Abstract
We aimed to characterize multiple psychotic experiences, each assessed on a spectrum of severity (ie, quantitatively), in a general population sample of adolescents. Over five thousand 16-year-old twins and their parents completed the newly devised Specific Psychotic Experiences Questionnaire (SPEQ); a subsample repeated it approximately 9 months later. SPEQ was investigated in terms of factor structure, intersubscale correlations, frequency of endorsement and reported distress, reliability and validity, associations with traits of anxiety, depression and personality, and sex differences. Principal component analysis revealed a 6-component solution: paranoia, hallucinations, cognitive disorganization, grandiosity, anhedonia, and parent-rated negative symptoms. These components formed the basis of 6 subscales. Correlations between different experiences were low to moderate. All SPEQ subscales, except Grandiosity, correlated significantly with traits of anxiety, depression, and neuroticism. Scales showed good internal consistency, test-retest reliability, and convergent validity. Girls endorsed more paranoia, hallucinations, and cognitive disorganization; boys reported more grandiosity and anhedonia and had more parent-rated negative symptoms. As in adults at high risk for psychosis and with psychotic disorders, psychotic experiences in adolescents are characterized by multiple components. The study of psychotic experiences as distinct dimensional quantitative traits is likely to prove an important strategy for future research, and the SPEQ is a self- and parent-report questionnaire battery that embodies this approach.
Highlights
Psychotic disorders such as schizophrenia and bipolar disorder typically begin in early adulthood sometime after the age of 18 years.[1]
Individuals who have psychotic experiences share some of the same risk factors as those known to be associated with psychotic disorders.[3,4]
Our data suggest that specific psychotic experiences appear to be quite distinct: they do not necessarily occur together in a general population sample of 16-year olds
Summary
Psychotic disorders such as schizophrenia and bipolar disorder typically begin in early adulthood sometime after the age of 18 years.[1] This makes studying psychotic experiences in adolescence, just prior to the most common age of onset of clinical disorder, especially interesting. Children and adolescents who display psychotic experiences have an elevated risk of developing psychosis.[2] Individuals who have psychotic experiences share some of the same risk factors as those known to be associated with psychotic disorders.[3,4] The last decade has seen increasing interest in the development of clinical interventions for individuals at high risk of psychosis.[5,6].
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