Delusional-like Experiences Research Articles

Сomparative analysis of social disadaptation and criticality indicators in patients with schizoaffective disorder and paranoid schizophrenia as components of pathopersonological transformations

Differential diagnosis of schizophrenia or (SAD), both are included in endogenous psychoses group, which represents an extremely important problem in clinical practice and modern psychiatric theory considering steady expanding and transforming ideas about the systematic typology of mental diseases in recent years. Correctness of psychiatric disease diagnosis by clinicians determines therapeutic strategy, which directly influences the quality and duration of remission, the side effects of medicines severity, medical and social prognosis and quality of patient’s life. The aim – to carry out a comparative analysis of pathopersonological transformations, types of attitude to the disease and adaptability of patients with schizophrenia and SAD. Contingents and methods. On the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia, Ukraine) there were examined 76 patients with an diagnosis of schizoaffective disorder and 96 patients with an established diagnosis of paranoid schizophrenia, episodic type of course, both with pronounced affective component in the structure of exacerbation episodes. Inclusion criterion in the sample for both groups was the state of clinical remission with reduction of psychotic symptoms. The main methods of investigation were catamnestic, clinical, psychopathological, psychodiagnostic (MMPI and PQBI techniques), as well as medical and statistical analysis. Results. The obtained results revealed a negative effect of both diseases on the level of psychosocial adaptation in various vectors (interpsychic for SAD and intrapsychic for schizophrenia), and also indicated the specific personological characteristics of the studied contingents. The prevalence of personality autization among patients with schizophrenia combined with anxious and neurotic features, which define the leading mechanism of delusion formation, while impulsivity and psychopathyzation, which dominate the personality profile of patients with SAD, corresponded to the affective radical associated with the context of delusional-like experiences. Conclusions. Detection of specific pathopersonological transformations contributes to the differential diagnosis of schizophrenia and SAD accuracy, thereby resulting in greater efficiency and purposefulness of therapeutic and rehabilitation measures.

Self-exploration accounts for delusional-like experiences in non-clinical adults

<b>Background</b><br /> Previous research on non-clinical samples found that younger age may predispose to delusional-like experiences (DLEs). We propose to seek its explanation within the process of identity formation and personality factors (i.e., fantasy proneness and need for cognitive closure).<br /> <br /> <b>Participants and procedure</b><br /> The study involved 201 individuals (131 women) ranging in age from 18 to 99 years (M = 29, SD = 13). The participants were recruited through social media sites in which we distributed a link to the online survey.<br /> <br /> <b>Results</b><br /> The results confirmed that DLEs were predicted in individuals with a younger age, identity exploration, fantasy proneness and decreased need for closure. Additionally, we found that identity exploration mediated the link between younger age and DLEs.<br /> <br /> <b>Conclusions</b><br /> This preliminary study supports the view that DLEs may accompany the “continuously emergent” self represents the status of the matured identity of our time. Further investigations are needed to replicate our findings.

Common mental disorders and recent physical activity status: findings from a National Community Survey.

To explore the association between histories of common mental disorders, delusional-like experiences, and recent physical activity using a large nationally representative population-based sample from Australia. We predicted that a past history of a common mental disorder or delusional-like experiences would be associated with insufficient physical activity. The study was based on the Australian National Survey of Mental Health and Wellbeing 2007 (n=8841). The Composite International Diagnostic Interview was used to identify a lifetime and past year history of common mental disorders and delusional-like experiences. Physical activity over the preceding week was estimated using the questions based on the Active Australia survey with respondents classified as (a) insufficiently physically active versus (b) sufficiently physically active based on national recommendations. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Almost half of the participants (46.0%) were classified as sufficiently physically active. Compared to those with no past mental disorder, those with lifetime or past year history of common mental disorders did not differ on recent physical activity status. Furthermore, we found no significant association between the number of lifetime mental disorders or the presence of delusional-like experience and recent physical activity status. Our findings suggest that a diagnosis of common mental disorder, with or without recent symptoms and comorbid diagnoses, or even having self-ascribed perception of poor mental well-being, is not associated with insufficient physical activity.

Age at first tobacco use and risk of subsequent psychosis-related outcomes: A birth cohort study.

Compared to the substantial body of research examining links between cannabis use and psychosis, there has been relatively little attention to the role of tobacco as a potential risk factor for psychosis. This study explored the association between age at first tobacco use and psychosis-related outcomes in a birth cohort. This study is based on a large birth cohort (the Mater-University Study of Pregnancy). At approximately 21 years of age, cohort members (N = 3752) were assessed for three psychosis-related outcomes (International Classification of Diseases non-affective psychosis, the presence of any hallucination and total count of delusional-like experiences) with the Composite International Diagnostic Interview and the Peters Delusional Inventory. Associations between age at first tobacco use and psychosis-related outcomes were examined using logistic regression in a model (a) adjusted for sex and age and (b) in a second model excluding all respondents who had a history of past problematic and current cannabis use. When adjusted for age and sex, those who commenced tobacco at 15 years of age or younger were significantly more likely to (a) have non-affective psychosis, (b) be in the highest quartile of total score of the Peters Delusional Inventory and (c) report hallucinations. After excluding all those with a history of a cannabis use disorder, or who were current (last month) cannabis users, a significant association between age at first tobacco use and the presence of hallucinations persisted. There is an association between age at first tobacco use and subsequent psychosis-related outcomes in young adults. While the findings cannot be used to deduce causality, it adds weight to the hypothesis that early tobacco use may contribute to the risk of developing psychosis-related outcomes.

Service Use for Mental Health Problems in People with Delusional-Like Experiences: A Nationwide Population Based Survey

ObjectivePrevious population-based studies have found that delusional-like experiences (DLEs) are prevalent in the community, and are associated with a wide range of mental health disorders. The aim of the study was to investigate mental health service use by people with DLEs.MethodsSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007 of 8 841community residents aged between 16 and 85 years. The Composite International Diagnostic Interview (CIDI) was used to identify DLEs. Service utilization was assessed using a module that elicited information about hospital admissions, consultations with various health professionals, and prescription medication use. This study focussed on service use for mental health problems. We used logistic regression to examine the association, adjusting for potential confounding factors.ResultsOf 8 773 included participants, 8.4% (n = 776) positively endorsed one or more DLEs. With respect to consultations for mental health needs, individuals who endorsed DLEs were more likely to consult health professionals compared with those who did not endorse DLEs. Individuals with DLEs were also more likely to use prescription medicine. When we repeated the main analysis in a subgroup excluding any CIDI diagnosis of mental health disorders the results remained largely unchanged.ConclusionsDLEs are common in the general population, and individuals with DLEs have an increased rate of accessing services for their mental health needs. Individuals endorsing both DLEs and increased help-seeking may identify a group of vulnerable people who have increased risk of developing psychotic illnesses later in life. This needs closer scrutiny in longitudinal prospective studies.

The Association Between Adult Attachment Style and Delusional-Like Experiences in a Community Sample of Women

Community-based surveys have found that many otherwise well individuals endorse delusional-like experiences (DLEs). There is extensive literature that describes the demographic and psychosocial correlates of DLE; however, we know little about the association between DLE and attachment style. The association between DLEs (assessed by the Peters Delusional Inventory [PDI]) and interpersonal relationship style (as assessed by the Adult Attachment Questionnaire and the Dyadic Adjustment Scale) was examined in 3360 women. When adjusted for the presence of depressive and anxiety symptoms, high scores on the PDI (lowest versus highest quartiles) were associated with a) difficulties in adult attachment style particularly in the discomfort with closeness and preoccupation with relationships subscales and b) conflictual dyadic adjustment (adjusted odds ratios and 95% confidence intervals, 2.43 and 1.94-3.04, 2.50 and 1.99-3.14, and 2.90 and 1.38-6.06, respectively). The association between adult attachment style and DLE provides new clues into the causal pathway underpinning these common experiences.

The heritability of delusional‐like experiences

Delusional-like experiences (DLE) are common in the general community and are associated with a family history of mental illness. The aim of this study was to estimate the heritability of DLE. The Peter's Delusional Inventory (PDI) was administered to a population-based cohort of mothers (n = 2861, aged 35-67 years) and their adult offspring (n = 3079, aged 18-23 years). Heritability of DLE was estimated from the sum scores of the 21 item PDI under the assumption that the covariance between mother-offspring scores is attributable to shared additive genetic factors. The means (medians and standard deviations) for the total PDI scores for the mothers and their offspring were 3.6 (3.0, 3.0) and 5.0 (4.0, 3.5), respectively. The Pearson correlation coefficient between mother and offspring PDI scores was 0.17 (P < 0.001). The heritability was estimated to be 0.35 (standard error 0.04). Heritable factors contribute to over a third of the variance of PDI scores in this population. In light of the association between a family history of a wide range of mental disorders and DLE, these experiences may represent a useful quantitative endophenotype for genetic studies of common mental disorders in population settings.

Delusional-like experiences are more common in those with cannabis dependence disorder, very early-onset alcohol use or dependence disorders, and daily smokers

QUESTION Question: Are tobacco, alcohol and cannabis use associated with delusional-like experiences (DLE)? Population: 8773 residents of Australia aged between 16 and 85 years that took part in the Australian...

Social support and delusional-like experiences: a nationwide population-based study

Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community sample. Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse/partners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors. Of the sample, 8.4% (n = 776) positively endorsed one or more DLEs. Individuals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse/partner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors. DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.

Anxiety and depressive disorders are associated with delusional-like experiences: a replication study based on a National Survey of Mental Health and Wellbeing

ObjectivesThere is growing evidence that delusional-like experiences (DLE) are associated with common mental disorders. In particular, a National Mental Health Survey conducted in Australia during 2007 reported an association between...

Socio-economic disadvantage and delusional-like experiences: A nationwide population-based study

PurposeDelusional-like experiences (DLE) have been associated with low income, suggesting that more broadly defined socio-economic disadvantage may be associated with these experiences. We had the opportunity to explore the association between DLE and both individual- and area-level measures of socio-economic disadvantage. MethodSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and physical disorders. Individual-level and area-level socio-economic disadvantage measures were available based on variables including income, educational attainment, employment status, and housing. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. ResultsOf the 8773 subjects, 8.4% (n=776) positively endorsed one or more DLE. DLE screen items were more likely to be endorsed by those who were (a) younger, (b) never married, or widowed, separated or divorced status, (c) migrants, or (d) living in rented houses. There were significant associations between socio-economic disadvantage and increased DLE endorsement, and this was found for both individual-level and area-level measures of socio-economic disadvantage. In general, the associations remained significant after adjusting for a range of potential confounding factors and in planned sensitivity analyses. ConclusionsDLE are associated with socio-economic disadvantage in the general population. We speculate that the link between socio-economic disadvantage and DLE may be mediated by psychosocial stress and general psychological distress.

The association between delusional-like experiences, and tobacco, alcohol or cannabis use: a nationwide population-based survey

BackgroundPrevious population-based studies have found that delusional-like experiences (DLE) are prevalent in the community, and are associated with a wide range of mental health disorders including substance use. The aim of the study was to explore the association between DLE and three commonly used substances - tobacco, alcohol and cannabis.MethodsSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and substance use. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors.ResultsOf 8 773 participants, 8.4% (n = 776) subjects endorsed one or more DLE. With respect to tobacco use, compared to nonusers, DLE were more common in those who (a) had daily use, (b) commenced usage aged 15 years or less, and (c) those who smoked heavily (23 or more cigarettes per day). Participants with cannabis use disorders were more likely to endorse DLE; this association was most prominent in those with an onset of 16 years or younger. In contrast, the pattern of association between DLE versus alcohol use or dependence was less consistent, however those with early onset alcohol use disorders were more likely to endorse DLE probe items.ConclusionsWhile cannabis use disorders have been previously linked with DLE, our findings linking alcohol and tobacco use and DLE suggest that the influence of these substances on psychosis-related outcomes warrants closer scrutiny in longitudinal prospective studies.

The association between delusional-like experiences and suicidal thoughts and behaviour

BackgroundDelusional-like experiences (DLEs) are common in the general population. Whilst it is well known that psychotic disorders increase the risk of suicide, it is unclear if DLEs are also associated with suicidal thoughts and behaviour. This study aims to explore these variables in a large population-based sample. MethodParticipants were drawn from a national survey of mental health (n=8841) in Australia. The Composite International Diagnostic Interview was used to identify DLEs, psychiatric disorders, and information related to suicidal ideation, suicide plan and suicide attempts. We examined the relationship between DLEs and suicidal ideation, plans and attempts using logistic regression, adjusted for a range of potentially confounding variables. Results8.4% of subjects endorsed one or more DLEs. 12.9% subjects reported suicidal ideation, 3.8% suicidal plans, and 3.0% a suicide attempt at some point in their lives. Those with any DLE were about two to four times as likely to report suicidal ideation, plans or attempts. There was a dose response relationship between DLEs and endorsement of suicide-related items. ConclusionsDLEs are common in the general population and appear to be independently associated with suicidal thoughts and behaviour. DLE may provide a marker of vulnerability to suicide, and thus could be of value in future suicide prevention research.

The association between trauma and delusional-like experiences

Individuals exposed to childhood trauma are more likely to report delusional-like experiences (DLE). This study examined the association between trauma exposure and DLE in a large community sample, investigating different trauma types and age-at-first-exposure to trauma. Subjects were from the Australian National Survey of Mental Health and Wellbeing 2007. Associations between DLE and (i) exposure to different trauma types and (ii) age-at-first-exposure were assessed using logistic regression with adjustments for potential confounding factors. 8.4% of 8773 subjects reported DLE and almost 75% reported at least one traumatic event. Exposure to a traumatic event was significantly associated with more than twice the odds of delusional-like experiences and exposure to more types of trauma increased the likelihood of DLE in a dose dependent fashion. The majority of the individual trauma items were independently associated with any endorsement of DLE. First exposure of trauma in childhood, adolescence and adulthood was all associated with DLE. Further understanding of biological and cognitive pathways is required to unravel the association between trauma exposure and delusional-like experiences.

The association between physical health and delusional-like experiences: a general population study.

ObjectiveDelusional-like experiences (DLE) are prevalent in the community. Recent community based studies have found that DLE are more common in those with depression and anxiety disorders, and in those with subclinical symptoms of depression and anxiety. Chronic physical disorders are associated with comorbid depression and anxiety; however, there is a lack of evidence about the association of DLE with common physical conditions. The aim of this study was to explore associations between the common physical disorders and DLE using a large population sample.MethodsSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007, a national household survey of 8841 residents aged between 16 and 85 years. The presence of DLE, selected common physical disorders and symptoms were assessed using a modified World Mental Health Composite International Diagnostic Interview (CIDI) schedule. We examined the relationship between DLE, and physical health-related variables using logistic regression, with adjustments for potential confounding factors.ResultsOf the 8771, 776 (8.4%) subjects positively endorsed one or more DLE. Of the six physical disorders examined, only diabetes and arthritis were significantly associated with the endorsement of DLE. Of the seven broad physical symptoms explored, only hearing problems were consistently associated with DLE.ConclusionDelusional-like experiences are common in the Australian community, and are associated with selected chronic physical disorders and with impaired hearing. The direction of causality between these variables warrants closer research scrutiny.

The association between family history of mental disorder and delusional‐like experiences: A general population study

Recent studies have indicated that isolated delusional-like experiences (DLE) are common in the general population. Furthermore, there is preliminary evidence to suggest that these experiences are more common in those with a family history of mental disorders. We had the opportunity to explore the association between family history of a wide range of mental disorders and DLE in an Australian general population survey. The Australian National Survey of Mental Health and Wellbeing 2007 examined 8,841 adult community residents. The Composite International Diagnostic Interview was used to generate various DSM-IV lifetime diagnoses and to assess DLE. The participants were asked to report mental disorders in their first-degree relatives. The influence of family history of mental disorders on DLE endorsement was assessed with logistic regression, with adjustments for age, sex, and the presence of comorbid psychiatric diagnoses in the respondents. A family history of anxiety, depression, schizophrenia, bipolar disorder, or alcohol or illicit drug abuse/dependence was each significantly associated with endorsement of DLE, and these associations remained significant when we adjusted for the presence of mental illness in the respondents. When we examined a more restrictive definition of DLE, only a family history of depression and schizophrenia remained significantly associated with DLE. DLE are associated with a family history of a wide range of mental disorders. These findings suggest that familial factors associated with DLE may be shared with a wide range of common mental disorders.

The association between general psychological distress and delusional-like experiences: A large population-based study

BackgroundDelusional-like experiences (DLE) are prevalent in the community, and are associated with the both clinical and subclinical depression and anxiety. The aim of this study was to explore the association between general psychological distress and DLE adjusting for the presence of psychiatric disorders in a large population-based sample. MethodsSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007 (n=8841). DLE were assessed using a modified World Mental Health Composite International Diagnostic Interview (CIDI) schedule, and psychological distress was measured using the Kessler-10 (K10) short questionnaire. We examined the relationship between DLE and quartiles of K10 scores using logistic regression, adjusting for depression and anxiety disorders, and other potential confounding factors. The analyses were also repeated in the subgroup of the sample who were free of lifetime clinical diagnoses. ResultsOf the participants, 776 (8.4%) endorsed one or more DLE. Individuals with moderate and severe psychological distress were two to three times more likely to endorse DLE. The association remained significant after adjusting for potential confounding factors, and in the subgroup of the population who remained after excluding those who met criteria for lifetime diagnosis for any mental disorder. ConclusionWhile DLE have traditionally been associated with psychotic disorders, our results suggest that they are associated with non-specific psychological distress in otherwise-well individuals.

Drs. Scott, Najman, and McGrath Reply

Back to table of contents Previous article Next article Letters to the EditorFull AccessDrs. Scott, Najman, and McGrath ReplyJAMES SCOTT M.B.B.S., F.R.A.N.Z.C.P.JAKE NAJMAN Ph.D.JOHN MCGRATH M.D., Ph.D.,JAMES SCOTT M.B.B.S., F.R.A.N.Z.C.P.Search for more papers by this authorJAKE NAJMAN Ph.D.Search for more papers by this authorJOHN MCGRATH M.D., Ph.D.Search for more papers by this author,Published Online:1 Sep 2009https://doi.org/10.1176/appi.ajp.2009.09050742rAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We thank Mr. Richardson for drawing attention to the likely relationship between low socioeconomic status in childhood and adult delusional-like experiences. Low socioeconomic status in childhood is associated with a wide array of adverse health outcomes, affecting both physical (1) and mental health (2) . We are also interested in the influence of socioeconomic status on adult delusional-like experiences and adult psychosis but would like to consider a number of potential confounding factors. For example, parental mental health problems would be associated with both low childhood socioeconomic status and an increased risk of delusional-like experiences in offspring (3) . Abuse in childhood is known to be more prevalent in families with low socioeconomic status, but this exposure is also associated with psychotic symptoms in adulthood (4) . Thus, any relationship between childhood socioeconomic status and adult delusional-like experiences would probably be complex and warrants detailed and focused investigation. We look forward to reporting our findings in this area in future studies and encourage further exploration of the many factors influencing pathways to psychosis. Queensland, AustraliaThe authors’ disclosures accompany the original article.This letter (doi: 10.1176/appi.ajp.2009.09050742r) was accepted for publication in June 2009.

Influence of Socioeconomic Status on Delusional-Like Experiences in Adults

Back to table of contents Previous article Next article Letters to the EditorFull AccessInfluence of Socioeconomic Status on Delusional-Like Experiences in AdultsTHOMAS RICHARDSON B.A.,THOMAS RICHARDSON B.A.Search for more papers by this author,Published Online:1 Sep 2009https://doi.org/10.1176/appi.ajp.2009.09050742AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: I read with great interest the article by James Scott, M.B.B.S., F.R.A.N.Z.C.P., et al. (1) , published in the May 2009 issue of the Journal . Importantly, Scott et al. showed that measures of psychopathology identified at ages 5 and 14 years predict delusional beliefs at age 21. Although previous cross-sectional studies have documented such a relationship (2) , this is one of few longitudinal studies in the area. In order to minimize the effect of potential confounding variables, the authors made adjustments for gender, age, and substance use. After doing so, statistical relationships remained significant. The authors also appear to have collected data from the study cohort on a number of additional relevant demographic variables, such as education and marital status. However, they did not examine the effects of these variables on the relationship between childhood psychopathology and adult delusions but rather explored the effects of these variables on missing data. In my view, a number of these demographic variables may be relevant to the data described in the article. In particular, variables that relate to socioeconomic status may be important. Research suggests that low socioeconomic status is related to both behavior problems in childhood (3) and later schizophrenia (4) . It is plausible that the relationships observed by Scott et al. could be moderated or mediated by socioeconomic variables. For example, being from a low socioeconomic background could increase the risk of both childhood psychopathology and adult psychosis independently. Thus, controlling for socioeconomic variables may influence the effect size of such relationships. In addition, it would be interesting to examine the effect sizes of relationships in low versus high socioeconomic subsets comparatively. I am unsure exactly what, if any, additional data on socioeconomic variables the authors hold for the study cohort. However, if they do hold such data, examining the effects of socioeconomic status would bring new insight into the important relationships observed in their article, which does state that “understanding the biological and psychosocial factors that influence this developmental trajectory may provide clues into the pathogenesis of psychotic-like experiences” ( 1 , p. 567). Bath, United KingdomThe author reports no competing interests.This letter (doi: 10.1176/appi.ajp.2009.09050742) was accepted for publication in June 2009.

Psychopathology During Childhood and Adolescence Predicts Delusional-Like Experiences in Adults: A 21-Year Birth Cohort Study

Community surveys have shown that many otherwise well individuals report delusional-like experiences. The authors examined psychopathology during childhood and adolescence as a predictor of delusional-like experiences in young adulthood. The authors analyzed prospective data from the Mater-University of Queensland Study of Pregnancy, a birth cohort of 3,617 young adults born between 1981 and 1983. Psychopathology was measured at ages 5 and 14 using the Child Behavior Checklist (CBCL) and at age 14 using the Youth Self-Report (YSR). Delusional-like experiences were measured at age 21 using the Peters Delusional Inventory. The association between childhood and adolescent symptoms and later delusional-like experiences was examined using logistic regression. High CBCL scores at ages 5 and 14 predicted high levels of delusional-like experiences at age 21 (odds ratios for the highest versus the other quartiles combined were 1.25 and 1.85, respectively). Those with YSR scores in the highest quartile at age 14 were nearly four times as likely to have high levels of delusional-like experiences at age 21 (odds ratio=3.71). Adolescent-onset psychopathology and continuous psychopathology through both childhood and adolescence strongly predicted delusional-like experiences at age 21. Hallucinations at age 14 were significantly associated with delusional-like experiences at age 21. The general pattern of associations persisted when adjusted for previous drug use or the presence of nonaffective psychoses at age 21. Psychopathology during childhood and adolescence predicts adult delusional-like experiences. Understanding the biological and psychosocial factors that influence this developmental trajectory may provide clues to the pathogenesis of psychotic-like experiences.