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Aim Method Results Conclusions Psychotic disorders and obsessive‐compulsive disorder (OCD) commonly co‐occur. Likewise, subthreshold psychosis symptoms (clinical high risk for psychosis; CHR) and obsessive compulsive symptoms (OCS) often overlap and may be difficult to differentiate. This study aimed to replicate research investigating the prevalence of OCD in a CHR clinic sample, validate and investigate factor structure of a self‐report OCS measure in a CHR sample, explore how OCS may relate to CHR and co‐occurring symptoms, and investigate whether real‐world CHR treatment improves OCS and CHR symptoms.This study analysed archival clinical data from baseline and 6‐month follow‐up assessments collected by a specialist outpatient CHR clinic. Data included assessments of CHR symptoms, OCS, and clinician‐rated diagnosis. Exploratory factor analysis examined the OCS measure.Within this CHR clinic sample, 13.5% experienced co‐morbid OCD. The self‐report OCS measure had two factors: (1) checking and counting behaviours and (2) intrusive thoughts and images of harm/guilt. The checking and counting factor correlated with depression and social anxiety. The intrusive thoughts and images of harm/guilt factor significantly correlated with unusual thought content and social anxiety. Between baseline to 6‐month follow‐up, clients exhibited CHR symptom improvement regardless of OCD diagnosis. However, OCS did not change.These findings support validity of a self‐report OCS measure in a CHR clinic sample and that types of OCS experiences may exhibit different clinical patterns. Additionally, it appears that individuals with comorbid OCD responded similarly to CHR treatment compared to those without OCD. [ABSTRACT FROM AUTHOR]

Suicide risk is markedly higher for clients at clinical high risk for psychosis (CHR-p) compared to the general population. Dialectical behavior therapy (DBT) has a strong evidence base supporting its utility for managing suicide risk. Meanwhile, acceptance and commitment therapy (ACT) has been shown to effectively treat individuals with psychosis symptoms, as well as comorbid anxiety and mood disorders in CHR-p clients. Despite the robust evidence for each of these modalities in addressing concerns around suicidality and psychosis risk independently, there is a paucity of literature on how to support clients experiencing co-occurring suicide and psychosis risk. Such overlapping risk is often central to presenting concerns in CHR-p clients. Our manuscript presents a case example of an integrated DBT-ACT approach to managing risk surrounding both suicide and psychosis symptoms in an outpatient setting. We highlight how an integrated approach may help outpatient providers to implement and modify effective treatment that promotes continued outpatient care focused on goals beyond immediate risk management of both suicide and emerging psychosis. We provide specific examples of DBT techniques and ACT interventions used by a supervised doctoral-level student clinician in treatment with a CHR-p client and discuss implications for future clinical research. [ABSTRACT FROM AUTHOR]

Aim: This exploratory study reports on borderline symptomatology within a sample of individuals at clinical high risk for psychosis (CHR‐P) through a validated, self‐report instrument, the short version of the Borderline Symptom List (BSL‐23). Methods: The sample consisted of 44 help‐seeking CHR‐P youth (ages 14–29 years) who completed an initial evaluation at a specialized clinic for psychosis‐risk. Results: The mean BSL‐23 score was 1.5 (SD = 1.0, range 0.1–4.0). Higher scores were strongly associated with greater reported depressive symptoms (r = 0.84, p < 0.001). Additionally, borderline symptoms associated with attenuated positive symptoms (r = 0.32, p = 0.034) and social anxiety (r = 0.34, p = 0.027). Borderline symptomatology was not associated with role or social functioning. Conclusions: This study is one of the first examinations of borderline symptomatology within a CHR‐P sample through a validated self‐report measure. Future research replicating these results is required to determine their robustness. [ABSTRACT FROM AUTHOR]

Aim: Successful delivery of care to individuals with early psychosis depends on the ability of community providers to identify and refer appropriate candidates for services. Although specialty centres commonly rely upon education and outreach campaigns to building bridges with community providers, few studies have examined the effectiveness of these campaigns or the mechanisms by which they may achieve their intended effects. Methods: We surveyed community clinicians (N = 39) about their screening behaviours, referral practices, and confidence in managing early psychosis just before and 3–6 months after attending an educational event designed to promote recognition and quality treatment of early psychosis. Results: Three to six months following attendance, providers reported screening a greater proportion of clients for early psychosis, referring a greater number of clients to specialty services, and feeling more confident in their ability to respond to clients with early psychosis. Increases in confidence following attendance were associated with corresponding increases in screening behaviour. Conclusions: The results suggest that outreach campaigns designed to enhance community providers' knowledge about early psychosis assessment and resources may be effective in promoting screening, referrals, and confidence in managing psychosis. Gains in provider confidence may contribute to increases in screening. Given the lack of control group and relatively short follow‐up period, more research is needed to determine the effects of early psychosis educational events and the mechanisms by which they may promote successful treatment delivery for young people in need. [ABSTRACT FROM AUTHOR]

Aim: Treatment for youth exhibiting signs of clinical high risk for psychosis (CHR‐P) has been emphasized in recent years, but there is need for a greater understanding of the course of symptoms and functioning across treatment. The aim of this study is to describe 10 years of naturalistic treatment outcomes in a real‐world, specialized CHR‐P outpatient clinic, the Center for Early Detection, Assessment, and Response to Risk (CEDAR) Clinic. Methods: The CEDAR Clinic routinely collects client outcomes data for the purposes of program development, monitoring treatment effectiveness, and characterizing the clinic population. Clients are assessed at baseline, every 6 months (for up to 2 years depending on duration of treatment), and at the end of treatment. A series of mixed‐effects models were performed to analyse change over time in outcomes (symptoms and functioning) between baseline and follow‐up time points. Results: Over time, clients' (N = 123) positive (F = 11.8, p <.001) and negative (F = 4.91, p =.002) symptoms declined relative to their baseline. Social functioning improved over time (F = 2.50, p =.049), as did depression (F = 8.60, p <.001) and hopelessness (F = 4.21, p =.004). Clients' total CEDAR treatment hours ranged across type of treatment service, but the amount of treatment clients received was not associated with any clinical outcomes. Conclusions: Over the course of treatment at this real‐world, specialized CHR‐P program, clients exhibited significant improvement in clinical outcomes and did not significantly decline in any measured outcomes. We discuss this study in the context of current understanding and guidelines for specialized coordinated specialty care treatment for CHR‐P. [ABSTRACT FROM AUTHOR]

Aim: Early intervention for psychosis has been of high interest in the past two decades. Research demonstrates that clinical high risk for psychosis (CHR‐p) populations experience impairments in role functioning. Although several vocational and cognitive interventions exist for people living with psychosis, there are no known evidence‐based treatments for role functioning difficulties during the CHR‐p stage. There is clear evidence for a need for interventions that directly target role functioning. Methods: This paper describes the theoretical development and implementation of a novel intervention targeting role functioning impairments: Individualized Vocational and Educational Support and Training (InVEST). The CEDAR Clinic, a specialized CHR‐p coordinated specialty care (CSC) team, has worked to develop InVEST to target core aspects of role functioning, namely executive functioning, stress sensitivity, and task initiation. The intervention is cost‐efficient, as bachelor level clinicians provide the service under supervision of licensed clinicians. This summary describes InVEST, provides a disguised case example, and presents initial exploratory data (N = 135) focused on the intervention's feasibility in this CSC program. Results: Although these preliminary data are limited, available information suggests that InVEST may provide a core treatment modality within CHR‐p treatment programs. Conclusions: More research formally investigating InVEST with a larger sample would provide further evidence of the intervention's efficacy. [ABSTRACT FROM AUTHOR]

The aim of the current study was to examine the prevalence of non-suicidal self-injury (NSSI), as well as the relationships between emotion dysregulation, negative attitudes towards the body, and NSSI, within a sample of college students. We administered self-report measures to 143 diverse college students. Results revealed an NSSI prevalence rate of approximately 27%. Those who identified as a racial/ethnic minority were no more likely to endorse NSSI than those who identified as White/European American. There were no significant differences in emotion dysregulation between participants who endorsed NSSI and those who did not, yet negative bodily attitudes were significantly related to NSSI. Based upon the results, it is argued that negative attitudes towards the body should be considered an important risk factor in NSSI engagement among diverse college students. [ABSTRACT FROM AUTHOR]