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Bipolar disorders are increasingly understood as part of a spectrum of clinical and subclinical symptoms and impairment. Upwards of 50% of patients with bipolar disorders experience psychotic symptoms as part of their mood episodes. However, studies largely have not examined the extent to which people with subclinical bipolar spectrum psychopathology experience psychotic-like or schizotypic symptoms. The present study examined the association of bipolar spectrum psychopathology (as assessed by the Hypomanic Personality Scale [HPS]) with interview ratings of psychotic-like and schizotypic experiences in a sample of 177 young adults. HPS scores were associated with positive and disorganized schizotypic symptoms, as well as with schizotypal and paranoid personality disorder traits. Contrary to hypotheses, questionnaire measures of positive, negative, and disorganized schizotypy did not moderate the associations of the HPS with measures of psychopathology and impairment. However, exploratory analyses suggested that the schizotypy subscales mediated the association of HPS scores with these outcomes. These findings indicate that subclinical expressions of bipolar spectrum psychopathology are associated with psychotic-like and schizotypic symptoms consistent with psychotic features that characterize bipolar disorders. Overall, this study supports a shared dimension of psychosis that extends through subclinical functioning both in the bipolar and schizophrenia spectrum psychopathologies.

The present study assessed the construct validity of the Multidimensional Schizotypy Scale (MSS). Specifically, it assessed the associations of the MSS positive, negative, and disorganized schizotypy subscales with interview-rated symptoms and impairment in 177 young adults. As hypothesized, the MSS positive schizotypy subscale was associated with interview-rated positive symptoms, and schizotypal and paranoid personality traits. Negative schizotypy was associated with interview-rated negative symptoms, and schizotypal and schizoid traits, and elevated rates of schizophrenia-spectrum personality disorders. Disorganized schizotypy was associated with disorganized symptoms and attentional deficits. All three subscales were associated with impaired functioning. This was the first study to evaluate the validity of the MSS using interview measures. The findings indicate that the schizotypy dimensions are associated with unique patterns of symptoms and impairment, and support the validity of the MSS.

The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy was associated with schizotypal and borderline personality traits; negative schizotypy was associated with schizotypal, schizoid, paranoid, and avoidant personality traits; and disorganized schizotypy was associated with paranoid, borderline, and avoidant personality disorder traits. Negative schizotypy predicted broad diagnoses of Cluster A personality disorders. Both negative and disorganized schizotypy predicted the broad diagnosis of any of the 5 personality disorders. The study further examined the association of the schizotypy dimensions with the individual personality disorder criteria to better understand the overall associations. Given the common origins and high comorbidity, we examined whether the schizotypy dimensions explained the association of borderline and schizotypal personality disorder traits. Positive and disorganized schizotypy fully mediated the association between borderline and schizotypal traits. In summary, the study replicated and extended previous findings that the schizotypy dimensions are uniquely associated with personality disorders and traits, as well as impaired functioning, in young adults. The study also provided additional support for the construct validity of the Multidimensional Schizotypy Scale and for the use of psychometric assessment of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

First published online: 15 September 2021 The assessment of schizotypy and schizophrenia-spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However, studies have not examined the validity of the measurement across different racial groups. The present study examined whether the associations of MSS positive, negative, and disorganized schizotypy subscales with interview-assessed ratings of functioning, schizophrenia-spectrum personality traits, and depressive disorders were generally comparable across nonclinically ascertained samples of Black (n = 46), Asian (n = 87), and White (n = 116) young adults. Consistent with previous findings, all three schizotypy subscales were associated with impairment and schizotypal and paranoid traits. Negative schizotypy was associated with schizoid traits, and disorganized schizotypy was associated with depressive disorders. These associations were comparable across the racial groups, supporting the use of the MSS in these groups. Culturally and empirically valid assessments are essential for providing accurate assessments across racial/ethnic groups and reducing the risk of overpathologizing people of color. The present findings support the cross-cultural validity of the MSS; however, future studies should expand upon these findings by including more diverse samples and longitudinal designs.

The present study employed structured diagnostic interviews to assess the construct validity of the brief version of the Multidimensional Schizotypy Scale (MSS-B), which was developed to assess positive, negative, and disorganized dimensions of schizotypy. It was hypothesized that the MSS-B subscales would be associated with differential patterns of symptoms and impairment, comparable to findings for the full-length MSS. A total of 177 young adults completed structured diagnostic interviews assessing symptoms and impairment. As hypothesized, MSS-B positive schizotypy was significantly associated with interview ratings of positive (psychotic-like) symptoms, as well as schizotypal and paranoid personality disorder traits. MSS-B negative schizotypy was associated with interview ratings of negative symptoms, as well as schizoid, paranoid, and schizotypal traits. Furthermore, negative schizotypy predicted Cluster A personality disorder diagnoses. MSS-B disorganized schizotypy was associated with interview ratings of disorganized symptoms. All three schizotypy dimensions were associated with impaired functioning. This was the first study to evaluate the validity of the MSS-B using interview measures, and the pattern of findings for each MSS-B subscale was closely comparable to the findings for the full-length MSS. Contrary to our hypothesis, cannabis use was largely unassociated with psychotic-like symptoms and did not moderate the expression of the schizotypy dimensions. The MSS-B has good psychometric properties, high concordance with the full-length MSS, and good construct validity. Thus, it appears to be a promising brief alternative to traditional schizotypy measures.