Psychosis-like Experiences Research Articles

The impact of exposure to gun violence fatality on mental health outcomes in four urban U.S. settings

RationaleGiven the widespread availability of firearms, high prevalence of gun violence in the U.S., and the intersection of race, cumulative violence and adverse mental health outcomes, it is important to understand the mental health consequences of exposure to gun violence fatality on racially/ethnically diverse secondary victims. ObjectiveThe aims of this study were to examine 1) the prevalence and demographic differences in exposure to gun violence fatality; 2) the associations between exposure and depression, psychological distress, suicidal ideation and psychosis-like experiences; and 3) the interaction between race and exposure in relation to depression, psychological distress, suicidal ideation and psychotic experiences. MethodsParticipants (n=1615) were adult community residents from Baltimore, New York, Philadelphia, and Washington, D.C, who participated in the online Survey of Police-Public Encounters. Chi-square, linear, and logistic regression were used to test study aims. ResultsTwenty-four percent of respondents reported exposure to gun violence fatality. Black, Latinx, younger, and those of lower income and education were disproportionately exposed. Exposed respondents had significantly higher levels of psychological distress, depression, suicidal ideation and/or psychotic experiences compared to those not exposed. There was a significantly stronger association between exposure and depression among Latinxs and “other” races relative to Whites. ConclusionsFindings suggest that vicarious exposure to gun violence fatality is widespread, disproportionately experienced by racial/ethnic minorities, and related to a higher prevalence of mental health symptoms. Implications of these findings are that clinicians should attend to the mental health needs of people vicariously exposed to gun violence fatality, and that gun violence reduction interventions may positively impact community-level mental health. Given that Blacks and Latinxs are disproportionately exposed to gun violence, a more extensive examination of exposure to gun violence fatality as a social determinant of mental health is warranted using longitudinal and nationally representative data.

Associations between Race, Discrimination, Community Violence, Traumatic Life Events, and Psychosis-Like Experiences in a Sample of College Students.

Self-report tools of psychosis-like experiences contribute to the understanding of psychosis and may aid in identification and prevention efforts across the severity spectrum. Current tools are likely limited by biases, leading to potential systematic health disparities. Principal component analyses in diverse samples of community participants reporting psychosis-like experiences may aid in the detection of measurement biases. The current study evaluated the fit of a two-component model for the Prime Screen, a self-report psychosis-like experiences measure, in a sample of Black (n = 82) and White (n = 162) community participants, and subsequently evaluated the relation of these components with measures of mental well-being, traumatic life experiences, community violence, and experiences of discrimination. Analyses indicated limited support for a two-component model of the Prime Screen, with four of the items showing high cross-loading across both components (“poor fit” items). Although many Prime Screen items correlated with mental well-being as expected, correlations between item scores and mental well-being were non-significant for poor fit items. Community violence emerged as a significant predictor of some individual item scores for both good and poor fit items, while discrimination predicted only some poor fit item scores. Results highlight the potential limitations of current self-report tools of psychosis-like experiences, as well as possible considerations for improvement for use in diverse populations.

Binge drinking during pregnancy and psychosis-like experiences in the child at age 11.

Increased frequency of psychosis-like experiences (PLEs) has been previously reported in children born to mothers with high general levels of alcohol intake during pregnancy. The aim of this study was to examine whether the risk of PLEs was likewise elevated in children prenatally exposed to binge drinking. Participants were 44,326 children and their mothers enrolled in the Danish National Birth Cohort from 1996-2002. Information on maternal binge drinking was collected twice in pregnancy by telephone interview and PLEs in the children were ascertained in a Web-based questionnaire at age 11. Analyses were carried out using weighted multinomial logistic regression models. Maternal binge drinking was relatively common among the participating women (27%). The adjusted relative risk ratio (RRR) for reporting one definite PLE symptom was 1.04 (95% confidence interval (CI) 0.95-1.13) and 1.06 (95% CI 0.95-1.20) for two or more symptoms in children exposed compared to unexposed to binge drinking during pregnancy. Furthermore, no association was found when addressing frequency and timing of binge drinking, nor for various levels of average alcohol consumption. When sub-dividing PLEs into specific types of experiences however, a slightly, although non-significant, increased risk was observed for one specific delusional idea, receiving messages from radio/TV, following prenatal exposure to binge drinking. Our results provide no evidence of an association between maternal binge drinking, nor average alcohol consumption in pregnancy, and overall occurrence of PLEs in the offspring. However, our results indicated that binge drinking might be related to a specific PLE.

Environmental control and psychosis-relevant traits modulate the prospective sense of agency in non-clinical individuals.

The sense of agency concerns the experience of being the source of one's own actions and their consequences. An altered sense of agency can occur due to task automation and in psychosis. We tested in a non-clinical sample the hypothesis that reducing voluntary task control diminishes intentional binding as an implicit indicator of the sense of agency, possibly interacting with psychosis-relevant personality traits. Agent-device interactions were manipulated obtaining positive-control (voluntary interaction), no-control (automation), and negative-control (device-commanded interaction) groups. The main results showed reduced prospective intentional binding (predictive coding of action consequences) in the no-control and negative-control groups, compared to the positive-control group. Psychosis-like experiences covaried positively with intentional binding in the no-control group, but negatively in the negative-control group. Moreover, positive-social traits were associated with increased intentional binding in the positive-control group. These findings demonstrate the interplay between environmental and individual differences variables in establishing the implicit sense of agency.

"Formal Thought Disorder" in a General-Community Sample With Elevated Schizotypal Traits.

Different dimensions of formal thought disorder (FTD) are distinguished by different patterns of cognitive dysfunction and cortical variability in patients with schizophrenia; however, inconsistent findings may relate to patient-related confounds. Investigating FTD in nonpatient samples with elevated levels of schizotypal traits avoids these confounds, but its utility to FTD research is unknown. Thus, we performed principal components analysis (PCA) of FTD ratings using the Scale for the Assessment of Thought, Language, and Communication (TLC) and the Thought and Language Index (TLI) in a general-community sample with elevated schizotypal traits. Both scales showed "clinically elevated" FTD, particularly, the TLC. PCA described a three-component TLC solution ("disorganization," "verbosity," "emptiness") and a two-component TLI solution ("negative," "idiosyncratic"), generally consistent with schizophrenia research. TLC "disorganization" and "emptiness" were correlated with psychosis-like experiences. TLI "negative" was associated with lower general cognitive function, consistent with schizophrenia research. FTD may have shared etiology along the schizophrenia spectrum.

Validation of the Spanish-language Cardiff Anomalous Perception Scale.

The Cardiff Anomalous Perceptions Scale (CAPS) is a psychometric measure of hallucinatory experience. It has been widely used in English and used in initial studies in Spanish but a full validation study has not yet been published. We report a validation study of the Spanish-language CAPS, conducted in both Spain and Colombia to cover both European and Latin American Spanish. The Spanish-language version of the CAPS was produced through back translation with slight modifications made for local dialects. In Spain, 329 non-clinical participants completed the CAPS along with 40 patients with psychosis. In Colombia, 190 non-clinical participants completed the CAPS along with 21 patients with psychosis. Participants completed other psychometric scales measuring psychosis-like experience to additionally test convergent and divergent validity. The Spanish-language CAPS was found to have good internal reliability. Test-retest reliability was slightly below the cut-off, although could only be tested in the Spanish non-clinical sample. The scale showed solid construct validity and a principal components analysis broadly replicated previously reported three component factor structures for the CAPS.

Functional Connectivity of Corticostriatal Circuitry and Psychosis-like Experiences in the General Community

BackgroundPsychotic symptoms are proposed to lie on a continuum, ranging from isolated psychosis-like experiences (PLEs) in nonclinical populations to frank disorder. Here, we investigated the neurobiological correlates of this continuum by examining whether functional connectivity of dorsal corticostriatal circuitry, which is disrupted in psychosis patients and individuals at high risk for psychosis, is associated with the severity of subclinical PLEs. MethodsA community sample of 672 adults with no history of psychiatric or neurological illnesses completed a battery of seven questionnaires spanning various PLE domains. Principal component analysis of 12 subscales taken from seven questionnaires was used to estimate major dimensions of PLEs. Dimension scores from principal component analysis were then correlated with whole-brain voxelwise functional connectivity maps of the dorsal striatum in a subset of 353 participants who completed a resting-state neuroimaging protocol. ResultsPrincipal component analysis identified two dimensions of PLEs that accounted for 62.57% of variance in the measures, corresponding to positive (i.e., subthreshold delusions and hallucinations) and negative (i.e., subthreshold social and physical anhedonia) symptom-like PLEs. Reduced functional connectivity between the dorsal striatum and prefrontal and motor cortices correlated with more severe positive PLEs. Increased functional connectivity between the dorsal striatum and motor cortex was associated with more severe negative PLEs. ConclusionsConsistent with past findings in patients and individuals at high risk for psychosis, subthreshold positive symptomatology is associated with reduced functional connectivity of the dorsal circuit. This finding suggests that the connectivity of this circuit tracks the expression of psychotic phenomena across a broad spectrum of severity, extending from the subclinical domain to clinical diagnosis.

One-Month Stability of Cyberball Post-Exclusion Ostracism Distress in Adolescents.

We examined one-month reliability, internal consistency, and validity of ostracism distress (Need Threat Scale) to simulated social exclusion during Cyberball. Thirty adolescents (13-18 yrs.) completed the Cyberball task, ostracism distress ratings, and measures of related clinical symptoms, repeated over one month. Need Threat Scale ratings of ostracism distress showed adequate test-retest reliability and internal consistency at both occasions. Construct validity was demonstrated via relationships with closely related constructs of anxiety, anxiety sensitivity, and emotion dysregulation, and weaker associations with more distal constructs of state paranoia and subclinical psychosis-like experiences. While ratings of ostracism distress and anxiety were significantly attenuated at retest, most participants continued to experience post-Cyberball ostracism distress at one-month follow-up, which indicates that the social exclusion induction of Cyberball persisted despite participants' familiarity with the paradigm. Overall, results suggest that the primary construct of ostracism distress is preserved over repeated administration of Cyberball, with reliability sufficient for usage in longitudinal research. These findings have important implications for translating this laboratory simulation of social distress into developmental and clinical intervention studies.

Intentional inhibition but not source memory is related to hallucination-proneness and intrusive thoughts in a university sample

Proneness to unusual perceptual states – such as auditory or visual hallucinations – has been proposed to exist on a continuum in the general population, but whether there is a cognitive basis for such a continuum remains unclear. Intentional cognitive inhibition (the ability to wilfully control thoughts and memories) is one mechanism that has been linked to auditory hallucination susceptibility, but most evidence to date has been drawn from clinical samples only. Moreover, such a link has yet to be demonstrated over and above relations to other cognitive skills (source monitoring) and cognitive states (intrusive thoughts) that often correlate with both inhibition and hallucinations. The present study deployed two tests of intentional inhibition ability – the Inhibition of Currently Irrelevant Memories (ICIM) task and Directed Forgetting (DF) task – and one test of source monitoring (a source memory task) to examine how cognitive task performance relates to self-reported i) auditory hallucination-proneness and ii) susceptibility to intrusive thoughts in a non-clinical student sample (N = 76). Hierarchical regression analyses were used to assess the independent and combined contributions of task performance to proneness scores. ICIM performance but not DF or source memory scores were significantly related to both hallucination-proneness and intrusive thoughts. Further analysis suggested that intrusive thoughts may mediate the link between intentional inhibition skills and auditory hallucination-proneness, suggesting a potential pathway from inhibition to perception via intrusions in cognition. The implications for studying cognitive mechanisms of hallucination and their role in “continuum” views of psychosis-like experiences are discussed.

Assessing validity of retrospective recall of physical activity in individuals with psychosis-like experiences

Psychosis-like experiences are present in the general population and may indicate risk for more severe forms of psychosis. They are associated with cognitive impairments, potentially impacting ability to accurately complete certain self-report measures. This study investigated whether the presence of psychosis-like experiences was associated with impairments in retrospective reports of physical activity, a measure salient to this population, by comparing post-study questionnaire data on activity level with reports of activity contemporaneously collected through ecological momentary assessment (EMA). Participants (n = 39) were 18–25 years of age and recruited via stratified sampling to maximize representation of a full psychosis-like experience spectrum. Mobile questionnaires were sent six times a day for one week, and included questions probing amount and intensity of activity. Upon completion of the EMA week, participants completed a retrospective recall of the past week's activity. High levels of psychosis-like experiences were associated with poorer recall for past sedentary behavior as evidenced by the moderating effect of psychosis-like experiences on the relation between retrospective and in vivo measured sedentary activity (interaction effect: b = −0.26, t(1) = −2.04, p = 0.05, f2 = 0.08). Findings call into question the validity of retrospective self-reporting of activity level for those experiencing psychosis-like experiences.

Tobacco Smoking and Psychotic-Like Experiences in a General Population Sample.

Recent findings suggest an association between tobacco and psychosis, but whether this association is mediated by confounding factors is unknown. Psychosis-like experiences (PLEs) are a subclinical expression of psychosis. To disentangle the association of tobacco with PLEs, we examined data from a large US population-based, nationally representative sample. Analysis was conducted on Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (N = 34,653 adults, conducted from 2004 to 2005). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV. Twenty-two PLEs previously described as observed indicators of psychosis were used. Participants were stratified according to their smoking status (never/former/current) for 5 different types of tobacco. There was a significant association (ie, with 95% CIs for which the lower value was ≥ 1) between smoking status and 14 of the 22 assessed PLEs. These associations remained significant after adjustment for sociodemographic variables (including urbanicity or ethnicity), lifetime drug use disorder, and past-year cannabis use. While 26.33% of nonsmokers reported at least 1 PLE, this prevalence was slightly higher in former smokers (27.48%) and rose as high as 39.09% in current smokers (for current smokers vs lifetime abstainers, adjusted OR = 1.33; 95% CI, 1.23-1.45). All 22 PLEs had higher prevalence in smokers than in former smokers or lifetime abstainers. A total of 8.56% of smokers reported at least 5 PLEs, compared to 3.42% in lifetime abstainers (aOR = 1.56; 95% CI, 1.32-1.84). In a large population-based, nationally representative sample, smoking status was associated with various PLEs. This association was not explained only by other known risk factors of PLEs or schizophrenia. There is a need to identify the potential neurobiological mechanisms by which smoking and PLEs are associated, for patients and from a public health perspective.

Association between sleep, childhood trauma and psychosis-like experiences

Psychosis-like experiences (PLEs), or attenuated positive symptoms of psychosis, present along a severity continuum and have been associated with distressing thoughts and impairments in functioning. Although knowledge of the clinical importance of PLEs is expanding, risk factors for their expression are still poorly understood. Sleep disturbances are one known factor that exacerbate PLEs expression and distress, and trauma exposure is associated with occurrence of PLEs, as well as increased risk of later sleep difficulties. This study examined the joint influences of sleep and trauma on PLEs in an undergraduate sample. Self-report questionnaires on presence and distress of PLEs, sleep problems, and occurrence of previous traumatic experiences were completed by participants (N=409). In order to determine the unique impact of sleep on PLEs, three sets of predictors: sociodemographic, psychosocial (including trauma), and sleep were entered in steps into a hierarchical multiple regression model. In the final model, specific sleep domains uniquely predicted PLEs, while previous trauma exposure, which was a significant predictor when entered in step two with other psychosocial variables, was no longer a significant predictor. Results suggest the possibility that disruptions in sleep following or occurring alongside a traumatic experience may somehow contribute to, or exacerbate the presence of PLEs.

Features of borderline personality disorder as a mediator of the relation between childhood traumatic experiences and psychosis-like experiences in patients with mood disorder

BackgroundPsychosis-like experiences (PEs) are common in patients with non-psychotic disorders. Several factors predict reporting of PEs in mood disorders, including mood-associated cognitive biases, anxiety and features of borderline personality disorder (BPD). Childhood traumatic experiences (CEs), often reported by patients with BPD, are an important risk factor for mental disorders. We hypothesized that features of BPD may mediate the relationship between CEs and PEs. In this study, we investigated the relationships between self-reported PEs, CEs and features of BPD in patients with mood disorders. MethodsAs part of the Helsinki University Psychiatric Consortium study, McLean Screening Instrument (MSI), Community Assessment of Psychic Experiences (CAPE-42) and Trauma and Distress Scale (TADS) were filled in by patients with mood disorders (n = 282) in psychiatric care. Correlation coefficients between total scores of scales and their dimensions were estimated, multiple regression and mediation analyses were conducted. ResultsTotal scores of MSI correlated strongly with scores of the CAPE-42 dimension “frequency of positive symptoms” (rho = 0.56; p ≤ 0.001) and moderately with scores of TADS (rho = 0.4; p ≤ 0.001). Total score of MSI and its dimension “cognitive symptoms”, including identity disturbance, distrustfulness and dissociative symptoms, fully mediated the relation between TADS and CAPE-42. Each cognitive symptom showed a partial mediating role (dissociative symptoms 43% (CI = 25–74%); identity disturbance 40% (CI = 30-73%); distrustfulness 18% (CI = 12-50%)). ConclusionsSelf-reported cognitive-perceptual symptoms of BPD fully mediate, while affective, behavioural and interpersonal symptoms only partially mediate the relationships between CEs and PEs. Recognition of co-morbid features of BPD in patients with mood disorders reporting PEs is essential.

Posttraumatic stress symptoms and dissociation between childhood trauma and two different types of psychosis-like experience

This study examined the roles of posttraumatic stress (PTS) symptoms and dissociation in the relationship between childhood trauma and two different types of psychosis-like experience, including persecutory ideation and aberrant experience, in non-psychotic psychiatric patients. From August 2015 to August 2016, among psychiatric out patients seeking treatment at the Department of Psychiatry at a major teaching medical hospital in Seoul, Korea, 169 patients who had never been diagnosed with a psychotic disorder, including schizophrenia spectrum disorder, bipolar disorder, and/or depressive disorder with psychotic features, completed the Korean Childhood Trauma Questionnaire, the Korean version of the Impact of Event Scale-Revised, the modified Korean version of the Peritraumatic Dissociation Experiences Questionnaire, and the Korean Minnesota Multiphasic Personality Inventory-2 (MMPI-2). The RC 6 (Ideas of Persecution) and RC 8 (Aberrant Experiences) of the restructured scales of the MMPI-2 were used as a measure of persecutory ideation and aberrant experience. Structural equation modeling analyses confirmed a partial mediation model in which PTS symptoms partially mediated the relationship between childhood trauma and persecutory ideation, and dissociation partially mediated the relationship between childhood trauma and aberrant experience. This implies that there are distinct mechanisms depending on the type of psychosis-like experience in relation to childhood trauma.

Social isolation and psychosis-like experiences: a UK general population analysis

Background: Social isolation is a complex construct characterised by both objective and perceived components and has been commonly identified as a risk factor for psychosis-like experiences (PLEs). Few studies, however, have modelled the association between social isolation and PLEs in the general population.Method: Data from a UK general population survey (N = 7403) were analysed using latent class analysis to identify distinct groups of individuals characterised by the same profile of social isolation. Six objective and perceived indicators of social isolation (e.g. living alone; feeling socially isolated and lonely) were modelled. Associations between classes and PLEs were analysed using multivariate binary logistic regression analysis.Results: Three classes were identified: an isolated and lonely class (Class 1), a no communication or close relationships class (Class 2) and a baseline class (Class 3). Compared to the baseline class, Class 1 was significantly more likely to endorse thought interference (OR = 2.0) and paranoia (OR = 3.3), while Class 2 was significantly more likely to endorse paranoia (OR = 8.6) and hallucinations (OR = 1.9).Conclusions: Social isolation in the general population seems to vary between two distinct groups. PLEs, in turn, seem to vary depending on the nature of this isolation.

Fever and infections during pregnancy and psychosis-like experiences in the offspring at age 11. A prospective study within the Danish National Birth Cohort.

Maternal exposures to fever and infections in pregnancy have been linked to subsequent psychiatric morbidity in the child. This study examined whether fever and common infections in pregnancy were associated with psychosis-like experiences (PLEs) in the child. A longitudinal study of 46 184 children who participated in the 11-year follow-up of the Danish National Birth Cohort was conducted. Pregnant women were enrolled between 1996 and 2002 and information on fever, genitourinary infections, respiratory tract infection, and influenza-like illness during pregnancy was prospectively collected in two interviews during pregnancy. PLEs were assessed using the seven-item Adolescent Psychotic-Like Symptom Screener in a web-based questionnaire completed by the children themselves at age 11. PLEs were reported among 11% of the children. Multinomial logistic regression models with probability weights to adjust for potential selection bias due to attrition suggested that maternal fever, genitourinary infections and influenza-like illness were associated with a weak to moderate increased risk of subclinical psychosis-like symptoms in the offspring, whereas respiratory tract infections were not. No clear pattern was observed between the strengths of the associations and the timing of exposure, or the type of psychosis-like symptom. In this study, maternal exposures to fevers and common infections in pregnancy were generally associated with a subtle excess risk of PLEs in the child. A more pronounced association was found for influenza-like illness under an a priori definition, leaving open the possibility that certain kinds of infections may constitute important risk factors.

Evidence of absence: no relationship between behaviourally measured prediction error response and schizotypy

ABSTRACTIntroduction: The predictive processing framework has attracted much interest in the field of schizophrenia research in recent years, with an increasing number of studies also carried out in healthy individuals with nonclinical psychosis-like experiences. The current research adopted a continuum approach to psychosis and aimed to investigate different types of prediction error responses in relation to psychometrically defined schizotypy.Methods: One hundred and two healthy volunteers underwent a battery of behavioural tasks including (a) a force-matching task, (b) a Kamin blocking task, and (c) a reversal learning task together with three questionnaires measuring domains of schizotypy from different approaches.Results: Neither frequentist nor Bayesian statistical methods supported the notion that alterations in prediction error responses were related to schizotypal traits in any of the three tasks.Conclusions: These null results suggest that deficits in predictive processing associated with clinical states of psychosis are not always present in healthy individuals with schizotypal traits.

A new paradigm to measure probabilistic reasoning and a possible answer to the question why psychosis-prone individuals jump to conclusions.

Jumping to conclusions (JTC) distinguishes patients with schizophrenia from both healthy and psychiatric controls. JTC is typically assessed using the beads task, which, however, faces a number of limitations as to its interpretability and reliability. The present study set out to validate a new paradigm to assess JTC: the box task. We adopted a psychometric psychosis proneness approach and divided a large population sample into participants who scored high versus low on a scale tapping psychosis-like experiences. Participants performed a variant of the original beads task along with a new JTC task, the box task, with or without time pressure. The box task requires participants to infer which of two ball colors will be more prevalent in a matrix of boxes. The box task and the beads task were significantly correlated at a medium effect size, thus demonstrating criterion validity for the box task. As hypothesized, participants who scored high on psychosis-like experiences showed particularly strong JTC and a decreased decision threshold relative to low scorers, especially in the box task version with time pressure; in contrast, group differences in the beads tasks only achieved trend-wise significance. Mediation analyses showed that fewer draws to decisions were predicted by either a lower decision threshold or by higher initial probability estimates for the dominant item. The study establishes the criterion and construct validity of a new JTC task. Its advantages over the traditional beads task are better comprehensibility and usability; multiple parallel versions can be created thus raising reliability. (PsycINFO Database Record

Measuring fluctuations across the Continuum of Auditory Hallucinations. Development and validation of a state inventory

In order to identify causes and triggers of hallucinations that can inform therapy, reliable, valid, and change-sensitive instruments to assess hallucinatory experiences in the subclinical and clinical range are needed. We developed and validated a novel scale, the Continuum of Auditory Hallucinations - State Assessment (CAHSA), to be used for repeated assessment of the subclinical factors vivid imagination, intrusive thoughts, and perceptual sensitivity as well as auditory hallucinations. After selecting items for the four factors in a first test sample (n=84), we tested factorial validity using CFA and criterion validity with self-reported psychosis-like experiences (n=534). Finally, within-subject variation of CAHSA scores over 14 days and time-lagged associations between its factors were explored (n=85). A 9-item CAHSA was selected that showed good factorial validity, criterion validity, and substantial, valid within-subject variation. Time-lagged regression showed that vivid imagination, perceptual sensitivity, and intrusive thought precede auditory hallucinations. In sum, the CAHSA validly measures fluctuation along the continuum of auditory hallucinations, is sensitive to change, and well suited for experimental studies, repeated measurement, and longitudinal research.

SA9. Associations of Subclinical Psychosis Spectrum Characteristics, Childhood Depressive Symptoms, and Schizophrenia Polygenic Risk Score: Analyses From the Philadelphia Neurodevelopmental Cohort

Background: Despite heterogeneity in adult clinical presentation of psychotic disorders, the childhood precursors and genetic underpinnings of this heterogeneity are unclear. Risk profile scores (RPS) summarize an individual’s risk for developing schizophrenia based on common genetic variants associated with the disease. The Philadelphia Neurodevelopmental Cohort (PNC) is a publicly available data set including genetic and psychopathology information for a large sample of adolescents/young adults. In light of findings of increased affective symptoms in youth at risk of schizophrenia, we examined the association of childhood psychosis spectrum (PS) characteristics and childhood depressive symptoms in relation to RPS. Methods: Complete neuropsychiatric and RPS data were available for 3217 participants of European-American ancestry (ages 11–21) from the PNC. From a large psychopathology assessment, items related to prodromal symptoms and psychosis-like experience were combined into a composite PS score. Using other items tracking DSM-IV criteria, we created binary variables representing “quasi-diagnoses” (QDx) for childhood psychiatric conditions including depression. RPS were calculated using the most strongly illness-associated genetic variants identified by the multinational Psychiatric Genetics Consortium. We tested for associations of PS and depression QDx with RPS using logistic regression, then tested for differences in RPS across QDx and levels of PS with mixed model analyses. Analyses in the full sample were repeated for “11–15” and “16 and older” subgroups. Results: We divided the sample into top 20%/bottom 80% PS groups for the analyses. Prevalence of the QDx for at least 1 depressive episode was 12.1%. PS group alone was not associated with RPS. Depression episode QDx was associated with RPS at the more restrictive RPS P value thresholds (e.g., RPS_5e-08 P = .003; R2 = .009). In mixed model analyses for the full sample (ages 11–20), we observed a small main effect of depression QDx on RPS for schizophrenia (e.g., RPS_5e-08 P = .003; η2 = .003). We observed no effect of depression QDx or psychotic experience on RPS in the younger subgroup (11–15) and no interaction. The older group (16–20) again showed a main effect of depression (RPS_5e-08 P =.0003; η2 = .009) and, also, a small but significant interaction of depression with PS(RPS_5e-08 P = .012; η2 = .004). Findings were similar for males and females. Conclusion: Affective symptoms are frequently observed in youth at risk of schizophrenia. These analyses suggest that, especially in the years leading up to the typical age of onset, common genetic risk of schizophrenia may be more strongly associated with depressive symptomatology than with psychotic-like experience. The associations of RPS with psychopathology were evident for the RPS based on the most strongly associated (“GWAS significant”) markers and not at more inclusive levels of RPS.