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Thompson EC, Andorko ND, Rouhakhtar PR, Millman ZB, Sagun K, Han SC, Chibani D, Reeves GM, Herman B, Schiffman J. Psychosis-Spectrum Screening and Assessment Within a College Counseling Center: A Pilot Study Exploring Feasibility and Clinical Need. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2022; 36:201-222. [PMID: 35694629 PMCID: PMC9175646 DOI: 10.1080/87568225.2020.1797604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Evidence supports the use of brief psychosis-spectrum screening tools for identifying individuals at an increased risk of developing a psychotic disorder. Screening has not been well studied in general mental health settings that serve young adults in the age range associated with highest risk for psychosis. This study explored the feasibility of psychosis-risk screening and assessment among help-seeking students at a university counseling center. The PRIME Screen-Revised was administered to students at clinic intake. Participants who screened positively were offered a follow-up assessment using the Structured Interview for Psychosis-risk Syndromes (SIPS). At intake, 510 students completed the PRIME Screen-Revised, with 132 (25.9%) screening positive. Comprehensive psychosis-spectrum evaluations were completed with 38 participants, and 22 met criteria for a psychosis-spectrum disorder, representing 57.9% of this subsample. Findings suggest that psychosis-risk screening in a college clinic is a promising approach to identifying those at high risk for or in the early stages of psychosis.
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Affiliation(s)
- Elizabeth C. Thompson
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Nicole D. Andorko
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | | | - Zachary B. Millman
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Kristin Sagun
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Susan C. Han
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Doha Chibani
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Gloria M. Reeves
- Child and Adolescent Psychiatry, University of Maryland Medical Center, Baltimore, MD, 21201
| | - Bruce Herman
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
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Thompson E, Rakhshan P, Pitts SC, Demro C, Millman ZB, Bussell K, DeVylder J, Kline E, Reeves GM, Schiffman J. Family functioning moderates the impact of psychosis-risk symptoms on social and role functioning. Schizophr Res 2019; 204:337-342. [PMID: 30205908 PMCID: PMC6489462 DOI: 10.1016/j.schres.2018.08.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/14/2018] [Accepted: 08/27/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Youth at clinical high-risk (CHR) for psychosis often experience difficulties in social and role functioning. Given evidence that family stress and support can impact psychosis-risk symptoms, as well as an individual's ability to fulfill social and role functions, family dynamics are hypothesized to moderate the effect of psychosis-risk symptoms on functioning. METHODS Participants at CHR (N = 52) completed the clinician-administered Structured Interview for Psychosis-risk Syndromes (SIPS) and the Family Assessment Device (FAD) General Functioning Scale, a self-report measure of family functioning including cohesion and support. Interviewers rated participants' current social and role functioning using the Global Functioning: Social and Role Scales. RESULTS Regression results indicated that positive symptoms, but not ratings of family functioning, statistically predicted social and role functioning. Perceived family functioning, however, moderated the effect of symptoms on social/role functioning. For individuals who perceived lower levels of family functioning, symptoms were moderately associated with social and role functioning (f2 = 0.17 and f2 = 0.23, respectively). In contrast, psychosis-risk symptoms were not significantly associated with social/role functioning for individuals with higher levels of perceived family functioning. Notably, positive symptoms and perceived family functioning were not associated with one another, suggesting that perceived family functioning did not directly impact symptom severity, or vice versa. CONCLUSIONS Findings support the notion that family functioning may be a clinically meaningful factor for individuals at CHR. Although this cross-sectional data limits our discussion of potential mechanisms underlying the pattern of findings, results suggest that familial support may be beneficial for individuals at risk for psychosis.
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Affiliation(s)
- Elizabeth Thompson
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States of America.
| | - Pamela Rakhshan
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
| | - Steven C. Pitts
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
| | - Caroline Demro
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
| | - Zachary B. Millman
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
| | - Kristin Bussell
- Division of Child and Adolscent Psychiatry, University of Maryland, School of Medicine, 700 West Pratt St., Baltimore, MD, 21201
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, 113 W 60th St, New York, NY 10023
| | - Emily Kline
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
| | - Gloria M. Reeves
- Division of Child and Adolscent Psychiatry, University of Maryland, School of Medicine, 700 West Pratt St., Baltimore, MD, 21201
| | - Jason Schiffman
- Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250
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Ärmänen A, Lahti M, Therman S, Suvisaari J, Lindgren M. Psychological, social and role functioning as predictors of psychosis in an adolescent psychiatric sample. Early Interv Psychiatry 2018; 12:1064-1071. [PMID: 28124493 DOI: 10.1111/eip.12414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/05/2016] [Accepted: 10/25/2016] [Indexed: 12/17/2022]
Abstract
AIM Recent evidence from psychosis risk studies of preselected samples suggests that early functional impairment may be a vulnerability marker for psychosis. We investigated whether functional impairment predicted later risk of psychotic disorder and psychiatric hospitalizations in adolescents at entry to general psychiatric services. METHODS A total of 154 adolescents, aged 15 to 18 years, were recruited to the study at entry to general adolescent psychiatric services in Helsinki, Finland. Structured Interview for Prodromal Syndrome and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorder for DSM-IV, Clinical version interviews were used to assess psychotic-like symptoms, psychosis risk and psychiatric diagnoses. Of the adolescents, 46 met the criteria for clinical high risk status. The level of functioning was assessed with Global Functioning Social, Role and Psychological scales. The adolescents were followed for 3 to 9 (median = 5) years via a hospital discharge register. Cox regression analyses were used to examine whether baseline functioning predicted psychotic disorders and psychiatric hospitalizations when controlling for the effect of psychosis risk symptoms. RESULTS Impairments in social, role or psychological functioning did not predict psychotic disorders beyond risk symptoms. Impairment in psychological functioning was the only significant predictor of any psychiatric hospitalization after adjusting for positive psychosis risk symptom severity and level of social and role functioning. CONCLUSIONS Psychosis was predicted by psychotic-like experiences at entry to psychiatric services. No aspect of functioning predicted psychosis in adolescents, which is likely to be explained by the low incidence of psychosis transitions. Severe mental disorders as assessed by psychiatric hospitalizations were predicted by more severe symptomatology as assessed by the psychological functioning scale.
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Affiliation(s)
- Anna Ärmänen
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Marius Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.,The Endocrinology Unit, British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Sebastian Therman
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Suvisaari
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Maija Lindgren
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
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Cieslak K, Walsh-Messinger J, Stanford A, Vaez-Azizi L, Antonius D, Harkavy-Friedman J, Goetz D, Goetz RR, Malaspina D. Olfactory performance segregates effects of anhedonia and anxiety on social function in patients with schizophrenia. J Psychiatry Neurosci 2015; 40:387-93. [PMID: 26107162 PMCID: PMC4622636 DOI: 10.1503/jpn.140268] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Social dysfunction is common among individuals with schizophrenia. While often attributed to anhedonia, social dysfunction could also result from unrecognized anxiety. We examined the contributions of anhedonia and anxiety to social function using olfactory function to examine whether the domains had separate underpinnings. METHODS We assessed anhedonia, anxiety and social function as well as olfactory function in well-characterized patients with schizophrenia or schizoaffective disorder and healthy controls. RESULTS We included 56 patients and 37 controls in our study. Patients exhibited significantly higher levels of anhedonia and anxiety than controls, and the domains were highly correlated in patients. The combination of anhedonia and anxiety more strongly predicted social dysfunction than either measure alone. Smell identification was differentially related to the symptoms, with better performance predicting less anhedonia but more social fear in male patients. LIMITATIONS The use of self-report measures precludes differentiation between recollected or recounted experience. Aside from smell identification and odour threshold, additional measures of olfaction may be considered for future studies. CONCLUSION Anhedonia and anxiety were strongly correlated and both negatively impacted social function. The olfactory biomarker results support the conclusion that these domains are separate. Social function in patients with schizophrenia may improve with interventions for anxiety, even in the presence of marked negative symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dolores Malaspina
- Correspondence to: D. Malaspina, InSPIRES, Department of Psychiatry, New York University School of Medicine, 1 Park Ave, 8th floor Rm 222, New York, NY 10016;
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