultural adaptation and inter-rater reliability of the Schizophrenia proneness instrument adult version (SPI-A) in the Indonesian context

This study aims to adapt the Schizophrenia Proneness Instrument, Adult Version (SPI-A) for the assessment of basic symptoms to the Indonesian context (culturally and linguistically) and analyze the inter-rater reliability of the translated version. Following a specific methodology for cultural adaptation, direct and back-translations were conducted together with cognitive interviews to analyze the comprehensibility of the translated version. A linguistic expert analyzes the resulting version to determine its grammatical and linguistic adequacy. Finally, the interclass correlation (ICC) of the three expert ratings of the samples (N = 9) was analyzed. The direct and back-translation phases showed good conceptual equivalence to the original version. The cognitive interviews revealed items that were challenging to understand and required revision. The final version also considered the judgments of a linguistic expert for grammatical and conceptual improvements. Inter-rater reliability analysis showed an excellent degree of agreement (ICC value: 0.984; 95% CI: 0.950-0.996). The translated SPI-A fits the Indonesian context and can be used in clinical settings to assess basic symptoms in help-seeking individuals in Indonesia.