Subclinical Psychotic-like Experiences Research Articles

Resting-state alterations in emotion salience and default-mode network connectivity in atypical trajectories of psychotic-like experiences.

Social cognition is commonly altered in people with psychosis. Two main brain networks have been implicated: the default-mode network (DMN), which is associated with socio-cognitive processing, and the salience network (SN) associated with socio-affective processing. Disturbances to the resting-state functional connectivity of these networks have been identified in schizophrenia and high-risk individuals, but there have been no studies in adolescents displaying distinct trajectories of subclinical psychotic-like experiences (PLEs). To address this, the present study measured SN and DMN resting-state connectivity in a unique longitudinally followed sample of youth (n = 92) presenting with typical and atypical 4-year PLE trajectories. Compared to the typically developing low PLE control group, the atypical increasing PLE trajectory displayed reduced connectivity between the SN and DMN, increased connectivity between left and right insula, and widespread dysconnectivity from the insula and amygdala. These alterations are similar to those reported in schizophrenia and clinical high-risk samples, suggesting that early detection may be useful for mapping the developmental trajectories of psychotic disorders.

Disparities in Psychosis Risk Symptoms for New Zealand Māori May Be Explained by Systemic Stressors and Inappropriate Conceptualization of Culturally Normative Experiences.

Māori, the indigenous peoples of New Zealand, experience increased rates of psychotic disorders and first-episode psychosis. However, it is unclear whether they also present with increased psychosis risk symptoms, such as subclinical psychotic-like experiences (PLEs). Measurement of risk symptoms is key for early intervention. Further, it is unclear if systemic factors such as the increased rates of social adversity and discrimination or cultural biases contribute to this disparity in psychosis rates. This study surveyed 466 18- to 30-year olds in New Zealand, and compared Māori to non-Māori participant responses on the Prodromal Questionnaire Brief, alongside the history of childhood trauma, discrimination, and financial adversity. Māori reported a higher number of PLEs compared to non-Māori-however, this was not associated with increased distress related to these experiences. The increased number of psychosis-like experiences reported by Māori was likely explained by systemic factors such as childhood trauma, discrimination, and financial stress. Māori were more likely to report that the PLEs were positive. Measurement of psychosis risk for Māori is nuanced, and increased scores on these tools may reflect pathologizing potentially normative experiences for Māori, such as spiritual encounters or discrimination, alongside the impact of increased rates of systemic discrimination, trauma, and financial stress.

Associations Between Cannabis Use, Polygenic Liability for Schizophrenia, and Cannabis-related Experiences in a Sample of Cannabis Users.

Risk for cannabis use and schizophrenia is influenced in part by genetic factors, and there is evidence that genetic risk for schizophrenia is associated with subclinical psychotic-like experiences (PLEs). Few studies to date have examined whether genetic risk for schizophrenia is associated with cannabis-related PLEs. We tested whether measures of cannabis involvement and polygenic risk scores (PRS) for schizophrenia were associated with self-reported cannabis-related experiences in a sample ascertained for alcohol use disorders (AUDs), the Collaborative Study on the Genetics of Alcoholism (COGA). We analyzed 4832 subjects (3128 of European ancestry and 1704 of African ancestry; 42% female; 74% meeting lifetime criteria for an AUD). Cannabis use disorder (CUD) was prevalent in this analytic sample (70%), with 40% classified as mild, 25% as moderate, and 35% as severe. Polygenic risk for schizophrenia was positively associated with cannabis-related paranoia, feeling depressed or anhedonia, social withdrawal, and cognitive difficulties, even when controlling for duration of daily cannabis use, CUD, and age at first cannabis use. The schizophrenia PRS was most robustly associated with cannabis-related cognitive difficulties (β = 0.22, SE = 0.04, P = 5.2e-7). In an independent replication sample (N = 1446), associations between the schizophrenia PRS and cannabis-related experiences were in the expected direction and not statistically different in magnitude from those in the COGA sample. Among individuals who regularly use cannabis, genetic liability for schizophrenia-even in those without clinical features-may increase the likelihood of reporting unusual experiences related to cannabis use.

Seeing minds – a signal detection study of agency attribution along the autism-psychosis continuum

ABSTRACT Introduction Diametrically aberrant mentalising biases, namely hypermentalising in psychosis and hypomentalising in autism, are postulated by some theoretical models. To test this hypothesis, we measured psychotic-like experiences, autistic traits and mentalising biases in a visual chasing paradigm. Methods Participants from the general population (N = 300) and psychotic patients (N=26) judged the absence or presence of a chase during five-second long displays of seemingly randomly moving dots. Hypermentalising is seeing a chase where there is none, whereas hypomentalising is missing to see a chase. Results Psychotic-like experiences were associated with hypermentalising. Autistic traits were not associated with hypomentalising, but with a reduced ability to discriminate chasing from non-chasing trials. Given the high correlation (τ = .41) between autistic traits and psychotic-like experiences, we controlled for concomitant symptom severity on agency detection. We found that all but those with many autistic and psychotic traits showed hypomentalising, suggesting an additive effect of traits on mentalising. In the second study, we found no hypermentalising in patients with psychosis, who performed also similarly to a matched control group. Conclusions The results suggest that hypermentalising is a cognitive bias restricted to subclinical psychotic-like experiences. There was no support for a diametrically opposite mentalising bias along the autism-psychosis continuum.

A systematic review and meta-analysis of the association between emotional stress reactivity and psychosis.

Emotional stress reactivity may be a mediating factor in the association between trauma and psychosis. This review aimed to (i) identify, summarise and critically evaluate the link between emotional stress reactivity and psychotic experiences (ii) examine evidence for a 'dose-response' relationship between stress reactivity and psychosis in the wider psychosis phenotype (i.e., sub-clinical symptoms). Electronic database searches (PsychINFO, MEDLINE, EMBASE) were conducted for studies which investigated the link between stress reactivity and psychosis, psychotic symptoms, or a vulnerability to developing psychosis (wider phenotype). Cross-sectional, experimental and experience sampling method study designs were eligible for inclusion. Fourty five eligible articles were identified (N participants=8830). Narrative synthesis showed that increased emotional stress reactivity was associated with psychosis and subclinical psychotic experiences across all study designs, however, findings were inconsistent across studies. The preliminary meta-analysis (k= 4, n= 383) showed increases in emotional stress reactivity was associated with higher negative affect in response to event-related stress, in those with psychosis compared to controls (mean difference in beta coefficients=0.05, 95% CI 0.02-0.08, p= .004). However, this difference was small with a considerable degree of heterogeneity (p= .001, I2 = 81%) so results should be interpreted with caution. Overall, the evidence suggests that there is a link between emotional stress reactivity and psychosis in those with psychosis, those at high risk of developing psychosis and in relation to subclinical psychotic-like experiences in the general population.

Socioemotional mechanisms of loneliness in subclinical psychosis

Loneliness is an important predictor of physical and mental health in the general population and in individuals across the psychosis spectrum, including those experiencing subclinical psychotic-like experiences (PLEs). However, the mechanisms underlying loneliness in the psychosis spectrum are not well understood. Emotion processing deficits are well described across the psychosis spectrum, and socioemotional processing biases are critical for the development and maintenance of loneliness through altered social appraisal, including judgements of rejection. Therefore, we propose that PLEs are associated with increased loneliness, and the relationship is mediated by alterations in socioemotional processing. We also explored how this pathway may be affected by mood and anxiety symptoms, which have been associated with loneliness across the psychosis spectrum. As part of the Human Connectome Project, generally healthy adults (n = 1180) reported symptomatology and social functioning and completed the Penn Emotion Recognition Task to assess efficiency in identifying emotions. We found that higher reported PLEs were associated with elevated levels of loneliness and perceived rejection and that these factors were linked by multiple independent pathways. First, anxiety/depression and emotion processing efficiency independently mediated the PLE-loneliness relationship. Second, we found that the association between PLEs and loneliness was serially mediated through inefficient emotion recognition then higher levels of perceived rejection. These separable mechanisms of increased loneliness in subclinical psychosis have implications for treatment and continued study of social functioning in the psychosis spectrum.

Predicting subclinical psychotic-like experiences on a continuum using machine learning

Previous studies applying machine learning methods to psychosis have primarily been concerned with the binary classification of chronic schizophrenia patients and healthy controls. The aim of this study was to use electroencephalographic (EEG) data and pattern recognition to predict subclinical psychotic-like experiences on a continuum between these two extremes in otherwise healthy people. We applied two different approaches to an auditory oddball regularity learning task obtained from N = 73 participants:A feature extraction and selection routine incorporating behavioural measures, event-related potential components and effective connectivity parameters;Regularisation of spatiotemporal maps of event-related potentials.Using the latter approach, optimal performance was achieved using the response to frequent, predictable sounds. Features within the P50 and P200 time windows had the greatest contribution toward lower Prodromal Questionnaire (PQ) scores and the N100 time window contributed most to higher PQ scores. As a proof-of-concept, these findings demonstrate that EEG data alone are predictive of individual psychotic-like experiences in healthy people. Our findings are in keeping with the mounting evidence for altered sensory responses in schizophrenia, as well as the notion that psychosis may exist on a continuum expanding into the non-clinical population.

M156. CORTICAL NEUROANATOMICAL SIGNATURE OF SCHIZOTYPY IN 2,695 INDIVIDUALS ASSESSED IN A WORLDWIDE ENIGMA STUDY

BackgroundCortical neuroanatomical abnormalities have been reported along a continuum between individuals with chronic schizophrenia, first-episode psychosis, clinical high risk for psychosis, and healthy individuals self-reporting subclinical psychotic-like experiences (or schizotypy). Recently, the Schizophrenia Working Group within the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium provided meta-analytic evidence for robust cortical thickness abnormalities in schizophrenia, while also indicating that these abnormalities are influenced by illness severity and treatment with antipsychotic medications. In this context, schizotypy research allows the investigation of cortical neuroanatomy associated with the expression of subclinical psychotic-like symptoms without the potential influence of a psychotic illness, its severity, or the use of antipsychotics. This study presents the first large-scale imaging meta-analysis of cortical thickness in schizotypy using standardized methods from 23 datasets worldwide.MethodsCortical thickness and surface area were assessed in MRI scans of 2,695 healthy individuals (mean [range] age of 29.1 [17–55.8], 46.3% male) who had also completed validated self-report schizotypy questionnaires. Each site processed their local T1-weighted MRI scans using FreeSurfer and, following the protocol outlined in the ENIGMA Schizophrenia Working Group study, extracted cortical thickness for 70 Desikan-Killiany (DK) atlas regions (34 regions per hemisphere + left and right hemisphere mean thickness). At each site, partial correlation analyses were performed between regional cortical thickness by ROI and total schizotypy scores in R, predicting the left, right and mean cortical thickness, adjusting for sex, age and site. Random-effects meta-analyses of partial correlation effect sizes for each of the DK atlas regions were performed using R’s metafor package. False discovery rate (pFDR < .05) was used to control for multiple comparisons.ResultsWe found significant positive associations between subclinical psychotic-like experiences and mean cortical thickness of the medial orbitofrontal cortex (r = .077; pFDR = .006) and the frontal pole (r = .073; pFDR = .006). When assessed separately by hemisphere, meta-analysis revealed a significant positive association between subclinical psychotic-like experiences and cortical thickness of the left medial orbitofrontal cortex (r = .066; pFDR = .044), and at trend-level with the right medial orbitofrontal cortex (r = .062; pFDR = .053) and the left frontal pole (r = .062; pFDR = .053). No significant associations were observed for surface area.DiscussionWorldwide cooperative analyses of large-scale brain imaging data support a profile of cortical thickness abnormalities involving prefrontal cortical regions positively related to schizotypy in healthy individuals. These findings are not secondary to potential influences of disease chronicity or antipsychotic medication on the neuroanatomical correlates of psychotic-like experiences. The directionality of the observed meta-analytical effects in schizotypy is opposite to those previously reported in patients with schizophrenia (i.e., thinner cortex). The present findings of increased thickness may indicate early microstructural deficits (e.g. in myelination) that contribute to vulnerability for psychosis. Alternatively, these may reflect mechanisms of resilience associated with the expression of subclinical manifestations of psychotic symptoms in otherwise healthy individuals.

Ontological insecurity II: Relationship to attachment, childhood trauma, and subclinical psychotic-like experiences.

To examine ontological insecurity as a predictor of positive psychotic-like experiences (PLEs) relative to concepts of childhood trauma, parental bonding, and adult attachment style. A nonclinical sample (N = 298) completed the Ontological Insecurity Scale (OIS-34), a new measure of ontological insecurity, along with measures of the above concepts. The OIS-34 accounted for a significantly greater proportion of unique variance in positive PLEs than any other theoretical variable. Anxious and avoidant adult attachment were also strongly associated with positive PLEs, but these relationships were mediated by the OIS-34, ceasing to be significant once this latter variable entered the hierarchical regression equation. The results are consistent with R. D. Laing's theory that ontological insecurity plays a significant role in psychosis. Moreover, the results suggest that this concept may mediate the established relationship between anxious/avoidant adult attachment and positive PLEs. Implications for psychological approaches to clinical psychosis are discussed.

Ontological insecurity I: Psychometric development of a new measure and relationship to subclinical psychotic-like experiences.

The present study sought to develop a new psychometrically sound measure of ontological insecurity, the OIS-34 and, determine its relationship with subclinical psychotic-like experiences (PLEs). A nonclinical sample (N = 600) completed an initial 60-item version of the new scale along with measures of PLEs, psychosis proneness, and mental health history. Exploratory factor analysis indicated a single factor, ontological insecurity, with 34 items loading positively and above a criterion of 0.4. Internal consistency and test-retest reliability were excellent. The OIS-34 correlated positively and significantly with psychosis proneness and subclinical positive and negative symptom PLEs. The OIS-34 also differentiated significantly between participants with and without a history of mental health problems, including psychosis. The OIS-34 appears to represent a psychometrically sound measure of ontological insecurity. The results suggest that the concept is associated with PLEs. Directions for further research are discussed.

Recovery from daily-life stressors in early and chronic psychosis

Initial affective and psychotic reactivity to daily stressors is altered in psychosis, and most notably in early psychosis. In addition to altered initial stress reactivity, results from studies using Experience Sampling Methodology (ESM) and psychophysiological measures indicate that impaired recovery from mild stressors may also be a risk factor for mental illness.The current ESM study investigated affective recovery from daily stressors in chronic psychosis patients (CP; n = 162), individuals at early stages of psychosis (EP; n = 127), and healthy volunteers (HV; n = 220) assessing fluctuations in negative affect (NA), tension, and suspiciousness ten times a day on six consecutive days. Recovery was operationalized for all three variables as the return to baseline (i.e., level at t−1) following the first stressful event of a day (i.e., t0).The EP group showed a delayed recovery of NA (t1-t3: B = 0.185; p = .007 and B = 0.228; p = .002) and suspiciousness (t1: B = 0.223; p = .010 and B = 0.291; p = .002) compared to HV and CP, respectively. Delayed recovery was detected for tension as well (t1-t2: EP > HV: B = 0.242; p = .040 and EP > CP: B = 0.284; p = .023), but contrary to both other momentary states, this effect disappeared when controlling for subsequent stressful events. There were no significant differences in recovery between HV and CP.These results suggest that in EP, stressful daily events have longer-lasting effects on overall negative affect and subclinical psychotic-like experiences. Future studies should incorporate physiological and endocrine measures in order to integrate recovery patterns of the different stress systems.

Persistence of psychosis in the population: Τhe cost and the price for humanity

Schizophrenia is a chronic and highly impairing condition that affects around 1% of the human population. Evolutionary theories lend support for the idea of a continuum approach to the diagnosis of psychosis. Subclinical psychotic-like experiences are relatively common in children and adolescents, occurring in about 17% of youths. The prevalence rate of psychotic symptoms in the general population is up to 8%, which is about ten times higher than the prevalence of diagnosed psychotic disorders. Some scientists have argued that there may be a shared genetic variation between illness and non-clinical psychotic- like symptom expression. The high prevalence of non-clinical psychotic symptoms in the population prompt neuroscientists to re-evaluate these symptoms in the light of evolutionary theory. The schizophrenia impaired physical health and reduced probability of reproduction raises an evolutionary puzzle. How does schizophrenia persist in the population at a stable prevalence rate? The question regarding what processes maintain the persistence of high heritable variation in relatively disadvantageous traits, such as schizotypy, in the general population, remains a universal challenge across the domains of psychiatric and evolutionary genetics. Furthermore, is there any link between the evolutionary persistence of psychosis in the population worldwide and the association of creativity with psychoticlike experiences in the general population? There has been a healthy debate on many hypotheses. One possibility is that schizophrenia remains in the human population because of shared genetic linkages to creativity. During last decade many scientists search the explanation for the evolutionary enigma of the persistence of schizophrenia, and the nature of its relation to creativity, although the notion that there is a heritable aspect of at least some aspects of high ability, including creativity, is going back at least to Francis Galton's book Hereditary genius (1869). Neuroscientists also suggested that schizophrenia may emerge as a by-product of social cognition or that certain types of hallucinations could be viewed as evolutionary by-products of a cognitive system designed to detect threat. Some traits, such as schizotypy, may have an optimal level of expression that is advantageous within the community. However, this trait has adverse consequences for the psychotic person, which becomes, as Sebastian Faulks (2006) suggested, "the price we pay for being what we are".

Multi-echo fMRI, resting-state connectivity, and high psychometric schizotypy.

Disrupted striatal functional connectivity is proposed to play a critical role in the development of psychotic symptoms. Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies typically reported disrupted striatal connectivity in patients with psychosis and in individuals at clinical and genetic high risk of the disorder relative to healthy controls. This has not been widely studied in healthy individuals with subclinical psychotic-like experiences (schizotypy). Here we applied the emerging technology of multi-echo rs-fMRI to examine corticostriatal connectivity in this group, which is thought to drastically maximize physiological noise removal and increase BOLD contrast-to-noise ratio. Multi-echo rs-fMRI data (echo times, 12, 28, 44, 60 ms) were acquired from healthy individuals with low (LS, n = 20) and high (HS, n = 19) positive schizotypy as determined with the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). After preprocessing to ensure optimal contrast and removal of non-BOLD signal components, whole-brain functional connectivity from six striatal seeds was compared between the HS and LS groups. Effects were considered significant at cluster-level p < .05 family-wise error correction. Compared to LS, HS subjects showed lower rs-fMRI connectivity between ventromedial prefrontal regions and ventral striatal regions. Lower connectivity was also observed between the dorsal putamen and the hippocampus, occipital regions, as well as the cerebellum. These results demonstrate that subclinical positive psychotic-like experiences in healthy individuals are associated with striatal hypoconnectivity as detected using multi-echo rs-fMRI. Further application of this approach may aid in characterizing functional connectivity abnormalities across the extended psychosis phenotype.

F242. CHILDHOOD ADVERSITY AND PSYCHOTIC EXPERIENCES IN THE GENERAL POPULATION: WHAT IS THE PREDICTIVE ROLE OF RESILIENCE, COPING STYLE AND SOCIAL SUPPORT?

BackgroundA history of childhood adversity is known to be associated with psychotic disorder as well as subclinical psychotic-like experiences. This study aimed to examine the relationship between specific types of childhood adversity and psychotic-like experiences in a general population sample, and to determine the predictive role of psychological resilience, coping style and perceived social support.MethodsAn online survey was conducted with a US-based general population sample of 748 participants (aged 18 – 35 years) using Amazon’s Mechanical Turk (an online crowd-sourcing service). Participants completed the following validated measures: the Adverse Childhood Experiences Questionnaire (ACE-Q) as a measure of childhood adversities, the Prodromal Questionnaire (PQ-16) as a measure of psychotic experiences, the Brief Resilience Scale (BRS) measuring level of psychological resilience, the Brief COPE Scale as a measure of predominant coping style, the Multidimensional Scale of Perceived Social Support and the Neighbourhood Cohesion Scale. A series of backwards stepwise hierarchical regression analyses was employed to determine predictors of PQ-16 score.ResultsParticipants reported an average of 2.99 attenuated psychotic symptoms (from a total of 16 on the PQ-16), and an average of 2.77 childhood adversities (from a total of 10 on the ACE-Q). In the final regression model, which explained 33% of the variance in PQ-16 score, the specific types of childhood adversity which significantly predicted PQ-16 score were verbal abuse, sexual abuse and physical neglect. Level of resilience and coping via emotional support were significant negative predictive factors of PQ-16 score. The coping styles of self-distraction, denial, substance use, venting, religion and self-blame were significant positive predictors of PQ-16 score. Perceived social support and neighbourhood cohesion were not significant predictors.DiscussionThe results of this study add support to the relationship between history of childhood adversity and psychotic-like experiences in the general population. Our data suggest that a differential effect exists dependent on the specific type of adversity (the strongest observed effect was for physical neglect). These findings highlight the need for routine clinical enquiry regarding childhood trauma for patients experiencing attenuated psychotic symptoms. We also found that psychological resilience and coping style were important predictive factors in this relationship (whilst perceived social support and neighbourhood cohesion were not). These may represent possible avenues for psychosocial augmentative interventions in the early stages of the psychosis continuum.

O6.2. NEUROBIOLOGY OF PSYCHOMETRIC SCHIZOTYPY: INSIGHTS FROM MULTIMODAL IMAGING RESEARCH

BackgroundThe continuum approach to psychosis proposes a dimensional continuity between the neurobiology of subclinical psychotic-like experiences in healthy individuals (or schizotypy) and psychotic symptoms in clinically relevant psychosis (Linscott and van Os, 2013, Nelson et al., 2013). Preclinical models propose that cortical glutamate dysfunction related to cortico-limbic-striatal hyper-responsivity to stress may underlie both hippocampal and striatal overdrive as well as gray matter loss associated with schizophrenia-like behaviors (Berretta et al., 2001, Lodge and Grace, 2011). Our recent studies investigated whether changes in brain glutamate are present in healthy individuals with high psychometric schizotypy, and whether these are related to changes in (1) corticolimbic response to emotion and (2) gray matter volume (GMV).MethodsForty-eight healthy participants were recruited based on their score on the O-LIFE questionnaire (Mason et al., 2005), after pre-screening 250 respondents to online advertisement. Participants with high levels of unusual experiences (HS group; that is, scored >7 on the Unusual Experiences (UE) subscale of the O-LIFE), and participants with low UE (LS group; that is, <2 on O-LIFE UE subscale), were invited to participate. Groups were matched by age, gender and IQ. A structural MRI scan, glutamate proton magnetic resonance spectroscopy in the anterior cingulate cortex (ACC), and functional magnetic resonance imaging (fMRI) measuring corticolimbic response during emotional processing were acquired at 3T in a single session. Glutamate levels were analyzed using LCModel 6.3-1L. Voxel-based morphometry was applied to quantify GMV and both GMV and fMRI group level analyses were run using SPM12. Standalone imaging results as well as fMRI/sMRI × glutamate interactions were considered significant after voxel-wise P<0.05 family-wise error correction.ResultsWhile viewing emotional pictures, HS individuals showed greater activation than did subjects with LS in the caudate, and marginally in the ACC, hippocampus, medial prefrontal cortex (MPFC) and putamen. Although no between-group differences were found in glutamate concentrations, within the HS group ACC glutamate was negatively correlated with striatal activation (bilaterally in caudate and in left putamen at P < 0.05) and marginally with MPFC (P = 0.052) and amygdala (left: P = 0.062; right: P = 0.079), correlations that were not present in LS subjects. Structurally, subjects with HS showed GMV decreases in the rolandic operculum/superior temporal gyrus (P < 0.05) at the whole-brain level, and significant increases in GMV were also detected using ROI in the precuneus and ACC (both P < 0.05). Furthermore, in HS subjects ACC glutamate levels were negatively correlated with GMV in the ACC (P < 0.05). Such association was absent in LS. These findings provide, to our knowledge, the first evidence that brain glutamate levels are associated with emotional hyper-responsivity and volumetric changes in HS in brain regions thought to be critical in the pathophysiology of psychotic symptoms.DiscussionCollectively, these results are in line with a dimensional view of psychosis by suggesting that interactions between brain structure, neurochemistry, and functional response to emotion within a corticolimbic circuit are involved in the expression of psychotic-like experiences at non-clinical and clinical levels. These findings may also serve as evidence of potentially protective mechanisms, as our studies involved high-functioning individuals with HS and some of the observed effects are opposite to what would have been predicted from studies in clinical groups.

Investigating the association between emotion regulation and distress in adults with psychotic-like experiences

Many individuals in the general population experience psychotic-like experiences in the absence of a psychotic disorder. The degree of psychological distress associated with these experiences is a key predictor of clinical outcomes. One factor that may influence the degree of distress from psychotic-like experiences is emotion regulation. Although it has been demonstrated that emotion regulation deficits are present in psychotic disorders, the association between emotion regulation and subclinical psychotic-like experiences is not well understood. Here, we examined the associations between frequency of and distress from psychotic-like experiences and several key components of emotion regulation: difficulties with emotion regulation; emotion regulation self-efficacy; and emotion regulation strategy use. Difficulties with emotion regulation and maladaptive patterns of emotion regulation strategy use were associated with the frequency of both positive and negative psychotic-like experiences. In addition, results suggest that habitual acceptance use and reappraisal self-efficacy may serve as protective factors against the distress associated with psychotic-like experiences.

Adding insult to injury: Childhood and adolescent risk factors for psychosis predict lower fractional anisotropy in the superior longitudinal fasciculus in healthy adults

Although epidemiological studies provide strong support for demographic and environmental risk factors in psychotic disorders, few data examine how these risk factors relate to the putative aberrant neurodevelopment associated with illness. The present study examined how the accumulation of risk factors including low IQ, low parental socioeconomic status (SES), history of adolescent cannabis use and childhood trauma, and high levels of subclinical psychotic-like experiences (PLEs) contributed to aberrant neurodevelopmental outcomes in 112 otherwise healthy adults recruited from the community. Participants were studied with diffusion tensor imaging (DTI), and voxel-wise statistical analysis of fractional anisotropy (FA) using tract-based spatial statistics (TBSS) was used to examine the relation between cumulative risk (CR) for psychosis and white matter (WM) integrity across the whole brain. Analyses revealed that higher CR was significantly associated with lower FA in a cluster in the left superior longitudinal fasciculus (SLF). These results suggest that risk factors previously associated with psychotic disorders are associated with WM integrity even in otherwise healthy adults and may provide insight into how previously identified risk factors contribute to the structural brain abnormalities associated with psychotic illness. Prospective longitudinal studies examining the effect of risk factors on the developmental trajectory of brain WM are warranted.

The relationship between temperament and character and subclinical psychotic-like experiences in healthy adults.

Considerable data support phenomenological and temporal continuity between psychotic disorders and subclinical psychotic-like experiences (PLE's). Although numerous studies have found similar personality correlates for schizophrenia and schizotypal personality disorder patients, their unaffected first-degree relatives, and healthy adults characterized for schizotypal traits, no study has yet investigated personality correlates of PLE's measured by the Community Assessment of Psychic Experiences (CAPE). Our study sought to examine personality correlates of PLE's using the CAPE in healthy adults. The CAPE and temperament and character inventory (TCI) were administered to 415 healthy adults. Regressions examined links between TCI traits and overall PLE levels as well as positive and negative PLE's separately. Consistent with past studies, lower self-directedness (SD) and reward dependence (RD) and higher self-transcendence (ST) and harm avoidance (HA) significantly predicted overall PLE levels. Higher ST and persistence (P) and lower SD significantly predicted higher levels of positive PLE's while lower SD and RD and higher HA, ST, and cooperativeness (C) predicted higher levels of negative PLE's. Associations between TCI and PLE's using the CAPE are strikingly similar to past work in non-clinical and patient samples and provide additional support for phenomenological continuity between psychotic disorders and sub-syndromal psychotic symptoms.

The relation between childhood maltreatment and psychosis in patients with schizophrenia and non-psychiatric controls

Several lines of evidence suggest that childhood maltreatment is associated with an increased risk for both psychotic disorders and subclinical psychotic-like experiences in the general population. Few studies, however, have sought to examine whether the strength of this relationship is comparable across patient and non-patient groups. The present study sought to compare the strength of the association between childhood maltreatment and self-reported psychotic symptoms in 447 healthy adult volunteers and 184 stable outpatients with schizophrenia or schizoaffective disorder. Strong positive correlations between childhood maltreatment and self-reported symptoms were observed in both groups. Although patients scored significantly higher than controls on both history of childhood maltreatment and self-reported symptoms, the strength of the relationship did not differ between groups. These data provide strong support for etiological continuity between subclinical psychotic symptoms and psychotic disorders.

Poster #M69 WHAT LIES BENEATH? A THEMATIC CONTENT ANALYSIS OF SUB-CLINICAL PSYCHOTIC EXPERIENCES AMONG CHILDREN AND YOUNG ADOLESCENTS FROM THE GENERAL POPULATION IN IRELAND AND THE UK

The idea that the content of delusions and hallucinations may have meaning or be symbolically significant is not new. From a psychodynamic perspective, the experience of psychosis has long been conceptualised as a defence against unbearable or unmanageable emotions (Martindaleetal2013)andthecontentofpsychoticexperiencesistherefore considered to have meaning and relevance for clinical practice (Martindale 2007). In adult samples, the content of delusions and hallucinations has been found to be associated with the experience of trauma and abuse (Raune et al. 2006, Reiff et al. 2012). To the best of our knowledge, no study to date has examined the content of sub-clinical psychotic-like experiences (PLEs) using non-clinical child or adolescent samples. This study aims to identify the presence of themes in the content of PLEs among children and adolescents from the general population and to examine associations between the content of the psychotic experience and adverse or abusive life events.