Differential Risk: Gender and Racial Differences in the Relationship between Trauma, Discrimination, and Schizotypy.

Traumatic experiences are associated with increased experiences of positive schizotypy. This may be especially important for People of Color, who experience higher rates of trauma and racial discrimination. No study to date has examined how racial disparities in traumatic experiences may impact schizotypy. Furthermore, of the studies that have examined the relationship between trauma and schizotypy, none have examined racial discrimination as a potential moderator. The present study examined if racial discrimination moderates the relationship between trauma and multidimensional (positive, negative, and disorganized) schizotypy. In a sample of 770 college students, we conducted chi-squared analyses, analyses of variance, and stepwise regressions. We found that Black students experienced significantly higher racial discrimination and trauma than Latinx and Asian students. Furthermore, Black and Latinx students experienced significantly more multidimensional schizotypy items than Asian students. Trauma and racial discrimination explained 8 to 23% of the variance in each dimension of schizotypy. Racial discrimination did not moderate the relationships between trauma and multidimensional schizotypy. Our findings suggest that we need to examine risk factors that may prevent recovery from psychotic disorders. Additionally, disorganized schizotypy showed the most robust associations and may be a critical site of intervention.

Measurement invariance of the Child Behavior Checklist (CBCL) across race/ethnicity and sex in the Adolescent Brain and Cognitive Development (ABCD) study.

There are numerous studies examining differences in the experience of disorders and symptoms of psychopathology in adolescents across racial or ethnic groups and sex. Though there is substantial research exploring potential factors that may influence these differences, few studies have considered the potential contribution of measurement properties to these differences. Therefore, this study examined whether there are differences across racial or ethnic groups and sex in the measurement of psychopathology, assessed in mother-reported behavior of 9-11 year old youth from the Adolescent Brain Cognitive Development study sample using updated Child Behavior Checklist scales (CBCL; Achenbach & Rescorla, 2001). Tests of measurement invariance of the CBCL utilized the higher order factor structure identified by Michelini et al. (2019) using this same Adolescent Brain Cognitive Development cohort. The dimensions include internalizing, somatoform, detachment, externalizing, and neurodevelopmental problems. The configural model had a good-to-excellent fit on all subscales of the CBCL across racial or ethnic groups and sex. The metric and scalar models fit just as well as the configural models, indicating that the scales are measuring the same constructs across racial or ethnic groups and sex and are not influenced by measurement properties of items on the CBCL, although some high-severity response options were not endorsed for youth in all racial or ethnic groups. These findings support the use of the CBCL in research examining psychopathology in racially or ethnically diverse samples of youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychosis superspectrum II: neurobiology, treatment, and implications.

Alternatives to traditional categorical diagnoses have been proposed to improve the validity and utility of psychiatric nosology. This paper continues the companion review of an alternative model, the psychosis superspectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). The superspectrum model aims to describe psychosis-related psychopathology according to data on distributions and associations among signs and symptoms. The superspectrum includes psychoticism and detachment spectra as well as narrow subdimensions within them. Auxiliary domains of cognitive deficit and functional impairment complete the psychopathology profile. The current paper reviews evidence on this model from neurobiology, treatment response, clinical utility, and measure development. Neurobiology research suggests that psychopathology included in the superspectrum shows similar patterns of neural alterations. Treatment response often mirrors the hierarchy of the superspectrum with some treatments being efficacious for psychoticism, others for detachment, and others for a specific subdimension. Compared to traditional diagnostic systems, the quantitative nosology shows an approximately 2-fold increase in reliability, explanatory power, and prognostic accuracy. Clinicians consistently report that the quantitative nosology has more utility than traditional diagnoses, but studies of patients with frank psychosis are currently lacking. Validated measures are available to implement the superspectrum model in practice. The dimensional conceptualization of psychosis-related psychopathology has implications for research, clinical practice, and public health programs. For example, it encourages use of the cohort study design (rather than case-control), transdiagnostic treatment strategies, and selective prevention based on subclinical symptoms. These approaches are already used in the field, and the superspectrum provides further impetus and guidance for their implementation. Existing knowledge on this model is substantial, but significant gaps remain. We identify outstanding questions and propose testable hypotheses to guide further research. Overall, we predict that the more informative, reliable, and valid characterization of psychopathology offered by the superspectrum model will facilitate progress in research and clinical care.

Measurement invariance of the Personality Inventory for the DSM-5 across U.S. East Asian, Southeast Asian, and White participants.

The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition (PID-5) was developed as a measure of the traits included in the alternative model of personality disorders (AMPD) in Section III of the DSM. The PID-5 is composed of 25 scales measuring each trait in the AMPD across five domains: negative affectivity, detachment, disinhibition, antagonism, and psychoticism. Previous research suggests that there may be important differences in the expression of personality pathology across race and culture, particularly between people with eastern and western cultural heritages. The goal of the current research was to examine the measurement invariance of the PID-5 across these groups. In the current study, 865 young men and women who identified as White, East Asian, or Southeast Asian completed the PID-5 and international personality item pool (IPIP). On the domain level, a multigroup exploratory structural equation model found that the PID-5 had configural and metric invariance, but lacked complete scalar invariance. On an item level, all scales had configural invariance, one lacked metric invariance, and 11 of the 25 scales lacked scalar invariance across race. For the invariant scales, East and Southeast Asians tended to have higher mean scores than White participants. The PID-5 scales had similar relations with IPIP scales across groups. These results suggest that the PID-5 scales are measuring similar constructs across groups on a global, structural level, but that mean scores may represent different levels of latent personality pathology across groups. The PID-5 may be confidently used in these groups, but mean comparisons should be interpreted with caution. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Principles and procedures for revising the hierarchical taxonomy of psychopathology.

Quantitative, empirical approaches to establishing the structure of psychopathology hold promise to improve on traditional psychiatric classification systems. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a framework that summarizes the substantial and growing body of quantitative evidence on the structure of psychopathology. To achieve its aims, HiTOP must incorporate emerging research in a systematic, ongoing fashion. In this article, we describe the historical context and grounding of the principles and procedures for revising the HiTOP framework. Informed by strengths and shortcomings of previous classification systems, the proposed revisions protocol is a formalized system focused around three pillars: (a) prioritizing systematic evaluation of quantitative evidence by a set of transparent criteria and processes, (b) balancing stability with flexibility, and (c) promoting inclusion over gatekeeping in all aspects of the process. We detail how the revisions protocol will be applied in practice, including the scientific and administrative aspects of the process. Additionally, we describe areas of the HiTOP structure that will be a focus of early revisions and outline challenges for the revisions protocol moving forward. The proposed revisions protocol is designed to ensure that the HiTOP framework reflects the current state of scientific knowledge on the structure of psychopathology and fulfils its potential to advance clinical research and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Measurement invariance of commonly used psychosis-screening scales in U.S. Spanish- and English-speaking Hispanic participants.

Two of the most commonly used psychosis screening measures are the Prodromal Questionnaire-Brief (PQ-B) and the Youth Psychosis at Risk Questionnaire-Brief (YPARQ-B). Both scales have considerable support for the reliability and validity of their scores for use with English- and Spanish-speaking participants, with measurement equivalence established across a subset of demographic characteristics. However, measurement invariance has not been examined across several important demographic variables, including native language, language of the scales used with Hispanic participants, education, occupation, income, birth country, and generation status. In the present study, (N = 1,191) measurement invariance was examined for each of these variables across three samples (ns = 505, 714, and 126). The PQ-B total scores and YPARQ-B were found to demonstrate configural and scalar invariance, while PQ-B Distress scores displayed configural, metric, and scalar invariance across most tested demographic variables. Psychosis scores were associated with social determinants of health (SDoH) including major and everyday experiences of discrimination, food insecurity, financial insecurity, acculturation, and ethnic identity. The associations between psychosis and SDoH were mostly consistent across groups. Compared to White-non-Hispanic participants, Hispanic participants had higher scores on all psychosis measures and tended to have higher scores on discrimination, food and housing insecurity, affirmation aspects of ethnic identity, and acculturative stress. Despite differences in psychosis levels, the groups did not differ in history of treatment. Overall, these results provide strong evidence that the PQ-B and YPARQ provide equivalent, nonbiased, valid, and reliable scores in Hispanic and Non-Hispanic participants in both English and Spanish. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Answering questions about the Hierarchical Taxonomy of Psychopathology (HiTOP): Analogies to whales and sharks miss the boat.

This commentary discusses questions and misconceptions about HiTOP raised by Haeffel et al. (2021). We explain what the system classifies and why it is descriptive and atheoretical, highlighting benefits and limitations of this approach. We clarify why the system is organized according to patterns of covariation or comorbidity among signs and symptoms of psychopathology, and we discuss how it is designed to be falsifiable and revised in a manner that is responsive to data. We refer to the body of evidence for HiTOP's external validity and for its scientific and clinical utility. We further describe how the system is currently used in clinics. In sum, many of Haeffel et al.'s concerns about HiTOP are unwarranted, and for those concerns that reflect real current limitations of HiTOP, our consortium is working to address them, with the aim of creating a nosology that is comprehensive and useful to both scientists and clinicians.

Development of the Thought Disorder Measure for the Hierarchical Taxonomy of Psychopathology.

The Hierarchical Taxonomy of Psychopathology consortium aims to develop a comprehensive self-report measure to assess psychopathology dimensionally. The current research describes the initial conceptualization, development, and item selection for the thought disorder spectrum and related constructs from other spectra. The thought disorder spectrum is defined primarily by the positive and disorganized traits and symptoms of schizophrenia-spectrum disorders. The Thought Disorder Sub-Workgroup identified and defined 16 relevant constructs and wrote 10 to 15 items per each construct. These items were administered, along with detachment and mania items, to undergraduates and people with serious mental illness. Three hundred and sixty-five items across 25 scales were administered. An exploratory factor analysis of the scale scores suggested a two-factor structure corresponding to positive and negative symptoms for two samples. The mania scales loaded with the positive factor, while the detachment scales loaded with the negative factor. Item-level analyses resulted in 19 preliminary scales, including 215 items that cover the range of thought disorder pathology, and will be carried forward for the next phase of data collection/analysis.

Momentary assessment of aberrant salience, anomalous self-experiences, and psychotic-like experiences.

To improve understanding of emerging psychosis, researchers have identified potential precursory mechanisms that may momentarily precede psychotic-like experiences, including aberrant salience and anomalous self-experiences. Aberrant salience is the misattribution of significance to neutral stimuli and may be linked to atypical dopamine transmission. Anomalous self-experiences include changes in the experience of the self, which may alter top-down cognitive processes. The present study extends previous research on these phenomena by examining the momentary dynamics of aberrant salience, anomalous self-experiences, and psychotic-like experiences in daily life. Participants were 246 young adults who were prompted to complete 6 smartphone surveys daily for 7 days. Baseline measures of aberrant salience and anomalous self-experiences each predicted occurrence of the same phenomena in daily life, supporting the use of these measures to examine within-subject changes. Dynamic structural equation modeling was used to examine lagged effects. Both aberrant salience and anomalous self-experiences exhibited carryover effects across timepoints. Furthermore, aberrant salience and anomalous self-experiences were each associated with psychotic-like experiences at subsequent timepoints, above and beyond the carryover effects of psychotic-like experiences. These temporal relationships provide preliminary support consistent with social-cognitive models of psychosis and support further examination of the within-subject dynamics of aberrant salience and anomalous self-experiences at the momentary scale. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Les progrès dans la réalisation de la classification quantitative de la psychopathologie.

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Anomalous self-experiences in cognition are negatively associated with neurocognitive functioning in schizophrenia.

INTRODUCTION: Anomalous self-experiences (ASEs) are disturbances in the subjective experience of the self and are common in people with schizophrenia. Theorists have suggested that ASEs may underlie the neurocognitive deficits that are also common in people with schizophrenia; however, few studies have empirically investigated the relationship between these variables. Thus, the current study aimed to determine whether self-reported ASEs, particularly disturbances in cognitive or mental experiences, are meaningfully related to neurocognitive performance in individuals with schizophrenia. METHODS: 48 individuals with schizophrenia and 34 healthy comparison participants completed the Inventory of Psychotic-Like Anomalous Experiences (IPASE), which is composed of five subscales including disturbances in cognition, and the MATRICS Consensus Cognitive Battery (MCCB). RESULTS: Participants with schizophrenia performed worse than controls on each MCCB domain and had higher ASE scores on the total IPASE and all five subscales. Only the IPASE-Cognition subscale was associated with cognitive performance. Specifically, IPASE-Cognition was negatively correlated with scores in attention, visual learning, reasoning, and working memory. CONCLUSIONS: These results suggest that self-reported subjective disturbances in cognition may be meaningfully associated with several objectively-measured domains of neurocognition. Severity of ASEs may therefore be an important consideration when analysing the extent of cognitive deficits in schizophrenia.

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence.

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.

Assessing aberrant salience in young community help-seekers with early psychosis: The approved Italian version of the Aberrant Salience Inventory.

OBJECTIVES: Aberrant salience (AS) has a crucial role in the onset of psychosis. The Aberrant Salience Inventory (ASI) is the only self-report instrument specifically developed for the assessment of AS. Aim of this study was to examine the reliability and the validity of the approved Italian version of the ASI in a clinical sample of young help-seekers. METHODS: The ASI was completed by 204 individuals, aged 13-35 years. Reliability was assessed examining internal consistency and test-retest reliability. Concordant validity was established with CAARMS ("Comprehensive Assessment of At-Risk Mental States"). RESULTS: The ASI showed high test-retest reliability and excellent internal consistency. The ASI total score had significant positive correlations with CAARMS "Positive Symptoms" subscores. CONCLUSIONS: The ASI showed satisfactory psychometric properties and seems to be a suitable instrument for early detection of psychosis in Italian mental health services.

Comparability of social anhedonia across epidemiological dimensions: A multinational study of measurement invariance of the Revised Social Anhedonia Scale.

Social anhedonia, or the loss of motivation in and pleasure from social engagement, is an important feature in understanding the etiology and outcome of various psychopathologies. While the Revised Social Anhedonia Scale (RSAS) represents one of the most commonly used self-report measures of social anhedonia, little is known regarding the construct comparability across populations. We examined measurement invariance of the full and brief RSAS in a diverse, international sample of 14,064 participants across nine epidemiological dimensions, including gender, age, ethnicity, education, community income, continent, migrant status, ethnic density, and urbanicity. Both the full and brief RSAS, as represented by a three-factor structure, achieved metric invariance for all dimensions. The full version showed considerable scalar noninvariance for ethnicity and continent, which was significantly reduced in the brief version. These findings suggest that while the scales measure the same construct across diverse groups, mean comparisons are only appropriate for the brief, and not the full, version. Future research may consider using the brief RSAS to ensure cross-national comparability. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Differential item functioning of the Multidimensional Schizotypy Scale and Multidimensional Scale-Brief across ethnicity.

Schizotypy refers to traits or symptoms similar to schizophrenia, but in a diminished form, and schizotypy is thought to reflect a liability for the future development of schizophrenia. The Multidimensional Schizotypy Scale (MSS) is a new measure of schizotypy that improves on existing measures. The MSS contains full and brief subscales for positive, negative, and disorganized schizotypy. Although MSS scores have been validated in a variety of populations, the scales have not been thoroughly examined for differential item functioning in East Asian, Southeast Asian, Hispanic, Multiracial, and White participants. The current study included 567 East Asian, 351 Southeast Asian, 360 Hispanic, 230 Multiracial, and 345 White undergraduate participants from the United States. Overall, few of the items in the full or brief versions of the scales displayed differential item functioning across groups. The full and brief versions of the scales also displayed similar and not-significantly different validity coefficients with the Detachment and Psychoticism scales of the Personality Inventory for DSM-5. These findings suggest that the MSS measures the same constructs across ethnic groups, and the scale scores represent the same latent level of schizotypy among groups. Future research may use the MSS in these diverse groups without concern that the psychometric properties differ significantly among groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The placement of anomalous self-experiences within schizotypal personality in a nonclinical sample.

Anomalous self-experiences are disturbances in the subjective experience of the self and have been shown to be related to the premorbid, prodromal, acute, and chronic phases of schizophrenia-spectrum disorders. Despite having a long history in psychopathology research, anomalous self-experiences are not explicitly represented in any major nosology of mental disorders. Previous research suggests that anomalous self-experiences are correlated, but distinct from other aspects of schizotypal personality, but this has not been examined with confirmatory factor analysis. The current research aimed to examine where anomalous self-experiences fit within the structure of schizotypal personality including cognitive-perceptual, interpersonal, disorganized, and paranoid factors. It also examined the measurement invariance of the factor structure across ethnicity and between sexes. Seven hundred forty-four participants completed multiple measures of anomalous self-experiences and schizotypal personality. The best fitting model was a five-factor model with anomalous self-experiences, cognitive-perceptual, interpersonal, disorganized, and paranoid factors. This model fit better than models with anomalous self-experiences loading on any of the four schizotypal personality factors. The structure had configural, metric, and scalar invariance across race/ethnicities, but lacked scalar invariance between sexes. Anomalous self-experience scores did not differ among race/ethnicity or between sexes. These results suggest that anomalous self-experiences are highly correlated with but distinct from other facets of schizotypal personality. Future research may examine whether anomalous self-experiences should be added to nosologies of psychotic-spectrum disorders.

Form and content of attenuated psychotic symptoms in psychometrically assessed positive and negative schizotypy.

AIM: Greater attention is being paid to early detection and identification of individuals who are at high risk of developing psychosis. One area of interest is the particular content types of psychotic-like experiences (PLEs), which can be thought of as attenuated, non-clinical positive symptoms (eg, feeling perplexed by reality). Previous research has examined content of PLEs in clinical high-risk samples. The current study aimed to build upon these findings by analysing content in a psychometrically determined high-risk sample. METHODS: One hundred fifty-three undergraduates with scores greater than 1.96 SDs above the mean on a measure of schizotypy symptoms participated in a semi-structured interview for the assessment of prodromal syndromes. Each interview was transcribed verbatim and content of PLEs was rated according to the Content of Attenuated Positive Symptoms scale. RESULTS: Frequencies of content items in the psychometric high-risk sample were similar to those found in a clinical high-risk sample. Multiple regression analyses revealed that certain content items were more predictive of decreased global functioning and increased positive symptom severity. CONCLUSIONS: Content items that were associated with worse outcomes may be cause for greater concern if endorsed by individuals presenting for treatment. Future research should examine content of PLEs in a longitudinal design to determine whether particular items could predict subsequent conversion to a schizophrenia-spectrum disorder.

Psychometric Properties of the Eating Disorder Examination-Questionnaire (EDE-Q): A Confirmatory Factor Analysis and Assessment of Measurement Invariance by Sex.

The original, theoretically derived factor structure of the Eating Disorder Examination-Questionnaire (EDE-Q) has received limited empirical support and there is no consensus on an appropriate alternative. Moreover, there is a paucity of data on the factor structure of the EDE-Q across sexes. The goals of the current study were to evaluate models of the EDE-Q factor structure and to assess the best-fitting model for differences by sex. Twelve models were compared using confirmatory factor analysis in a sample of 940 undergraduates. Confirmatory factor analysis did not support the original factor structure. A four-factor model fit the data reasonably well with factors corresponding to themes of (a) dietary restraint, (b) preoccupation and restriction, (c) weight and shape concern, and (d) eating shame. The EDE-Q was found to be invariant by sex across all factors except Factor 3. The implications of these findings are discussed.