Search

Aim: Evidence supports the use of brief psychosis‐spectrum screeners for identifying individuals at risk for psychosis. Screening has not been well‐studied in help‐seeking college samples. This study investigated the use of the Behavior Assessment System for Children, Second Edition (BASC‐2) Atypicality Scale as a psychosis‐spectrum screening tool within a university counselling centre. Methods: Atypicality scores from the BASC‐2 were compared to interview‐based assessment, the Structured Interview for Psychosis‐risk Syndromes (SIPS), to explore associations across the measures and evaluate the scale's ability to identify individuals who meet criteria for a psychosis‐spectrum diagnosis. Results: Forty‐three participants completed the BASC‐2 and SIPS, and 23 were SIPS‐positive. Compared to the SIPS‐negative group, the SIPS‐positive group had significantly higher Atypicality scores. Exploratory results indicated that Atypicality scores identified SIPS‐positive individuals with an overall accuracy of 72% (78% sensitivity, 65% specificity). Conclusion: The Atypicality Scale may be an appropriate first‐line psychosis‐spectrum screening tool in college counselling centres. [ABSTRACT FROM AUTHOR]

Background Sensorimotor abnormalities precede and predict the onset of psychosis. Despite the practical utility of sensorimotor abnormalities for early identification, prediction, and individualized medicine applications, there is currently no dedicated self-report instrument designed to capture these important behaviors. The current study assessed and validated a questionnaire designed for use in individuals at clinical high-risk for psychosis (CHR). Methods The current study included both exploratory (n = 3009) and validation (n = 439) analytic datasets—that included individuals identified as meeting criteria for a CHR syndrome (n = 84)—who completed the novel Sensorimotor Abnormalities and Psychosis-Risk (SMAP-R) Scale, clinical interviews and a finger-tapping task. The structure of the scale and reliability of items were consistent across 2 analytic datasets. The resulting scales were assessed for discriminant validity across CHR, community sample non-psychiatric volunteer, and clinical groups. Results The scale showed a consistent structure across 2 analytic datasets subscale structure. The resultant subscale structure was consistent with conceptual models of sensorimotor pathology in psychosis (coordination and dyskinesia) in both the exploratory and the validation analytic dataset. Further, these subscales showed discriminant, predictive, and convergent validity. The sensorimotor abnormality scales discriminated CHR from community sample non-psychiatric controls and clinical samples. Finally, these subscales predicted to risk calculator scores and showed convergent validity with sensorimotor performance on a finger-tapping task. Conclusion The SMAP-R scale demonstrated good internal, discriminant, predictive, and convergent validity, and subscales mapped on to conceptually relevant sensorimotor circuits. Features of the scale may facilitate widespread incorporation of sensorimotor screening into psychosis-risk research and practice. [ABSTRACT FROM AUTHOR]

Aim: Prior to the release of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, experts in the field of psychosis research considered including a psychosis high‐risk syndrome—attenuated psychosis syndrome—as a formal diagnosis. Opponents argued that such a diagnosis may increase the risk of stigmatization of individuals whose symptoms often remit. Although previous research has examined provider perceptions of attenuated psychosis syndrome, little work has focused on lay perceptions. Methods: A total of 455 college students read three vignettes, each depicting a character with a different level of psychotic disorder (attenuated psychosis syndrome, schizophrenia or no psychosis). Following each vignette, participants responded to questions assessing: (1) identification of the character as mentally ill, (2) stigmatizing attitudes and (3) beliefs regarding the helpfulness of potential treatments. Results: Compared to a character with no psychosis, participants identified the attenuated psychosis syndrome character as more likely to be experiencing mental illness, but endorsed only slightly more stigmatizing attitudes. Participants tended to rate psychological types of treatment as more helpful than other types for an attenuated psychosis syndrome character. Conclusions: Non‐expert undergraduates appear to view attenuated psychosis symptoms as indicative of mental illness, though not as severe as schizophrenia symptoms. The minimal level of stigma endorsement indicates that college students may not be especially likely to spontaneously stigmatize peers with attenuated psychosis syndrome. [ABSTRACT FROM AUTHOR]

Background: The onset of psychosis-spectrum symptoms may be challenging to young people who are developing their identity. Internalized mental health stigma--the internalization of negative mental illness stereotypes (e.g., believing stereotypes to be true and applying them to yourself)--can lead to secrecy, shame, and withdrawal. Family factors can impact individuals who are experiencing early psychosis, but more work is needed to understand the relationship between family factors and stigma. One objective of this study was to examine if there were differences in internalized stigma across diagnostic groups. Another objective of this study was to better understand the predictors of internalized stigma among youth, particularly understudied aspects of youth stigma such as family functioning and specific types of psychosis-spectrum symptoms (e.g., positive symptoms). Methods: Participants aged 12–25 (N = 68; Mean age = 16.41, SD = 2.88) were recruited from community providers, clinics, hospitals, and schools in Maryland, USA. Participants were classified as meeting criteria for clinical high risk for psychosis (51%), early psychosis (24%), or help-seeking controls (25%). The sample was predominantly White (53%), followed by Black/African-American (19%), Biracial/Multiracial (18%), and Asian (10%). Psychosis-spectrum symptoms and depressive symptoms were measured via the clinician-administered Structured Interview for Psychosis-Risk Syndromes (SIPS) and family functioning (e.g., cohesion, support) was measured via the self-reported Family Assessment Device. Internalized stigma was measured using the self-reported Internalized Stigma of Mental Illness (ISMI) scale. ANOVA was used to test for differences in internalized stigma between high risk, early psychosis, and help-seeking controls. Multiple regression was used to evaluate predictors of internalized stigma. Results: Initial analyses indicated that there were no significant differences between the three diagnostic groups (F = 1.50, p = .23), but that clinical high risk for psychosis participants had the highest endorsement of internalized stigma (η2 = .05). Regression analyses indicated that unusual thought content/delusional ideas (one type of psychosis-spectrum positive symptom experiences measured by the SIPS), depressive symptoms, and lower family functioning significantly predicted (p < .05) higher internalized stigma, controlling for other psychosis-spectrum positive symptom experiences. These variables explained 26% of the variance in ISMI in the model (F = 4.01, p = .001). Negative, disorganized, and general SIPS items (except depression), as well as age, gender, race/ethnicity, relationship status, family history of psychosis, and income level, were unrelated to ISMI. Discussion: This is the first study to assess the relationship between family functioning, psychosis-spectrum symptoms, and internalized stigma among youth. Youth endorsement of unusual thought content/delusional ideas, depressed mood, and lower family functioning were associated with more self-reported internalized stigma from mental health concerns. Better understanding the predictors of internalized stigma among youth can lead to more tailored and effective treatment approaches. This study suggests that a particular focus on certain positive symptoms and family functioning may be warranted in the treatment of internalized stigma. Future research is needed to determine the temporal precedence and nature of the impact of these factors on ISMI, in addition to the potential differential impact of family factors by race/ethnicity and culture. [ABSTRACT FROM AUTHOR]

Social defeat has been proposed as the common mechanism underlying several well-replicated risk factors for sub-threshold psychotic experiences (PEs) identified in epidemiological research. Victimization by the police may likewise be socially defeating among vulnerable individuals and, therefore, may be associated with elevated risk for PEs. However, no prior studies have examined the relation between police victimization and PEs. We tested the hypothesis that exposure to police victimization (ie, physical, sexual, psychological, and neglect) would be associated with increased odds for PEs in the Survey of Police--Public Encounters data (N = 1615), a general population sample of adults from 4 US cities. Respondents who reported each type of police victimtization were more likely to report PEs in logistic regression analyses (all P < .01), most of which were significant even when adjusting for demographic variables, psychological distress, and self-reported crime involvement (adjusted OR range: 1.30 to 7.16). Furthermore, the prevalence of PEs increased with greater exposure to police victimization in a linear dose-response relation, OR (95% CI) = 1.44 (1.24-1.66). These findings suggest that police victimization is a clinically important and previously unreported risk factor for PEs in the urban US population. These findings support the need for community-based outreach efforts and greater police training to reduce the prevalence of this exposure, particularly in socially disadvantaged urban communities. [ABSTRACT FROM AUTHOR]