The Intricate Relationship between Psychotic-Like Experiences and Associated Subclinical Symptoms in Healthy Individuals.

Lui Unterrassner,Wulf Rössler,Helene Haker,Diana Wotruba,Thomas A Wyss

doi:10.3389/fpsyg.2017.01537

Abstract

The interplay between subclinical psychotic, negative, and affective symptoms has gained increased attention regarding the etiology of psychosis spectrum and other mental disorders. Importantly, research has tended to not differentiate between different subtypes of psychotic-like experiences (PLE) although they may not have the same significance for mental health. In order to gain information on the subclinical interplay between specific PLE and other symptoms as well as the significance of PLE for mental health, we investigated their specific associations in 206 healthy individuals (20–60 years, 73 females) using correlational and linear regression analyses. PLE were assessed with the Magical Ideation Questionnaire, the revised Exceptional Experiences Questionnaire, and subscales of the Schizotypal Personality Questionnaire (SPQ). The revised Symptom Checklist 90, the SPQ, and the Physical Anhedonia Scale were used to measure subclinical negative symptoms, affective symptoms, and other symptoms such as, emotional instability. As hypothesized, we found that (1) most affective symptoms and all other subclinical symptoms correlated positively with all PLE, whereas we found only partial associations between negative symptoms and PLE. Notably, (2) magical ideation and paranormal beliefs correlated negatively with physical anhedonia. In the regression analyses we found (3) similar patterns of specific positive associations between PLE and other subclinical symptoms: Suspiciousness was a specific predictor of negative-like symptoms, whereas ideas of reference, unusual perceptual experiences, and dissociative anomalous perceptions specifically predicted anxiety symptoms. Interestingly, (4) ideas of reference negatively predicted physical anhedonia. Similarly, paranormal beliefs were negatively associated with constricted affect. Moreover, odd beliefs were a negative predictor of depression, emotional instability, and unspecific symptoms. Our findings indicated that subtypes of PLE are differentially implicated in psychological functioning and should therefore not be categorized homogeneously. Moreover, paranormal beliefs, odd beliefs, and partly ideas of reference might also contribute to subjective well being in healthy individuals. Our results might serve as a starting point for longitudinal studies investigating the interplay of subtypes of subclinical symptoms along a psychopathological trajectory leading to mental disorders. Importantly, this research might help to improve therapeutic strategies for psychosis prevention.

Highlights

Psychotic disorders are primarily characterized by the presence of delusions and hallucinations
We investigated specific associations between subtypes of psychotic-like experiences (PLE) and three groups of symptoms: (1) negative-like symptoms, (2) affective symptoms, and (3) other subclinical symptoms that may be present in psychiatrically healthy individuals from the general population, such as, emotional instability
As we examined healthy individuals, we expected magical ideation, paranormal beliefs, and odd beliefs to be negatively correlated with the SCL-90-R subscale depression

Summary

Introduction

Psychotic disorders are primarily characterized by the presence of delusions and hallucinations. Awareness has increased that delusions and hallucinations are a feature of psychotic disorders but are subtly present in affective disorders, i.e., depression and anxiety (Olfson et al, 2002; Hanssen et al, 2003; Kelleher and Cannon, 2011; Wigman et al, 2012; Jeppesen et al, 2015). The various disorders that belong to the psychotic disorder spectrum might be conceptualized as different manifestations of one syndrome that share etiology and psychopathology (van Os, 2015). Patients with fewer negative and psychotic symptoms but with a high prevalence of affective symptoms might be diagnosed with bipolar disorder (van Os and Kapur, 2009). Evidence suggests that fundamental trans-diagnostic associations between different psychopathological domains such as, psychotic symptoms, affective symptoms, negative symptoms, and disorganized symptoms (difficulties in memory, attention, and executive functions) extend from subclinical to clinical symptom levels (van Os and Reininghaus, 2016)

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Discussion

Conclusion