Large General Population Sample Research Articles

Parallel exploratory and confirmatory factor analysis of the Hungarian Fear of COVID-19 Scale in a large general population sample: a psychometric and dimensionality evaluation

BackgroundThis study aims to confirm validity and reliability of the Hungarian version of Fear of COVID-19 Scale (FCV-19S) and evaluate its dimensional structure.MethodsCross-sectional survey was carried out in 2021 among Hungarian general population. In addition to classical test theory methods, construct dimensionality of FCV-19S was assessed using EFA with principal axis factoring method and CFA with diagonally-weighted least squares estimation. Fear score was compared in age, gender, educational level, vaccination and infection subgroups.ResultsSignificant differences in FCV-19S mean scores were observed between three subgroups (age, gender, vaccination). Items showed good internal consistency (Cronbach α = 0.88). EFA identified two latent factors (eig = 4.2 and 1.02), though parallel analysis supports the one-factor model. The two-dimensional structure was confirmed by CFA, items 3,4,6,7 correlated with Factor 1 (physiological fear), items 1,2,5 with Factor 2 (emotional fear).ConclusionThe Hungarian version of FCV-19S seems valid and reliable. The EFA identified two-latent factors (emotional and physiological fear), that was confirmed by CFA. The two-factor structure had better model fit, though its’ acceptance is limited.

Is unemployment benefit stigma related to poverty, payment receipt, or lack of employment? A vignette experiment about Australian views

AbstractThe present study sought to better understand the extent to which negative perceptions of people who receive unemployment benefits is due to their poverty status, their unemployment, and/or their receipt of income support payments. We sought to differentiate these three factors in a vignette‐based experiment drawing on a large Australian general population sample (N = 778). Participants rated the personality and capability of two fictional characters. The key experimental manipulation of employment status and benefit receipt was embedded in description of other characteristics. Participants rated vignette characters who received unemployment benefits less favorably on personality (conscientiousness, emotional stability, agreeableness), competence, and warmth than characters described as having a job, as being poor, or as not having a job but without mention of receiving benefits. There was a gradient in the strength of negative assessments across these conditions, but only warmth, conscientiousness and employability distinguished between individuals receiving unemployment benefits and individuals without a job but no reference to benefit receipt. This study provides new insights showing that receiving benefits due to unemployment contributes to negative perceptions over and above the effects of poverty or being unemployed.

A network approach to relationships between cannabis use characteristics and psychopathology in the general population

Cannabis use characteristics, such as earlier initiation and frequent use, have been associated with an increased risk for developing psychotic experiences and psychotic disorders. However, little is known how these characteristics relate to specific aspects of sub-clinical psychopathology in the general population. Here, we explore the relationships between cannabis use characteristics and psychopathology in a large general population sample (N = 2,544, mean age 29.2 years, 47% women) by employing a network approach. This allows for the identification of unique associations between two cannabis use characteristics (lifetime cumulative frequency of cannabis use, age of cannabis use initiation), and specific psychotic experiences and affective symptoms, while controlling for early risk factors (childhood trauma, urban upbringing). We found particularly pronounced unique positive associations between frequency of cannabis use and specific delusional experiences (persecutory delusions and thought broadcasting). Age of cannabis use initiation was negatively related to visual hallucinatory experiences and irritability, implying that these experiences become more likely the earlier use is initiated. Earlier initiation, but not lifetime frequency of cannabis use, was related to early risk factors. These findings suggest that cannabis use characteristics may contribute differentially to risk for specific psychotic experiences and affective symptoms in the general population.

The structure of the symptoms of major depression: Factor analysis of a lifetime worst episode of depressive symptoms in a large general population sample

BackgroundA range of depressive symptoms may occur during an episode of major depression (MD). Do these symptoms describe a single disorder liability or different symptom dimensions? This study investigates the structure and clinical relevance of an expanded set of depressive symptoms in a large general population sample. MethodsWe studied 43,431 subjects from the Dutch Lifelines Cohort Study who participated in an online survey assessing the 9 symptom criteria of MD (DSM-IV-TR) and additional depressive symptoms during their worst lifetime episode of depressive symptoms lasting two weeks or more. Exploratory factor analyses were performed on expanded sets of 9, 14, and 24 depressive symptoms. The clinical relevance of the identified symptom dimensions was analyzed in confirmatory factor analyses including ten external validators. ResultsA single dimension adequately accounted for the covariation among the 9 DSM-criteria, but multiple dimensions were needed to describe the 14 and 24 depressive symptoms. Five dimensions described the structure underlying the 24 depressive symptoms. Three cognitive affective symptom dimensions were mainly associated with risk factors for MD. Two somatic dimensions –appetite/weight problems and sleep problems—were mainly associated with BMI and age, respectively. LimitationsRespondents of our online survey tended to be more often female, older, and more highly educated than non-respondents. ConclusionsDifferent symptom dimensions described the structure of depressive symptoms during a lifetime worst episode in a general population sample. These symptom dimensions resembled those reported in a large clinical sample of Han-Chinese women with recurrent MD, suggesting robustness of the syndrome of MD.

Sexual assault and psychosis in two large general population samples: Is childhood and adolescence a developmental window of sensitivity?

BackgroundResearch has shown a strong relationship between psychosis and sexual assault. Theories on developmental trauma as a causal factor for psychosis suggest that exposure to sexual trauma in childhood would have a stronger association with psychosis than sexual trauma in adulthood. We hypothesized that exposure to sexual trauma earlier in childhood and adolescence would be more strongly associated with hallucinations, delusional beliefs and psychotic disorder than sexual trauma that occurred later in life. MethodsUsing the 2007 and 2014 Adult Psychiatric Morbidity Surveys (N = 14,949) we calculated the prevalence of sexual assault, hallucinations, delusional beliefs, and psychotic disorder. We used logistic regression to examine the relationship between age of exposure to sexual assault (first exposure <16 vs first exposure ≥16) and odds of hallucinations, delusions, and psychotic disorder. ResultsSexual assault at any age was associated with an increased odds of hallucinations (aOR = 2.00, 95%CI = 1.63–2.46), delusional beliefs (aOR = 2.55, 95%CI = 2.24–2.89) and psychotic disorder (aOR = 5.28, 95%CI = 3.59–7.76). There was no significant difference, however, in the prevalence of hallucinations, delusional beliefs or psychotic disorders in individuals first exposed to sexual assault <16 and individuals first exposed ≥16. ConclusionsContrary to our hypothesis, we did not find evidence that exposure to sexual assault in childhood and adolescence was more strongly associated with hallucinations, delusional beliefs or psychotic disorder than exposure to sexual assault age >16. Our findings do not support the idea that childhood and adolescence are uniquely sensitive periods for the emergence of psychotic experiences or psychotic disorder in relation to sexual trauma.

Assessment of General Family Functioning: Psychometric Evaluation of the German Version of the Brief Assessment of Family Functioning Scale

The functionality of the family system is not only a central theme in developmental psychology and family research, but also plays a key role in many physical illnesses and mental disorders. Despite its high relevance, there are only a very few brief and user-friendly self-report measures assessing general family functioning. This gap is closed by the Brief Assessment of Family Functioning Scale (BAFFS), which consists of three items of the General Functioning Scale of the internationally well-established Family Assessment Device. In this study, the German version (KSAFF) of the BAFFS was psychometrically evaluated for the first time in a large and representative general population sample (n=2463). Using multigroup confirmatory factor analyses, strong measurement invariance was shown for relevant subsamples (women vs. men; participants in partnerships with vs. without children) with good model fit. Although one of the three items, which is the only negatively formulated item, yielded insufficient psychometric item characteristics, the internal consistency was Cronbach's α=0.71. As an indication of adequate construct validity, associations of family functioning with socioeconomic status as well as with current depression and anxiety were found in accordance with the hypothesis. Although application experiences and psychometric analyses of the German version of the BAFFS in relevant clinical samples are pending, this three-item self-report measure can be recommended as an economic, user-friendly assessment device for general family functioning, particularly since it yielded satisfactory to good psychometric properties in the general population.

Further developing the Frith-Happé animations: A quicker, more objective, and web-based test of theory of mind for autistic and neurotypical adults.

The Frith-Happé Animations Test, depicting interactions between triangles, is widely used to measure theory of mind (ToM) ability in autism spectrum disorder (ASD). This test began with recording, transcribing, and subjectively scoring participants' verbal descriptions, which consistently found ToM-specific difficulties in ASD. More recently in 2011, White et al. created a more objective version of this ToM test using multiple-choice questions. However, there has been surprisingly little uptake of this test, hence it is currently unclear if White et al.'s findings replicate. Further, the lack of an online version of the test may be hampering its use in large-scale studies and outside of research settings. Addressing these issues, we report the development of a web-based version of the Frith-Happé Animations Test for autistic and neurotypical adults. An online version of the test was developed in a large general population sample (study 1; N=285) and online data were compared with those collected in a lab-based setting (study 2; N=339). The new online test was then administered to adults with a clinical diagnosis of ASD and matched neurotypical controls (study 3; N=231). Results demonstrated that the test could successfully be administered online to autistic adults, who showed ToM difficulties compared to neurotypical adults, replicating White et al.'s findings. Overall, we have developed a quicker, more objective, and web-based version of the Frith-Happé Animations Test that will be useful for social cognition research within and beyond the field of autism, with potential utility for clinical settings. LAY SUMMARY: Many autistic people find it hard to understand what other people are thinking. There are many tests for this 'mentalising' ability, but they often take a long time to complete and cannot be used outside of research settings. In 2011, scientists used short silent animations of moving shapes to create a fast way to measure mentalising ability. We developed this into an online test to use in research and clinics to measure mentalising ability in autism.

Valuation of SF-6Dv2 Health States in China Using Time Trade-off and Discrete-Choice Experiment with a Duration Dimension.

ObjectivesOur objective was to generate a value set for the SF-6Dv2 using time trade-off (TTO) and a discrete-choice experiment with a duration dimension (DCETTO) in China.MethodsA large representative sample of the Chinese general population was recruited from eight provinces/municipalities in China, stratified by age, sex, education level, and proportion of urban/rural residence. Respondents completed eight TTO tasks and ten DCETTO tasks during face-to-face interviews. Ordinary least squares (OLS), random-effects, fixed-effects, and Tobit models were used for TTO data, and conditional logit and mixed logit models were used for DCETTO. The monotonicity of model coefficients and the consistency of the predicted values according to intraclass correlation coefficient (ICC), mean absolute difference (MAD), and mean squared difference (MSD) were compared between the two approaches.ResultsIn total, 3320 respondents (50.3% male; range 18–90 years) were recruited. The random-effects model and the conditional logit model were preferred for the TTO and DCETTO, respectively. The TTO values ranged from − 0.277 to 1, with 927 (4.94%) states considered as worse than dead (WTD). The corresponding range for DCETTO was − 0.535 to 1, with a higher WTD of 8.50%. DCETTO presented minor non­monotonicity with the coefficients in two dimensions. Values from the two approaches were highly consistent (ICC 0.9804, MAD 0.0588, MSD 0.0055), albeit those with DCETTO were slightly lower than those with TTO. The value set generated by TTO was preferred given the better monotonicity and the statistical significance of coefficients.ConclusionsThe Chinese value set for the SF-6Dv2 was established based on the TTO approach, but the DCETTO also performed well. Minor issues of non­monotonicity did present for DCETTO.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-020-00997-1.

Lower values of a novel index of Vagal-Neuroimmunomodulation are associated to higher all-cause mortality in two large general population samples with 18\xa0year follow up

In recent clinical practice, a biomarker of vagal neuroimmunomodulation (NIM), namely the ratio of vagally-mediated heart rate variability (vmHRV) and CRP, was proposed to index the functionality of the cholinergic anti-inflammatory pathway. This study aims to transfer and extend the previous findings to two general population-based samples to explore the hypothesis that NIM-ratio is associated with all-cause mortality. Two large population studies (MIDUS 2: N = 1255 and Whitehall II wave 5: N = 7870) with complete data from a total of N = 3860 participants (36.1% females; average age = 56.3 years; 11.1% deaths, last exit 18.1 years post inclusion) were available. NIM indices were calculated using the vagally-mediated HRV measure RMSSD divided by measures of CRP (NIMCRP) or IL-6 (NIMIL6). The NIM-ratios were quartiled and entered into age, ethnicity and body mass index adjusted Cox proportional hazards models. For NIMIL6 the lowest quartile was 45% more likely to die during the observed period (max. 18 years follow-up) compared to the highest quartile (HR = 0.55 CI 0.41–0.73; p < .0001). NIMCRP parallel these results. Here we show that an easily computable index of IL-6 inhibition is associated with all-cause mortality in two large general population samples. These results suggest that this index might be useful for risk stratification and warrant further examination.

2D:4D and Self-Employment: A Preregistered Replication Study in a Large General Population Sample

The 2D: 4D digit ratio, the ratio of the length of the second finger to the length of the fourth finger, is often considered a proxy for testosterone exposure in utero. A recent study reported, among other things, an association between the left-hand 2D:4D and self-employment in a sample of 974 adults. In this preregistered study, we replicate the 2D:4D results on a sample of more than 2100 adults from the German Socioeconomic Panel-Innovation Sample (SOEP-IS). We find no statistically significant associations between 2D:4D and self-employment.

Spatial working memory in young adolescents with different childhood trajectories of internalizing, conduct and hyperactivity/inattention problems.

In children, internalizing and externalizing problems impact on learning. However, there is limited research on the specific impact of such problems on spatial working memory (SWM), strongly related to cognitive ability and children's learning. We explored distinct trajectories of internalizing problems and externalizing problems (conduct problems and hyperactivity/inattention) in a large general-population sample of children followed from age 3 to age 11years. We then assessed their role in SWM performance at age 11years. Data were drawn from the UK's Millennium Cohort Study. Our analytic sample was children with data on SWM at age 11years (N=12,589). There were two stages of data analysis. Trajectory group membership was firstly estimated by group-based trajectory modelling for internalizing problems, conduct problems, and hyperactivity/inattention at ages 3-11years. Multiple regression then assessed the relationship between SWM at age 11years and trajectory group membership after accounting for confounders. Trajectories of internalizing, conduct, and hyperactivity/inattention symptoms across ages 3 to 11years were related to SWM at age 11years, even after controlling for confounding variables. For each of the three symptom domains, poor SWM was most consistently found in children with chronically high levels of symptoms. In general, atypical patterns of internalizing problems, conduct problems, and hyperactivity/inattention in childhood were related to poorer SWM in early adolescence.

"INSIDE" Project on Sexual Health in Spain: Sexual Life During the Lockdown Caused by COVID-19.

IntroductionThe COVID-19 pandemic is becoming a major hazard to public health worldwide. This is causing a significant impact on life and physical health, as well as on the psychological well-being of the general population. Since the emotional distress and the social restrictions caused by this epidemic, it must be expected that its impact will also extend to sexual health. The purpose of this study, the first including a large sample of the Spanish general population, was to analyze sexual behavior during the 99 days of confinement in Spain (INSIDE Project).MethodOne thousand four hundred forty-eight Spanish people, between 18 and 60 years old, were evaluated through an online survey during April 2020. The variables analyzed were the physical and social environment during confinement, sexual desire, type of sexual activity, masturbation, sexual intercourse, online sexual activity, general sexual frequency, sexual fantasies, degree of self-control over sexual drive, sexual abuse, general impact of confinement on sexuality, and emotional mood.ResultsConfinement has affected the sexual life of half of the Spanish population (47.7%), especially women. Those who reported a worsening of their sexual life are almost three times more (37.9%) than those who reported an improvement (14.4%).ConclusionsDifferent factors have been significant predictors of the positive or negative evaluation about the impact of this confinement on sexual life, such as gender, couple life, privacy, stress level, and the perception of confinement as unbearable.Policy ImplicationsThese results have important implications for the public health and more especially sexual health of the Spanish population.

Liver fibrosis marker is an independent predictor of cardiovascular morbidity and mortality in the general population

BackgroundA growing body of evidence suggests that Non-alcoholic fatty liver disease (NAFLD) and liver fibrosis are associated with cardiovascular disease (CVD). However, the independent role of liver fibrosis markers in the prediction of CVD in the general population is seldom tested. AimsTo assess whether a marker of liver fibrosis predicts the first occurrence of a CVD event in a large sample of community-based general population. MethodsHistorical cohort using data from a large health provider that operates a centralized computerized medical record. The level of liver fibrosis was measured by the fibrosis-4 (FIB-4) score, and the association with CVD was adjusted for the European Systematic Coronary Risk Evaluation calculator (SCORE). ResultsThe study included 8,511 individuals, 3,292 with inconclusive fibrosis and 195 with advanced fibrosis (FIB-4 ≥ 2.67). People with advanced fibrosis had higher risk for CVD, after adjustment for sociodemographic characteristics, the SCORE, use of statins and aspirin (HR [95%CI], 1.63 [1.29–2.06]). The association persisted in both women and men. Using age-specific cut-offs, there was a dose-response association between inconclusive and advanced fibrosis and CVD (HR [95%CI], 1.15 [1.01–1.31]) and HR [95%CI], 1.60 [1.27–2.01], respectively, P for trend<0.001). ConclusionsA simple fibrosis score is independently associated with CVD, suggesting that fibrosis markers should be considered in primary-care risk assessment.

P.267 Association of chronotype and variation in the CLOCK gene in a large general European population sample

Classic arterial and venous anatomy of the upper extremity are presented in this chapter. Congenital variants are discussed, as well as clinical correlates.

Die deutsche Version des Reflective Functioning Questionnaire (RFQ): Eine teststatistische Überprüfung in der Allgemeinbevölkerung

The concept of mentalization has attracted broad clinical and scientific interest, particularly because of its high clinical and therapeutic relevance. To make this concept accessible for empirical research, the 8-item Reflective Functioning Questionnaire (RFQ-8) was developed, which comprises 2 subscales tapping into uncertainty about mental states (or hypomentalizing), and certainty about mental states (i. e. hypermentalizing). Although first psychometric examinations have evaluated the RFQ-8 positively, these findings must be interpreted with caution for methodological reasons. The aim of this study was the psychometric evaluation of the German version of the RFQ-8 in a large general population sample (n=2477). Various confirmatory and exploratory factor analyses indicated that the originally introduced 2-factor solution is mis-specified. Instead, the RFQ-8 seems to cover a unidimensional construct. Having excluded 2 items due to their insufficient psychometric qualities, the 6-item measure (RFQ-6) showed high internal consistency (McDonald's ω=0,88) as well as significant rank correlations with depression, anxiety and bodily complaints. Considering the psychometric limitations of the RFQ-8, its use in clinical routine and research should be viewed very critically, particularly with respect to its ability to assess hypermentalizing.

Defining the normal QT interval in newborns: the natural history and reference values for the first 4 weeks of life.

Evaluation of the neonatal QT interval is important to diagnose arrhythmia syndromes and evaluate side effects of drugs. We aimed at describing the natural history of the QT interval duration during the first 4 weeks of life and to provide reference values from a large general population sample. The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation of newborns. Eight-lead electrocardiograms were obtained and analysed with a computerized algorithm with manual validation. We included 14164 newborns (52% boys), aged 0-28 days, with normal echocardiograms. The median values (ms, 2-98%ile) for the corrected intervals QTc (Bazett), QTc (Hodges), QTc (Fridericia), and QTc (Framingham) were 419 (373-474), 419 (373-472), 364 (320-414), and 363 (327-405). During the 4 weeks, we observed a small decrease of QTcFramingham, and an increase of QTcHodges (both P < 0.01), while QTcBazett and QTcFridericia did not change (P > 0.05). Applying published QT interval cut-off values resulted in 5-25% of the newborns having QT prolongation. Uncorrected QT intervals decreased linearly with increasing heart rate (HR). Sex and infant size did not affect the QT interval and the gestational age (GA) only showed an effect when comparing the extreme low- vs. high GA groups (≤34 vs. ≥42 weeks, P = 0.021). During the 4 weeks QTcFramingham and QTcHodges showed minor changes, whereas QTcBazett and QTcFridericia were stable. The QT interval was unaffected by sex and infant size and GA only showed an effect in very premature newborns. Reference values for HR-specific uncorrected QT intervals may facilitate a more accurate diagnosis of newborns with abnormal QT intervals.

Seasonality of mood and affect in a large general population sample.

Mood and behaviour are thought to be under considerable influence of the seasons, but evidence is not unequivocal. The purpose of this study was to investigate whether mood and affect are related to the seasons, and what is the role of neuroticism in this association. In a national internet-based crowdsourcing project in the Dutch general population, individuals were invited to assess themselves on several domains of mental health. ANCOVA was used to test for differences between the seasons in mean scores on the Positive and Negative Affect Schedule (PANAS) and Quick Inventory of Depressive Symptomatology (QIDS). Within-subject seasonal differences were tested as well, in a subgroup that completed the PANAS twice. The role of neuroticism as a potential moderator of seasonality was examined. Participants (n = 5,282) scored significantly higher on positive affect (PANAS) and lower on depressive symptoms (QIDS) in spring compared to summer, autumn and winter. They also scored significantly lower on negative affect in spring compared to autumn. Effect sizes were small or very small. Neuroticism moderated the effect of the seasons, with only participants higher on neuroticism showing seasonality. There was no within-subject seasonal effect for participants who completed the questionnaires twice (n = 503), nor was neuroticism a significant moderator of this within-subjects effect. The findings of this study in a general population sample participating in an online crowdsourcing study do not support the widespread belief that seasons influence mood to a great extent. For, as far as the seasons did influence mood, this only applied to highly neurotic participants and not to low-neurotic participants. The underlying mechanism of cognitive attribution may explain the perceived relation between seasonality and neuroticism.

The effect of Sexual violence on women’s suicide risk. A mediation analysis based on the nationally-representative 2017 French Health Barometer survey

Abstract Objectives The experience of sexual violence has been associated with a host of mental health problems, especially among women. However, data on this association from a large sample of general population is surprisingly limited. Also, no study quantifies sex-differences in the effect of sexual victimization on suicide risk. Methods The French “Health Barometer” (Baromètre Santé) is a cross-sectional phone survey, which recruited a nationally representative sample of French adults aged 18 to 75 years in 2017 (n = 25319). Data were weighted to be representative of the French adult population. The Experience and timing of lifetime physical sexual violence, as well as suicide risk were measured for all participants. We conducted adjusted mediation analyses, using the counterfactual approach, to evaluate the contribution that lifetime sexual victimisation has in the association between sex and suicide risk. Results The median age for the first experience of sexual violence was 12. Women were around five times more likely to report lifetime sexual violence compared to men (9.1% vs 1.9%), and were more at risk of any suicidal ideation (Ora =1.20 (95%CI: 1.07-1.36)) and suicidal imagery (Ora=1.39 (95%CI: 1.20 -1.61)). We estimated that 47% of the increased risk of suicidal ideation in the preceding year women have compared to men is mediated by lifetime sexual assault. Lifetime sexual assault also explained 39% of the association between sex and having imagery of suicide. Discussion Our findings reiterate the importance of the prevention of sexual violence and an adequate care for sexual assault victims, especially women, in public health and mental health policies and initiatives.

S4. IDENTIFYING HETEROGENEITY IN SYMPTOM NETWORKS IN THE GENERAL POPULATION: A RECURSIVE PARTITIONING APPROACH

BackgroundNetwork models of psychopathology have gained increasing ground recently. It is suggested that psychopathology arises from the reciprocal associations between symptoms and other psycho-biological factors. Given the heterogeneity in psychopathological phenomena, it seems likely that subgroups with distinct network structures may emerge given different demographic and environmental risk factors. Thus, the identification of heterogeneity in symptom networks associated with specific variables may promote an understanding of the mechanisms that underlie the relation between environmental factors and psychopathology.MethodsWe took a recursive partitioning approach based on conditional inference trees that iteratively splits the sample of interest based on a predefined set of covariates to detect subgroups with significantly different network structures, resulting in a network tree. We used general population data from the 2000 and 2007 English National Survey of Psychiatric Morbidity, with a combined sample size of n = 15,983 (age range: 16–95 years, 55.9% female), to model networks of psychotic experiences (hallucinations, persecutory ideation) and affective symptoms (worry, mood instability, depression, anxiety, sleep problems). Split variables explored as sources of heterogeneity in networks were sex, age, and exposure to environmental risk factors (cannabis use in past month, lifetime sexual abuse, lifetime experience of bullying). We used a stop-splitting rule based on Bonferroni-adjusted p-values to determine the final tree size (α = .01).ResultsEnvironmental factors were the primary sources of heterogeneity in network structures, with exposure to these factors being linked to more densely connected networks. Globally, cannabis use was associated with particularly strong connections between hallucinations and persecutory ideation, depression and persecutory ideation, and depression and mood instability. In those participants with cannabis use and experiences of sexual abuse, the association between depression and persecutory ideation was particularly strong, and further, strong connections were present between the affective symptoms. Similarly, those with exposure to both cannabis and bullying showed stronger associations involving sleep problems than participants exposed to either bullying or cannabis alone. Exposure to either bullying or sexual abuse without concurrent cannabis use was linked to a strongly connected cluster of worry, anxiety, and depression, with only weak associations to other symptoms. Lastly, the sample was split at 60 years of age. The younger group was divided further by age, with participants younger than 26 years showing stronger associations between hallucinations and persecutory ideation and worry and depression than those older than 26 years. In participants older than 60 years, another split was made by gender: women showed a more densely connected network than men.DiscussionFindings from this exploratory analysis document substantial heterogeneity in symptom network structures in a large general population sample. Exposure to risk factors is linked to more strongly connected, probably less resilient symptom networks, with evidence for additive vulnerability given the presence of several risk factors. Exposure to sexual abuse or bullying mainly seems to relate to higher connectivity of affective symptoms, while cannabis use links to higher connection of psychotic symptoms with each other, but also with affective symptoms. The analysis also highlights demographic variables as sources of heterogeneity in symptom networks, pointing to specifically relevant symptom interactions in subgroups of age and gender.

M153. THE RELATION BETWEEN PSYCHOTIC EXPERIENCES AND SLEEP IMPAIRMENTS IN THE GENERAL POPULATION

BackgroundAlthough previous studies reported a link between sleep dysfunction and psychotic symptoms, more detailed information is needed to translate this association into clinical practice. This study investigates the impact of different aspects of sleep quality on prevalence, type and severity of psychotic-like experiences, in a large general population sample. In doing so, we distinguish between hallucinations in the auditory (AH) and visual (VH) domains and delusions, to arrive at a more comprehensive understanding of the detrimental effects of impaired sleep.MethodsAn online survey was used to gather information on self-reported psychotic-like experiences and sleep quality in a sample of 10.301 Dutch participants (median age 32 yrs; 68.9% females). The Questionnaire for Psychotic Experiences (QPE) was used to assess aspects of AH and VH. A subset of the participants also filled-out a second part of the QPE regarding occurrence of delusion. Furthermore, a measure of general sleep quality was derived based on seven sleep domains as assessed using the Pittsburgh Sleep Quality Index (PSQI).Binomial logistic regression was used to investigate the effects of the seven sleep domains on the likelihood that participants had experienced hallucinations in the preceding week, using 3324 participants with and a random subsample of 3391 participants without such experiences. The same analysis was performed on the data regarding delusions, using 438 participants with and a random subsample of 445 participants without delusions in the past week. Reported odds ratios (OR) reflect the increment in likelihood of occurrence of hallucinations and delusions.To further assess whether impaired sleep affects the level of distress caused by hallucinations, participants were divided into ‘good’ and ‘poor’ sleepers using a cut-off score of 5 points on the total PSQI score. Chi-square tests were then used to compare the two groups on occurrence of distressing vs non-distressing AH and VH.ResultsImpaired sleep showed to entail significant predictors of the prevalence of hallucinations. Specifically, sleeping less than 5 hours a night (OR 1.88), having sleep disturbances more than 3 times a week (OR 5.81), the use of sleep medication more than 2 times a week (OR 1.61) and decreased daytime functioning more than 3 times a week (OR 1.87) increased the odds to experience hallucinations, as compared to participants without these sleep difficulties. Furthermore, experiencing sleep disturbances more than 2 times a week (OR 9.24) and decreased daytime functioning more than 2 times a week (OR 5.53) also strongly increased the odds to experience delusions. Subjective sleep quality, sleep latency, and sleep efficiency were not significant predictors for the prevalence of hallucinations or delusions.Importantly, sleep impairment also affected the experienced distress as caused by hallucinations. A larger proportion of the poor sleepers than of the good sleepers experienced distressing AH (p < .001) and reported that the AH had a negative impact on their functioning (p < .001). Likewise, a larger proportion of the poor sleepers than of the good sleepers reported distressing VH (p < .001) and reported a negative impact of VH on their functioning (p < .001).DiscussionSleep impairments were associated with increased prevalence of psychotic-like experiences, and with more severe distress as caused by hallucinations. Sleep restoration should be explored as a first line intervention for people suffering from psychotic-like experiences. In case of delusions, such interventions should be directed at decreasing the number of nightly disturbances, while for individuals suffering from hallucinations additional focus should be put on increasing the achieved hours of sleep.