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Background: The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students. Method: We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory–II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females). Results: We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism. Conclusion: Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers. [ABSTRACT FROM AUTHOR]

Background: The main goal of the present study was to examine the characteristics of schizotypal traits and their correlations with genetic (i.e., family history of mental illness), demographic (i.e., age, sex), environmental (e.g., income, urbanicity, tobacco/alcohol/cannabis use), and psychological (i.e., personal history of mental illness other than psychosis) factors in Tunisian high-school and university students. Our secondary goal was to contribute the literature by examining the factor structure and factorial invariance of the Arabic Schizotypal Personality Questionnaire (SPQ) across sex and age (adolescents [12–18 years] vs. young adults [18–35 years]) groups. Method: This was a cross-sectional study involving 3166 students: 1160 (36.6%) high-school students (53.0% females, aged 14.9 ± 1.8); and 2006 (63.4%) university students (63.9% females, aged 21.8 ± 2.3). All students were asked to complete a paper-and-pencil self-administered questionnaire containing sociodemographic characteristics as well as the Arabic version of the SPQ. Results: The total sample yielded total SPQ scores of 24.1 ± 16.6 out of 74. The SPQ yielded good composite reliability as attested by McDonald's omega values ranging from.68 to.80 for all nine subscales. Confirmatory Factor Analysis indicated that fit of the 9-factor model of SPQ scores was acceptable. This model is invariant (at the configural, metric and structural levels) across sex and age. Except for "Odd or eccentric behavior", all schizotypy features were significantly higher among female students compared to males. Multivariable analyses showed that female sex, being a university student, lowest family incomes, tobacco use, and having a personal history of psychiatric illness were significantly associated with higher positive, negative and disorganized schizotypy subscales scores. Conclusion: Future research still needs to confirm our findings and investigate the contribution of the identified factors in the development of clinical psychosis. We can also conclude that the Arabic SPQ is appropriate for measuring and comparing schizotypy across age and sex in clinical and research settings. These findings are highly relevant and essential for ensuring the clinical utility and applicability of the SPQ in cross-cultural research. [ABSTRACT FROM AUTHOR]

• Impulsivity—a prominent feature of psychotic disorders at the different stages of the disease—seems to be highly prevalent, can distinguish patients from healthy controls, and has a range of negative consequences on patients across the psychosis spectrum. • It remains unclear and understudied how impulsivity might differ across the course of psychosis and what impact it could have on clinical, psychological and functional outcomes in patients at the early stages of the disease. • Our findings showed that a substantial proportion of UHR individuals (38.7 %) were considered highly impulsive at baseline, with no significant changes over time having been noted in the scores of the three impulsivity dimensions over the 12-month follow-up period. • At 6 months of follow-up, higher 6-month attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. • Given the identified impact of impulsivity on different aspects of patients' everyday lives, it appears to be worthwhile to consider it as one of the major assessment and treatment targets in young people in the prodromal phase of psychosis. Impulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. UHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. Findings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. Interventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms' severity, as well as improve quality of life in UHR individuals. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbances in schizophrenia are common throughout its course including in the prodrome, and have been mainly attributed to severity of symptoms and antipsychotic use. We aimed to investigate whether early course patients with schizophrenia and young non‐psychotic siblings of patients with schizophrenia also show sleep disturbances and whether sleep correlates with symptoms and functioning. Methods: Three study groups, that is, adults newly diagnosed with schizophrenia (n = 54), young non‐psychotic siblings of schizophrenia patients (n = 56) and a sample of healthy controls matched to the patients and siblings (n = 61) were evaluated on Horne and Ostberg Morningness‐Eveningness Questionnaire, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Severity of symptoms and functioning are assessed using the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale, respectively. Age, gender, occupation and marital status were regarded as covariates, and differences between the three groups were evaluated using analysis of covariance. Results: Early course schizophrenia patients and non‐psychotic siblings of schizophrenia patients showed significantly reduced sleep quality relative to healthy controls (P <.001). Schizophrenia patients had significantly higher daytime sleepiness compared to controls (P <.001). Chronotypes in schizophrenia patients and unaffected siblings did not significantly differ from those of the healthy controls. Conclusions: Like chronic medicated schizophrenia patients, early course schizophrenia patients and young non‐psychotic siblings of individuals with schizophrenia have sleep disturbances. These findings indicate that sleep markers can distinguish unaffected siblings of schizophrenia from healthy controls and serve as an endophenotype for schizophrenia. [ABSTRACT FROM AUTHOR]

• There is sufficient evidence that levels of suicidality are typically higher in individuals at ultra-high risk (UHR) for psychosis than in other clinical groups, such as help-seekers that reach UHR clinics but do not meet UHR criteria, and young people with first episode psychosis (FEP). • The limited studies that have focused on suicidal thoughts and behaviors in UHR populations were predominantly cross-sectional and most of them have emerged from western countries. In addition, there is a lack of research on the role of potential and well-established causal factors for suicidality in this population. • The present study contributes to the existing literature by providing novel prospective data on suicidality in UHR individuals from a previously unexplored country and region. • Our findings support previous evidence that the prevalence of suicidal ideation and behavior in UHR individuals is concerning, and suggest that a routine monitoring of suicide risk by early intervention services is highly required. • Some factors related to suicidal ideation and attempts have preliminarily been identified in the present study, and deserve further investigations, i.e. the duration of untreated illness, self-esteem levels, and the severity of psychotic symptoms. The limited studies that focused on suicidality in individuals at Ultra-High Risk (UHR) of psychosis were predominantly cross-sectional, emerging from Western countries. We aimed to examine suicide risk among Tunisian UHR and First Episode Psychosis (FEP) patients at baseline, and to evaluate the evolution and correlates of suicidal ideation over a 12-month period in the UHR group exclusively. 35 UHR (aged 22.8 ± 4.0 years, 45.7% male) and 33 FEP (aged 27.3 ± 4.8 years, 63.6% male) participants were included. The Comprehensive Assessment of at Risk Mental States, the Positive and Negative Syndrome Scale (PANSS), The Rosenberg Self-Esteem Scale, and The Multidimensional Scale of Perceived Social Support were used. No significant differences were found between the UHR and the FEP groups with regard to levels of suicidal ideation at baseline. Suicidal ideation scores showed a significant decrease over time in UHR participants (p =.014; η2=0.242). An increase in total PANSS scores at 1 year (Beta=0.03; p =.048; 95%CI 0.001, 0.060; η2=0.182) significantly increased suicidal ideation scores at 1 year in the UHR group. Our findings contribute to the limited body of evidence on this topic by providing new prospective data from a population, country and region that has never been researched previously. [ABSTRACT FROM AUTHOR]

Abstract: The concept of early intervention in psychosis is still novel and evolving in some Arab countries, while completely non-existent in most of the other countries. What further complicates the introduction of this concept in the Arab world is the lack of easy-to-use and low-cost Arabic language screening tools. We aimed through the present study to perform a cross-country validation of the Prodromal Questionnaire–Brief (PQ‐B) into the Arabic language. We conducted a cross-sectional cross-national analysis based on 3247 respondents from six countries (i.e., Tunisia, Lebanon, Kuwait, Egypt, Jordan, Morocco). All participants answered the Arabic PQ-B and a set of measures used to determine the discriminant validity of the scale (psychological distress and suicidal ideation). Within this study, we also analyzed the factorial structure of the scale and its reliability. We found that 54.2% of participants screened positive for prodromal symptoms, with variations across countries ranging from 47.7% in Lebanon to 62.0% in Egypt. Confirmatory factor analysis indicated that fit of the one-factor model of PQ-B items was very good (CFI = .92; TLI = .91; RMSEA = .075 [90% CI .073–.077]. The Cronbach’s alpha values were > .90 for the total sample, in all six countries and in both genders. Findings also showed that the Arabic PQ-B is invariant across gender groups at the metric, configural, and scalar levels. Between-gender comparisons revealed no significant differences between males and females regarding PQ-B scores. Higher PQ-B scores correlated significantly but weakly with higher levels of psychological distress and more suicidal ideation. Findings provide evidence of excellent reliability and discriminant validity of the one-factor structure of the PQ-B in its Arabic version. The Arabic PQ-B appears thus promising as a screening tool to detect prodromal psychosis symptoms in Arabic speaking communities. [ABSTRACT FROM AUTHOR]