Psychotic-like experiences in help-seeking adolescents: Dimensional exploration and association with different forms of bullying victimization - A developmental social psychiatry perspective

The dimensionality of perceptual anomalies and their relationships with bullying victimization among Chinese adolescents: From a network perspective

Anomalous perceptual experiences in adolescents are common and may predict future psychotic disorders and other psychopathologies. However, the underlying structure and their specific relationships with bullying victimizations, a typical stressor for adolescents, remain unclear. Therefore, the current study aimed to clarify the structure of perceptual anomalies as assessed by the Cardiff Anomalous Perceptions Scale (CAPS) using exploratory graph analysis (EGA), a new factor retention method based on network psychometrics. The second aim was to explore whether specific dimensions of perceptual anomalies are particularly associated with certain forms of bullying victimization. Data from a validated sample of 1199 Chinese adolescents (56.0 % females, age range: 14-20) on perceptual anomalies and bullying victimizations were analyzed using network approaches, including EGA and mixed graphical modeling (mgm). Results showed that each anomalous perception was experienced by 13.8-50.3 % of the participants. EGA identified four dimensions: aberrant bodily perceptions, altered daily experiences, chemosensation (i.e., abnormal gustatory and olfactory experiences), and clinical psychosis (i.e., visual and auditory hallucinatory experiences). Among them, the altered daily experiences dimension possessed the highest centrality. Physical bullying and cyberbullying were directly and positively linked to two of the aberrant bodily experiences. Bootstrap analyses suggest that the results are reliable. The current findings support the existence of multiple contributive factors to perceptual anomalies and underscore the importance of bullying prevention in reducing mental health risks for adolescents, particularly the risk of psychosis.

The effect of stressful life events on the risk for psychosis: differences between Mexican at clinical and familial high risk

Background

Stressful life events (SLEs) in the development of early psychosis have been little studied in low-income countries. This study examines differences in the prevalence of SLEs in Mexican at clinical high risk (CHR) and those with familial high risk for psychosis who do not meet CHR criteria (non-CHR FHR). We also analyze the association between SLEs and CHR.

Methods

Participants included 43 persons with CHR and 35 with non-CHR FHR. CHR criteria were assessed with the Comprehensive Assessment of At-Risk Mental State. SLEs were assessed using the Questionnaire of Stressful Life Events.

Results

Participants with CHR reported more SLEs associated with negative academic experiences than those in the non-CHR FHR group. Bullying (OR = 7.77, 95% CI [1.81, 33.32]) and low educational level (OR = 21.25, 95% CI [5.19, 46.90]) were the strongest predictors of CHR, while starting to live with a partner (OR = 0.26, 95% CI [0.10, 0.84]) was associated with a lower risk of CHR.

Conclusion

Negative school experiences increase the risk of psychosis, particularly bullying, suggesting that schools may be ideal settings for implementing individual preventive strategies to reduce risk factors and increase protective factors to improve the prognosis of those at risk of developing psychosis. In Latin America, there are multiple barriers to early intervention in psychosis. It is thus crucial to identify risk and protective factors at the onset and in the course of psychosis in order to design effective preventive interventions.

Educational achievement and bullying: The mediating role of psychological difficulties

BACKGROUND

Bullying has a profound and enduring impact on academic achievement. However, there is a lack of clarity surrounding the specific mechanisms of this relationship.

AIMS

This study examined the link between bullying at age 9 and Numeracy/Literacy achievement at age 15 to determine if this relationship is partially or fully explained by psychological difficulties at age 13.

SAMPLE

Secondary data analysis was completed on waves 1, 2 and 3 of child cohort (Cohort'98) of the Growing Up in Ireland (GUI) study, respectively, at 9 years (N = 8568), 13 years (N = 7527) and 15 years of age (N = 6216).

RESULTS

Longitudinal path mediation model was conducted with bullying at age 9 as the predictor, total (emotional and behavioural) difficulties at age 13 as the mediator and Numeracy/Literacy scores at age 15 as outcomes revealing significant indirect effects of bullying on achievement, via psychological difficulties.

CONCLUSIONS

We discuss the impact of bullying on the student's psychological well-being, the relationship between bullying and academic attainment and how this may be tackled to avoid consequences throughout education and later in life.

EDUCATIONAL IMPACT AND IMPLICATIONS

This study emphasizes the need for schools to address the emotional and behavioural difficulties occurring as a result of bullying in order to improve the overall educational experience of a child. Existing interventions can be built upon by focusing on the continuous remediation of such psychological difficulties.

Association between Parents’ Relationship, Emotion-Regulation Strategies, and Psychotic-like Experiences in Adolescents

This study aimed to examine the association between the psychotic-like experiences (PLEs) and emotion-regulation (ER) strategies of adolescents and their parents’ relationship, and we hypothesized that the parents’ relationship moderates the link between ER strategies and PLEs. We recruited a total of 2708 first-year college students (1659 males and 1049 females) aged 15–20 years (mean = 17.9). Participants completed assessments of PLEs, their use of ER strategies, and reported their parents’ relationship as harmonious, conflicting, or divorced. Regression analyses indicated that the lower the use of the emotion-reappraisal strategy, the greater the use of the emotion-suppression strategy and that parental conflict or divorce predicted the number of PLEs endorsed and the level of distress from the PLEs. The parents’ relationship moderated the association between ER strategies and distress from PLEs. Among those who reported parental conflict or divorce, their lower use of the reappraisal strategy predicted their experiencing higher levels of distress from their PLEs. This study suggested the direct and interactive influence of the parents’ relationship and ER strategies on the presence of PLEs and PLE-related distress levels among adolescents, which may represent potential intervention targets.

Pathways linking school bullying and psychotic experiences: Multiple mediation analysis in Chinese adolescents and young adults

It is found that people with psychotic experiences have a 4-fold increased risk of developing a psychotic disorder later in life. Indeed, accumulating evidence has suggested that the association between school bullying and psychotic experiences works linearly. Previous studies are mainly carried out in a Western context, and only seldomly do studies address whether the association exists in the Chinese population and the related psychological and cognitive mechanisms. Therefore, we carried out the current study to address this gap in the literature focusing on the lifelong school bullying experiences of Chinese adolescents and young adults. We examined them in relation to psychotic experiences while assessing the mediating role of self-esteem, the personality trait of neuroticism, and a cognitive bias in thinking called interpretation bias. We found that multiple victimizations were quite common in Hong Kong secondary schools. In addition to a significant association between school bullying and psychotic experiences, we found partial mediating effects of proposed psychological and cognitive mediators in constructed multiple mediation models utilizing bootstrapping approach. Specifically, bullying quantity reflecting the number of victimizations, had its association with psychotic experiences partially mediated by the personality trait of neuroticism. In contrast, bullying duration reflecting the lasting of victimization was associated with psychotic experiences partially mediated by the personality trait of neuroticism and interpretation bias. Our findings enhance our knowledge of mechanisms underpinning the psychosis spectrum development and have implications for school-based intervention programs targeting bullying victims.

Victimization among children and adolescents accessing the Meyer pediatric hospital: A retrospective study

Problem

The consistent prevalence and occasionally severe consequences of bullying and victimization suggest the need to include a more accurate assessment of these episodes within the Emergency Departments (ED). However, the literature on mental health related symptoms of bullying/victimization treated in the ED is still scarce. The aim of this study is to assess the prevalence of peer victimization amongst children and adolescents referred to an Italian Pediatric Emergency Department. Differences between Hospital Departments, type of victimization and ages are tested.

Methods

A retrospective observational study was conducted with 705 subjects. The age range was from 6 to 18 years old (M = 13.09; SD = 3.048).

Findings

15.3% of the sample reported to be victimized (8.2% occasionally; 7.1% systematically). For the Child and Adolescent Psychiatry Unit, we found a significant association between peer victimization and being adolescent (Fisher's p = 0.003). In addition, a significant association was found between verbal victimization and Child and Adolescent Psychiatry Unit (Fisher's p = 0.02) and physical victimization and Child Abuse Department (Fisher's p < 0.001).

Conclusion

Findings suggest the importance of an accurate assessment of victimization experiences of children and adolescents with access to ED, to prevent future re‐victimization and crystallization of symptoms across time.

The association between sibling bullying and psychotic-like experiences among children age 11-16 years in China

BACKGROUND

Few studies exist on sibling bullying or even sibling aggression more generally in the past 30 years. Studies of sibling bullying have shown that sibling bullying may associate with depression, anxiety, self-harm, suicide ideation in early adulthood. Nevertheless, few studies have explored the relationship between sibling victimization types and the occurrence of psychosis, not to mention that psychotic-like experiences (PLEs) always occur before psychotic disorders. Therefore, the current study aims to examine the association between sibling bullying and PLEs among children age 11-16 years in China.

METHOD

This is a cross-sectional study which included 3231 students from eight junior middle schools in three cities of Hunan Province, China. Frequency and types of sibling bullying was assessed with Sibling Bullying Questionnaire and PLEs was assessed with Community Assessment Psychic Experiences-42.

RESULTS

The percentage of sibling bullying were 12.9% for victimization and 10.8% for perpetration. Sibling bullying plays as an independent influence factor for all subtypes of PLEs, and verbal victimization was the most important risk factor in developing different subtypes of PLEs followed by physical victimization and verbal perpetration.

CONCLUSION

The current study found that sibling bullying is associated with PLEs. Intervention programs should be conducted to focus on those children and adolescents who are involved in multiple types of sibling victimization or perpetration.

Threats to epistemic agency in young people with unusual experiences and beliefs

A good therapeutic relationship in mental health services is a predictor of positive clinical outcomes for people who seek help for distressing experiences, such as voice hearing and paranoia. One factor that may affect the quality of the therapeutic relationship and raises further ethical issues is the impact of the clinical encounter on users' sense of self, and in particular on their sense of agency. In the paper, we discuss some of the reasons why the sense of epistemic agency may be especially fragile in young people with unusual experiences and beliefs. We argue that it is important to identify and avoid behaviours that can undermine young people's contributions as epistemic agents in the clinical encounter.

Details of the Contents of Paranoid Thoughts in Help-Seeking Adolescents with Psychotic-Like Experiences and Continuity with Bullying and Victimization: A Pilot Study

Background: Psychosis recognizes an interaction between biological and social environmental factors. Adversities are now recognized to be consistently associated with psychotic-like experiences (PLEs). The purpose of this study was to describe the contents of paranoid symptoms and to focus on their relationship with bullying and victimization in help-seeking adolescents. Methods: Help-seeking adolescents who screened positive for PLEs participated in the study. They performed a battery self-report questionnaire for data collection (paranoia: the Specific Psychotic Experiences Questionnaire (SPEQ); the content of paranoid thoughts: the Details of Threat (DoT); bullying victimization: the Multidimensional Peer Victimization Scale (MPVS); depression: the Children's Depression Inventory (CDI); and anxiety: the Multidimensional Anxiety Scale (MASC)). Results: The participants were 50 adolescents (52% female; mean age: 170 months). The contents of their paranoid symptoms were related to victimization and, in particular, the certainty of threats was correlated with physical (0.394, p < 0.01) and verbal bullying (0.394, p < 0.01), respectively. The powerfulness of the threats correlated with verbal victimization (0.295, p < 0.05). The imminence of the threats was linked to verbal (0.399, p < 0.01) victimization. Hours under threat correlated with verbal (0.415, p < 0.01) victimization. The sureness of the threat had a moderate correlation with physical (0.359, p < 0.05) and verbal (0.443, p < 0.01) victimization, respectively. The awfulness of the threat was linked to social manipulation (0.325, p < 0.05). Conclusions: We described the content of the persecutory symptoms. The powerfulness, imminence, sureness, and awfulness of threats correlated with the level of physical, verbal and social manipulation victimization. Teachers and family must actively monitor early signs of bullying victimization, and school psychologists should promote preventive and therapeutic intervention. From a social psychiatry perspective, the prevention of bullying victimization is necessary.

Terminology and assessment tools of psychosis: A systematic narrative review

AIM

Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'.

METHODS

EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded.

RESULTS

A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization.

DISCUSSION

A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.

Epidemiological pattern of bullying using a multi-assessment approach: Results from the Bullying and Youth Mental Health Naples Study (BYMHNS)

BACKGROUND

Bullying is a widespread phenomenon that has captured attention from mental health researchers. Several studies have assessed bullying prevalence with some methodological concerns.

OBJECTIVES

Preliminary, we analyzed the psychometric properties of two bullying scales for victimization (the multidimensional peer victimization scale - MPVS) and for perpetration (the bully subscale of the Illinois bully scale - IBS-B); then, we estimated bullying prevalence; finally, we evaluated the effect of gender and classroom on the phenomenon.

PARTICIPANTS AND SETTING

2959 students from the metropolitan city of Naples constituted the sample.

METHODS

Data collection was obtained using a multi-assessment approach that included both single-item questions and intensity scales in order to compare the two methods.

RESULTS

The two scales resulted valid and showed good reliability. The MPVS displayed a 1-factor second order model. The IBS-B had a mono-factorial structure. Both showed full invariance for gender and classroom. Prevalence of victimization was 37% whereas that for perpetration was 21%. As expected we obtained several bullying prevalence results depending on the specificity of questions and in particular repetitiveness of episodes. There was a good correspondence between results of single-item questions and multi-item scales. Finally results demonstrated several differences for gender and classroom attended.

CONCLUSION

In this epidemiological study the multi-assessment approach identified different but complementary features of bullying phenomena. The use of the two measurement approaches allowed us to obtain more precise and exhaustive information on bullying prevalence and compare it with previous findings.

A glance into psychiatric comorbidity in adolescents with anorexia nervosa

BACKGROUND

Eating disorders display several psychiatric comorbidities. The aim of this study was to describe these comorbidities in a group of adolescent patients with anorexia nervosa or OSFED (Other Specified Feedind or Eating Disorder). We have evaluated the comorbidity both with a clinical interview (categorical comorbidities) and with a self-report interview (dimensional comorbidities) in order to compare the two profiles.

METHODS

The study was carried out at the Division of Child and Adolescent Psychiatry (eating disorder service for developmental age) of the Luigi Vanvitelli University of Campania (ex Second University of Naples). Data were collected retrospectively from chart review, routinely gathered during the clinical assessment.

RESULTS

Seventy-two subjects constituted the sample, 62 (86.1%) were female and 10 (13.9%) male. The most frequent categorical comorbidities were social anxiety disorder (SS: 38; 52.8%), Depression disorder (SS: 30; 41.7%) and generalized anxiety disorder (SS: 14; 19.4%). The mean scores at dimensional questionnaires were 15.5 (SD: 10.7) for the depression (Children Depression Inventory) and 34.8 (SD: 28.3) for social anxiety (Liebowitz Social Anxiety Scale).

CONCLUSIONS

Data analysis showed that social anxiety and depression were the most common categorical comorbidities in young patients with eating disorders. However, comparing the data from the clinical interview with those of the self-interviews revealed that patients well recognize social anxiety symptoms, but tend to deny depressive ones.

Phantom Phone Signals in youths: Prevalence, correlates and relation to psychopathology

The term Phantom Phone Signals (PPS) refers to the perception of a mobile phone ringing, vibrating and blinking when in fact it did not. Data in youth are lacking, and controversies exist on whether PPS is related to psychopathology. In the present study, we showed data on the prevalence of PPS in a population (N = 2959) of students aged 10 to 14 years. We also explored the possible association between PPS and emotional or behavioural problems. Our results showed that PPS is a relatively common phenomenon with a prevalence rate of 58.9%, being more frequent in females. In univariate and multivariate analyses, we also found an association between the presence of PPS and emotional problems and temper tantrums, after accounting for relevant covariates. PPS is a relevant phenomenon to be considered in youth. It is common and may be a signal for emotional problems.