Unusual Perceptual Experiences Research Articles

Relationships between psychotic and affective symptoms, schizotypal and dissociative phenomena, and adverse life events among individuals with psychotic disorders

Background: Psychotic symptoms and self-rated schizotypal phenomena have similar dimensional structures. Additionally, dissociative phenomena have conceptual links with psychosis/schizotypy and all of these phenotypes are associated with adverse life events (ALEs). The relationships between these factors among individuals with psychotic disorders are not well established and were investigated in this study. Method: 76 participants with any psychotic disorder were recruited from mental health services in West Yorkshire, UK. Lifetime psychotic and affective symptoms were assessed by research interviews and case record review. The self-rated Schizotypal Personality Questionnaire (SPQ) with additional questions regarding inappropriate affect, Dissociative Experiences Scale (DES), and questionnaires regarding cumulative adverse life events in childhood (CLEQ) and in the year before clinical onset (BLEQ) were also administered. Relationships between factors were assessed using Spearman correlations and linear regression analysis. Results: Correlations with relevant psychotic symptoms ranged from ~0.3 for some positive and negative SPQ subdomains to ~0 for disorganised subdomains. In contrast, SPQ and DES were highly correlated (~0.7). In univariate analysis, ALEs were associated with depression, DES, and positive and disorganised SPQ subdomains. In multivariable analysis, ALEs in childhood and before onset were independently associated with the SPQ Unusual perceptual experiences subdomain. Conclusion: Among individuals with psychotic disorders, neither SPQ nor DES questionnaire responses are likely to be useful proxies for psychotic symptoms. However, particularly questionnaire-based unusual perceptual experiences may be useful when assessing the range of phenomena associated with adverse life events.

Pathways from trauma to unusual perceptual experiences: Modelling the roles of insecure attachment, negative affect, emotion regulation and dissociation.

A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual-sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma-related voices (TRV) model was developed to generate novel research in this area. This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model. The PTSD Diagnostic Scale for DSM-5, State Adult Attachment Measure, Depression Anxiety and Stress Scales-21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi-modality Unusual Perceptual Experiences Questionnaire. We used path analysis in a non-clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi-sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation. Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs = .14-.61) and indirect pathways (βs = .01-.08) were significant (ps < .001). Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation. Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model.

Linguistic marker of schizotypy: a study on nominal reference

Semantic impairments are considered linguistic identifiers of schizotypal personality disorder. Particularly, failures in building reference of nominal expressions have been said to distinguish schizophrenia, high-schizotypy and control groups, and these failures reflect difficulties in using linguistic contextual cues. Our experimental study investigated covariances between schizotypal traits, in a nonclinical population, and interpretations of definite singular nominal expressions as referring either to kinds of objects (generic reading) or to specific objects (specific reading). The experiment was conducted in Brazilian Portuguese, where specific reading is the strong/default meaning of definite singular nominals, while generic reading is the weak meaning, being dependent on contextual information. Results indicate associations between interpretation of definite singular nominals and two schizotypal traits: constricted affect (a negative trait) and unusual perceptual experiences (a positive trait). Speakers in general had preference for assigning specific interpretations to definite singular nominals. Those with higher measurements of constricted affect and lower traits of unusual perceptual experiences, however, showed significant higher preference for this reading with an additive effect in discourse-contexts containing cues for specificity. This suggests that schizotypal traits might manifest themselves within language as a tendency to hold onto strong meaning.

Schizotypal Traits are Associated with Decreased Functional Connectivity between Medial Prefrontal Cortex and Cerebellum in a Non-clinical Sample

IntroductionSchizotypy is associated with increased vulnerability to schizophrenia spectrum disorders. Therefore, investigation of its brain correlates seems prominent for better understanding of schizophrenia-spectrum continuum as well as for development of biological treatments for schizotypal personality disorder. Functional alterations of prefrontal cortex (PFC) and their associations with clinical symptoms are well-known to exist in schizophrenia. However, their relevance to schizotypy remains unclear.ObjectivesThe aim of the study was to check for associations between schizotypal traits in a non-clinical sample and whole-brain functional connectivity (FC) of lateral as well as medial PFC (lPFC and mPFC, respectively).MethodsEighty-two healthy individuals (52 females, mean age 24.8±5.48) filled out the Schizotypal Personality Questionnaire (SPQ-74) and underwent resting-state fMRI (3T). Seeds in lPFC and mPFC were taken from frontoparietal and default mode networks (atlas by Yeo et al., 2011). We analyzed correlations between four schizotypal factors (cognitive/perceptual, paranoid, negative, and disorganization; Stefanis et al., 2004) and whole-brain FC of the seeds (statistical threshold: p&lt;.001 voxelwise; p[FDR]&lt;.05 clusterwise).ResultsCognitive/perceptual factor (‘Odd beliefs/magical thinking’ and ‘Unusual perceptual experiences’ SPQ-74 subscales) is negatively correlated to FC of bilateral mPFC with a cluster in the right cerebellum (Crus 1, 2).ConclusionsPrefrontal-cerebellar dysconnectivity may be one of the neurobiological factors underlying positive-symptoms-like schizotypal traits in non-clinical subjects. To some extent, it coincides with the data on associations between functional features of these brain structures and positive symptoms in schizophrenia (Pinheiro et al., 2021; Goghari et al., 2010).DisclosureThe study was supported by RFBR Grant 20-013-00748.

Interrelations between insomnia, dreaming, and schizotypy in the general population: A network model

IntroductionInsomnia and Nightmare disorder are the two most common comorbid sleep disturbances in psychotic conditions. However, insomnia and psychotic symptoms are umbrella terms that hide the heterogeneity of these concepts. Several studies have found that worsening sleep quality is associated with the strengthening of psychotic symptoms. Until now, there was less interest in the relationship between the specific insomnia symptoms (trouble with falling asleep, fragmented sleep, early awakenings, daytime consequences) and the specific dimensions of schizotypy (disorganization, unusual perceptual experiences, anhedonia, and impulsive nonconformity).ObjectivesThe study aimed to depict the network structure of insomnia, dreaming features (dream recall/bad dream/nightmare frequency), and schizotypy dimensions.MethodsExploratory network analysis was conducted on cross-sectional data of the general population (N=1419, 77 % female). We modeled the interrelations between insomnia symptoms (Athens Insomnia Scale), dreaming features (the frequency of dream recall/bad dreams/nightmares), and the dimensions of schizotypy (OLIFE-S).Resultsshow a highly connected network with strong stability. The nodes of schizotypy, insomnia, and dream feature perfectly correspond to their own clusters, but the nodes were also densely connected between the three clusters. Disorganization, frequent awakenings, and nightmares are the most central nodes of the clusters. The node of frequent nightmares seems to be the bridge symptom in this network which connects unusual experiences dimension and frequent awakenings.ConclusionsThese results suggest that specific dimensions of schizotypy and specific sleep complaints are differently connected. However further research is needed to investigate the finer details of these heterogenic phenomena.DisclosureNo significant relationships.

Positive schizotypy is associated with amplified mnemonic discrimination and attenuated generalization

Tendency to experience inaccurate beliefs alongside perceptual anomalies constitutes positive schizotypal traits in the general population and shows continuity with the positive symptoms of schizophrenia. It has been hypothesized that the positive symptomatology of schizophrenia, and by extension, the odd beliefs and unusual perceptual experiences in the general population, are associated with specific alterations in memory functions. An imbalance between memory generalization and episodic memory specificity has been proposed on several counts; however, the direction of the imbalance is currently unclear. Here, we evaluated the association between positive schizotypy, and memory alterations related to hippocampal computations in a general population sample enriched for positive schizotypy. We found that memory generalization is attenuated while memory specificity is elevated in participants with more pronounced positive schizotypal traits. Our findings show that people who are prone to irrational beliefs and unusual experiences also show measurable alterations in memory and likely have difficulty grasping the global picture and rather be overpowered by fragments of information.

Borderline personality disorder symptoms as mediational mechanisms linking childhood trauma and nonsuicidal self-injury among women with bulimia nervosa.

Nonsuicidal self-injury (NSSI) frequently co-occurs with eating disorders, especially bulimia nervosa (BN). Theoretical models and empirical evidence show many overlapping risk factors for the onset and maintenance of NSSI and BN. However, among those with BN, it remains unclear what distinguishes those who do versus do not engage in NSSI. The primary objective of the present study was to identify factors predicting NSSI among women with BN. Specifically, we tested four domains of borderline personality disorder as mediators between childhood trauma and NSSI. Using structural equation modeling we tested a parallel mediation model to predict NSSI among women with BN (N=130). Childhood trauma (measured by the Childhood Trauma Questionnaire at baseline) was the independent variable. The four parallel mediators (measured at baseline via the Diagnostic Interview for Borderlines, Revised) were lifetime negative affect, impulsive actions, atypical cognitions (e.g., odd thinking, unusual perceptual experiences, quasi-psychotic thinking), and interpersonal problems. The dependent variable was instances of NSSI during a subsequent two-week ecological momentary assessment protocol. Childhood trauma was significantly associated with all four mediators (all p values < .01), but only atypical cognitions predicted NSSI (p=.03). The indirect path from childhood trauma to NSSI, through atypical cognitions was significant (path coefficient=.001, SE < .001, p=.01). Among women with BN, childhood trauma was associated with atypical cognitions, which in turn predicted NSSI. Atypical cognitions may be a mechanism for NSSI in this population.

Identifying and changing cognitive vulnerability in the classroom: preliminary evaluation of CUES-Ed, a school-based universal cognitive behavioural early intervention service for 7-10 year olds.

School-based early intervention may alleviate current emotional and behavioural problems, and, by targeting underlying vulnerability, safeguard children's future mental health. Improving on mixed outcomes to date is an international public health priority. CUES-Ed is a classroom-based, clinician-led, universal cognitive behavioural programme for primary school children, designed to promote emotional literacy and regulation. Additionally, CUES-Ed targets cognitive mechanisms implicated in the future development of mental disorder: stigmatising appraisals of emotional expression and of unusual perceptual experiences, and the tendency to jump-to-conclusions (JTC). We report here on fitness for purpose of our in-service assessment of cognitive vulnerability, and change in cognitive vulnerability following CUES-Ed and compared with a naturalistic waitlist. From 05/2017-11/2017, 960 children participated (900 CUES-Ed; 60 naturalistic waitlist). Assessments were completed in whole classes; 732 children provided pre-post data on all measures; 227 were missing data through absence or poor completion (n = 1 declined assessment). Relationships between baseline cognitive vulnerability measures and their components were consistent with reliable and valid assessment. Cognitive vulnerability reduced from before to after CUES-Ed and compared with the naturalistic waitlist, for JTC (large effects) and stigmatising appraisals (small-medium effects), for all children (ESs pre-post: 0.2-1.0; between-group: 0.1-1.0) and vulnerable subgroups (ESs pre-post: 0.5-1.7; between-group: 0.2-2.0). Targeted cognitive vulnerability mechanisms change following CUES-Ed. As stigmatising appraisals and JTC may increase vulnerability to future mental illness, findings suggest a promise in reducing future risk. A formally controlled research study, with longer-term follow-up, is required to test this. Limitations and implications for future evaluation are discussed.

The Relationships Between Childhood Abuse and Neglect, Sub-clinical Symptoms of Psychosis and Self-harm in a Non-clinical Community Sample.

There is now substantial evidence that childhood adverse events are a significant risk factor for symptoms of psychosis in both clinical and community samples. Both childhood trauma and positive symptoms of psychosis are associated with an increased risk of self-harming behaviours. Therefore the current study aimed to consider the relationship between retrospective reports of childhood adversity, sub-clinical positive symptoms of psychosis and self-harm in a non-clinical community sample. The study employed a cross-sectional survey design, distributed online. Participants were asked to complete psychometric assessments relating to: demographic characteristics including past-year substance misuse; childhood adversity; sub-clinical symptoms of psychosis (delusions and hallucinations) and self-harming behaviours. The results found that, after controlling for substance misuse, childhood adversity predicted significant variance in sub-clinical delusions and hallucinations in the general population. Both symptoms of psychosis and childhood adversity increased the risk of self-harming behaviours. Positive symptoms partially mediated the relationship between early adversity and self-harming behaviours. For some people, the sequelae of early adversity including sub-clinical delusions and hallucinations may increase the risk of self-harming behaviours. Future research would benefit from considering the role of dissociation in these relationships and the affective impact of pseudo-psychotic experiences. Practitioners should consider the impact of childhood adversity, unusual perceptual experiences and distorted beliefs when working with people who self-harm. The current research was limited by the cross-sectional survey design and non-random sampling methodology.

Distinguishing multimodal versus multisensory hallucinations in psychosis: Key definitions and a way forward.

The study of hallucinations across multiple senses in psychosis has garnered renewed interest. Recent studies have adopted the term multimodal hallucinations to describe these experiences, yet some appear to be investigating a different, but related, phenomenon. In the current paper, we suggest use of the terms multimodal hallucinations and multisensory hallucinations to categorise distinct events that involve unusual sensory experiences across multiple domains. We propose that the constructs of temporality and relatedness are critical to delineating these experiences, where multimodal hallucinations refer to hallucinations in two or more sensory modes occurring concurrently in time and/or with significant thematic overlaps. Multisensory hallucinations conversely denote similar multisensory experiences, but with no temporal or relatedness constraints. This is accompanied by a decision-making framework for identifying whether a set of unusual perceptual experiences constitutes multimodal hallucinations or otherwise. We conclude by suggesting several priorities for future research, including empirical validation of our proposed model, further investigation of phenomenology, developing appropriate assessment tools and investigating underlying cognitive and other aetiological mechanisms.

Schizotypal personality traits and multisensory integration: An investigation using the McGurk effect

Multisensory integration, the process by which sensory information from different sensory modalities are bound together, is hypothesized to contribute to perceptual symptomatology in schizophrenia, in whom multisensory integration differences have been consistently found. Evidence is emerging that these differences extend across the schizophrenia spectrum, including individuals in the general population with higher levels of schizotypal traits. In the current study, we used the McGurk task as a measure of multisensory integration. We measured schizotypal traits using the Schizotypal Personality Questionnaire (SPQ), hypothesizing that higher levels of schizotypal traits, specifically Unusual Perceptual Experiences and Odd Speech subscales, would be associated with decreased multisensory integration of speech. Surprisingly, Unusual Perceptual Experiences were not associated with multisensory integration. However, Odd Speech was associated with multisensory integration, and this association extended more broadly across the Disorganized factor of the SPQ, including Odd or Eccentric Behaviour. Individuals with higher levels of Odd or Eccentric Behaviour scores also demonstrated poorer lip-reading abilities, which partially explained performance in the McGurk task. This suggests that aberrant perceptual processes affecting individuals across the schizophrenia spectrum may relate to disorganized symptomatology.

The Relationship Between Multisensory Temporal Processing and Schizotypal Traits.

Recent literature has suggested that deficits in sensory processing are associated with schizophrenia (SCZ), and more specifically hallucination severity. The DSM-5's shift towards a dimensional approach to diagnostic criteria has led to SCZ and schizotypal personality disorder (SPD) being classified as schizophrenia spectrum disorders. With SCZ and SPD overlapping in aetiology and symptomatology, such as sensory abnormalities, it is important to investigate whether these deficits commonly reported in SCZ extend to non-clinical expressions of SPD. In this study, we investigated whether levels of SPD traits were related to audiovisual multisensory temporal processing in a non-clinical sample, revealing two novel findings. First, less precise multisensory temporal processing was related to higher overall levels of SPD symptomatology. Second, this relationship was specific to the cognitive-perceptual domain of SPD symptomatology, and more specifically, the Unusual Perceptual Experiences and Odd Beliefs or Magical Thinking symptomatology. The current study provides an initial look at the relationship between multisensory temporal processing and schizotypal traits. Additionally, it builds on the previous literature by suggesting that less precise multisensory temporal processing is not exclusive to SCZ but may also be related to non-clinical expressions of schizotypal traits in the general population.

Positive schizotypy and the experience of creativity: The distinctive roles of suspiciousness and dispositional mindfulness

Positive schizotypy has been shown to predict emergence of schizophrenia-spectrum disorders, with suspiciousness/paranoia regarded a key risk factor. However, magical thinking and unusual perceptual experiences, other aspects of positive schizotypy, are associated with creativity. We investigated whether suspiciousness attenuates the relationship of magical thinking and unusual experiences with creative experience, and explored the interaction of dispositional mindfulness with positive schizotypy and creative experience. 342 (256 females) healthy adults (mean age: 25.9; SD 8.4) completed online self-report measures of schizotypy, creative experience, and dispositional mindfulness. Moderation analysis showed that suspiciousness attenuated the positive relationship of magical thinking (b = −0.29, p = .03) and unusual perceptual experiences (b = −0.23, p = .01) with an aspect of creative experience related to positive affect – power/pleasure. This effect was not present for 4 other aspects of creative experience. Multiple linear regressions revealed higher dispositional mindfulness to interact with aspects of positive schizotypy associated with heightened creative experience of power/pleasure (b = 0.06, p = .03), clarity/preparation (b = 0.03, p = .004), and differing levels of anxiety associated with creative engagement (b = −0.06, p = .003; b = 0.03, p = .047). Higher dispositional mindfulness was also associated with lower suspiciousness (rs = −0.33, p < .001). The study highlights the importance of considering the role of suspiciousness/paranoia when investigating the relationship between positive schizotypy and creativity. The findings provide support for the application of mindfulness-based interventions for mitigating psychosis-risk associated with suspiciousness, whilst supporting the otherwise favourable association of positive schizotypy with creativity.

Stronger Top-Down and Weaker Bottom-Up Frontotemporal Connections During Sensory Learning Are Associated With Severity of Psychotic Phenomena.

Recent theories in computational psychiatry propose that unusual perceptual experiences and delusional beliefs may emerge as a consequence of aberrant inference and disruptions in sensory learning. The current study investigates these theories and examines the alterations that are specific to schizophrenia spectrum disorders vs those that occur as psychotic phenomena intensify, regardless of diagnosis. We recruited 66 participants: 22 schizophrenia spectrum inpatients, 22 nonpsychotic inpatients, and 22 nonclinical controls. Participants completed the reversal oddball task with volatility manipulated. We recorded neural responses with electroencephalography and measured behavioral errors to inferences on sound probabilities. Furthermore, we explored neural dynamics using dynamic causal modeling (DCM). Attenuated prediction errors (PEs) were specifically observed in the schizophrenia spectrum, with reductions in mismatch negativity in stable, and P300 in volatile, contexts. Conversely, aberrations in connectivity were observed across all participants as psychotic phenomena increased. DCM revealed that impaired sensory learning behavior was associated with decreased intrinsic connectivity in the left primary auditory cortex and right inferior frontal gyrus (IFG); connectivity in the latter was also reduced with greater severity of psychotic experiences. Moreover, people who experienced more hallucinations and psychotic-like symptoms had decreased bottom-up and increased top-down frontotemporal connectivity, respectively. The findings provide evidence that reduced PEs are specific to the schizophrenia spectrum, but deficits in brain connectivity are aligned on the psychosis continuum. Along the continuum, psychotic experiences were related to an aberrant interplay between top-down, bottom-up, and intrinsic connectivity in the IFG during sensory uncertainty. These findings provide novel insights into psychosis neurocomputational pathophysiology.

Complicated grief, unusual perceptual experiences, and hope in widowhood

Complicated grief, unusual perceptual experiences, and hope in widowhood

Positive schizotypy, maladaptive openness, and openness facets.

Positive schizotypy includes magical beliefs and unusual perceptual experiences and is highly correlated with the cognitive-perceptual symptoms of schizotypal personality disorder. Increased openness to experience is associated with increased genetic risk for schizophrenia, and it has been commonly thought that positive schizotypy might also be related to increased openness. However, much previous research has failed to identify a sizable association between positive schizotypy and openness. The current research examined whether associations between positive schizotypy and openness might be higher (a) when using measures that more effectively assess the maladaptively high end of openness and (b) for distinct aspects of openness. Participants (n = 672) completed two measures of openness, the Big Five Aspects Scale (BFAS) and Experiential Permeability Index (EPI). We found that associations between positive schizotypy and BFAS-Open were small. However, in item response theory analyses, there was evidence that one facet of the EPI Oddity subscale highly associated with BFAS-Open was more sensitive to the maladaptively high end of openness than BFAS-Open. Further, positive schizotypy was more strongly associated with this EPI facet than with BFAS-Open. In addition, positive schizotypy was especially associated with a second facet of the EPI Oddity subscale. Hence, our study provides further evidence that associations between positive schizotypy and openness increase when assessing the maladaptively high end of openness and that positive schizotypy is most highly associated with particular facets of openness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Schizotypal traits are not related to multisensory integration or audiovisual speech perception.

Multisensory integration, the binding of sensory information from different sensory modalities, may contribute to perceptual symptomatology in schizophrenia, including hallucinations and aberrant speech perception. Differences in multisensory integration and temporal processing, an important component of multisensory integration, are consistently found in schizophrenia. Evidence is emerging that these differences extend across the schizophrenia spectrum, including individuals in the general population with higher schizotypal traits. In the current study, we investigated the relationship between schizotypal traits and perceptual functioning, using audiovisual speech-in-noise, McGurk, and ternary synchrony judgment tasks. We measured schizotypal traits using the Schizotypal Personality Questionnaire (SPQ), hypothesizing that higher scores on Unusual Perceptual Experiences and Odd Speech subscales would be associated with decreased multisensory integration, increased susceptibility to distracting auditory speech, and less precise temporal processing. Surprisingly, these measures were not associated with the predicted subscales, suggesting that these perceptual differences may not be present across the schizophrenia spectrum.

Polish adaptation of the Prodromal Questionnaire-Brief version PQ-B(PL) in psychiatric patients and healthy persons.

Cognitive and affective experiences considered typical of psychotic disorders may also occur in the general population,though in aless severe form. The ability to differentiate them from prodromal states, preceding the onset of full-blown psychosis, is an important element of prevention and early detection of high risk of asudden deterioration of mental state. In response to the current lack of questionnaire tools enabling assessment of psychotic-like experiences (PLEs), an attempt was made to adapt the PQ-B questionnaire for use in the Polish population. In the pilot study, a sample of 652 persons (66% women), aged 18-78 years, approximately 10% of whom were psychiatric patients, completed the Polish version of the PQ-B, and the O-LIFE, HCL-33, SWLS and TCT-DP measures. Results yielded a one-factor structure, satisfactory reliability (α > 0.85) and construct validity of the 21-item self-report questionnaire assessing the incidence of PLEs in the past month and severity of accompanying distress. Furthermore, there were significant correlations between PQ-B scores and symptoms of schizotypy (especially unusual perceptual experiences and cognitive disorganization), emotional lability (p < 0.05) and depressed mood (p > 0.001) typical of hypomania, as well as unconventional thinking (p > 0.05). The PQ-B(PL) can be a useful tool in both Polish clinical practice and scientific research, filling the existing gap among screening tests for traits on the border of health and psychopathology.

Phenomenological characteristics and explanations of unusual perceptual experiences, thoughts and beliefs in a population sample of early adolescents

Often referred to as psychotic experiences, unusual perceptual experiences, thoughts and beliefs (UPTBs) are not uncommon in youth populations. Phenomenological studies of these experiences are lacking. This study aimed to (1) describe the phenomenological characteristics of UPTBs in a sample of young adolescents and (2) explore how young people made sense of those experiences. Participants were 53 young people aged 11-13 years from a population-based study of mental health. All met criteria for UPTBs following clinical interviews as part of the study. Documentary data on UPTBs in the form of transcribed notes, recorded during clinical interviews, were analysed using content analysis. Data on UPTBs were coded, organised into categorical themes and quantified using descriptive statistics. Qualitative themes on how participants made sense of their experiences were identified. Participants reported UPTBs across four domains: auditory verbal, auditory non-verbal, non-auditory perceptual experiences and unusual thoughts and beliefs. UPTBs were phenomenologically rich and diverse. Young people sought to make sense of their experiences in multiple ways: normalising them, externalising them by attributing them to paranormal entities and distancing them from psychiatric explanations. Uncertainty about the source of UPTBs was identified as a superordinate theme. Findings from this study offer new insights into the phenomenological qualities and characteristics of UPTBs in young adolescents. They also reveal that early adolescents may not make sense of their experiences within a psychiatric framework. These findings highlight the need to develop a more phenomenologically sensitive and nuanced approach to studying UPTBs in young people.

M32. THE NATURE OF THE RELATIONSHIP OF SUICIDALITY WITH SCHIZOTYPY AND PSYCHOSIS EXPERIENCE

BackgroundMeehl portrayed pervasive, chronic suicidality as a key sign of schizotypy. Consistent with this view, positive schizotypy predicts concurrent and future suicidality, is particularly predictive of greater lethality, and is a more potent predictor of suicidality than other psychopathology. Whereas the most prominent explanation for this relationship is that it is spurious, several possible causal connections have not been tested. Also, most existing evidence relates to positive schizotypy and psychosis experience. We describe three studies of the schizotypy – suicidality link.MethodsIn the first, we tested whether, as Meehl argued, schizotypy is associated with suicide dread. A general population sample (n = 350) of young adults (18 to 24 years) reported on schizotypy and suicidality, including efforts to avert suicide attempts. In univariate analyses, positive, negative, and disorganized components of schizotypy each significantly predicted persistent or frequent suicidal ideation in the past month (ORs from 2.10 to 3.71), history of attempts with intent to die (1.59 to 2.15), fear or dread of the possibility of making an attempt (1.58 to 1.63), and worry about acting on an unwanted impulse to attempt suicide (2.48 to 2.62). In fully-adjusted analyses (controlling for depression, anxiety, stress, and all schizotypy components), positive schizotypy predicted reporting of greater worry about impulsive suicidal behaviour (OR = 1.71, p = .009, 95% CI 1.15 to 2.56).In the second, we tested whether the schizotypy – suicidality link can be understood using contemporary suicide theory. In a random sample of high school pupils (n = 177), schizotypy components predicted classification as an active suicidal ideator (R2 = 0.76, 95% CI 0.56 to 0.95). These effects were accounted by the influences of magical thinking, unusual perceptual experiences, and suspiciousness being mediated in part by perceived burdensomeness, as per the interpersonal theory of suicide. However, direct effects were also observed from social anxiety and magical ideation components of schizotypy.In the third, we modelled latent growth mixtures of suicidality using data from five waves of the Dunedin Multidisciplinary Health and Development Study. We test how growth in suicidality (from 18 to 38 years) is related to psychosis experience (age 11 years) and schizotypy (age 13 and 15 years). Schizotypy predicted membership of a growth class characterised by chronically death- and suicidal-ideation that, in turn, predicted attempt behaviour.ResultsSee above.DiscussionThe complexity of the observed links of schizotypy and psychosis experience with suicidality do not lend themselves to being discounted as spurious or due to common underlying causal factors. Research addressing possible causal connections is warranted, as are efforts to identify whether reduction of suicidality may result from interventions targeting features of subclinical psychosis.