scholarly journals T37. PREPULSE INHIBITION IN UNAFFECTED SIBLINGS OF SCHIZOPHRENIA AND CLINICAL-HIGH RISK WITHOUT FAMILY HISTORY OF PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S245-S246
Author(s):  
Mao Zhen ◽  
Qijing Bo ◽  
Qing Tian ◽  
Fang Dong ◽  
Xianbin Li ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Prepulse Inhibition ◽  
Spatial Separation ◽  
Structured Interview ◽  
Clinical High Risk ◽  
Priority Effect ◽  
Stimulus Interval ◽  
Psychosis Risk ◽  
History Of

Abstract Background It is reported that prepulse inhibition (PPI) deficiency of startle reflex in schizophrenia is associated with positive symptoms and is hereditary. In this study, the perceived spatial separation (PSS) induced-prepulse inhibition paradigm based on the priority effect effectively was used to explore PPI levels of genetically high-risk (GHR) of schizophrenia and clinical high risk (CHR) without family history of psychosis Methods We examined startle magnitude and PPI in38 CHR (No family history of psychosis), 28 GHR (Siblings or children of schizophrenia), and 44 healthy controls (HC). Modified acoustic PPI paradigm included PSS-PPI and perceived spatial co-location PPI (PSC-PPI) with inter-stimulus interval (ISI) of 60 or 120ms. The Structured Interview for Psychosis risk Syndromes (SIPS) and MATRICS Consensus Cognitive Battery (MCCB) was used to measure psychotic symptom and neuropsychological state of individuals Results Using gender, age, and smoking as covariates, Covariance analysis for modified PPI level results revealed that there were significant differences in PSSPPI60 (F = 6.25, p = 0.03) and PSSPI120 (F = 6.57, p = 0.03) paradigm between the three groups. Compared with HC, PSSPPI paradigm detected PPI defects of CHR individuals at 60ms ISI (F = 14.25, p ＜0.001) and 120ms ISI (F = 14.01, p ＜0.001). PPI deficiency was not detected in GHR individuals. PPI level in both groups were unrelated to demographics, clinical characteristics, and cognition. Using GLM analysis, the interaction between grouping and experimental paradigm had no significant effect on PPI level at 60ms (F = 1.88, P = 0.16) and 120ms (Z = 1.66, P = 0.19). Discussion It seems that mere heritability of psychosis is not enough to produce PPI defects, which may be related to the progression of psychosis

scholarly journals T39. IMPAIRED SENSORIMOTOR GATING USING THE ACOUSTIC PREPULSE INHIBITION PARADIGM IN INDIVIDUALS AT A CLINICAL HIGH RISK FOR PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S246-S246
Author(s):  
Qijing Bo ◽  
Zhen Mao ◽  
Qing Tian ◽  
Weidi Li ◽  
Lei Zhao ◽  
...  
Keyword(s):  
High Risk ◽  
Prepulse Inhibition ◽  
Clinical Characteristics ◽  
Sensorimotor Gating ◽  
Spatial Separation ◽  
Structured Interview ◽  
First Episode ◽  
Clinical High Risk ◽  
Neurocognitive Functions ◽  
First Episode Schizophrenia

Abstract Background Many robust studies on prepulse inhibition (PPI) were conducted in patients with schizophrenia, and, increasingly, evidence has indicated individuals who are at clinical high risk for psychosis (CHR). The specificity of the PPI is insufficient with the classic paradigm. The current study investigated an improved perceived spatial separation PPI (PSSPPI) paradigm in CHR individuals, compared with patients of first-episode schizophrenia (FES) and healthy controls (HC), and the relationship between PPI, demographics, clinical characteristics, and cognitive performance. Methods We included 53 FESs, 55 CHR individuals, and 53 HCs. CHRs were rated on the Structured Interview for Prodromal Syndromes (SIPS). The prepulse inhibition measures of perceived spatial co-location PPI (PSCPPI) and PSSPPI paradigms were applied using 60- and 120-ms lead intervals. The MATRICS Consensus Cognitive Battery (MCCB) was used to assess neurocognitive functions. Results Compared with HC, the CHR group had lower PSSPPI level (ISI=60 ms, P<0.001; ISI=120 ms, P<.001). PSSPPI showed a large effect size (ES) between CHR and HC (ISI=60 ms, ES=0.91; ISI=120 ms, ES=0.98); on PSSPPI using 60-ms lead interval, ES ranged from small to large from CHR to FES. PPI deficits in CHR were unrelated to demographics, clinical characteristics, and cognition. Discussion CHR individuals show a sensorimotor gating deficit similar to FES patients on PSSPPI of the startle response, with greater sensitivity than the classic PPI paradigm. PSSPPI appears a promising objective approach for identifying individuals at clinical high risk for psychosis related to a high risk of transition to schizophrenia.

scholarly journals Impaired Sensorimotor Gating Using the Acoustic Prepulse Inhibition Paradigm in Individuals at a Clinical High Risk for Psychosis

2020 ◽  
Author(s):  
Qijing Bo ◽  
Zhen Mao ◽  
Qing Tian ◽  
Ningbo Yang ◽  
Xianbin Li ◽  
...  
Keyword(s):  
High Risk ◽  
Prepulse Inhibition ◽  
Characteristic Curve ◽  
Structured Interview ◽  
First Episode ◽  
Enhancement Effect ◽  
Clinical High Risk ◽  
Stimulus Interval ◽  
Cohen’S D ◽  
Cohen's D

Abstract Many robust studies have investigated prepulse inhibition (PPI) in patients with schizophrenia. Recent evidence indicates that PPI may help identify individuals who are at clinical high risk for psychosis (CHR). Selective attention to prepulse stimulus can specifically enhance PPI in healthy subjects; however, this enhancement effect is not observed in patients with schizophrenia. Modified PPI measurement with selective attentional modulation using perceived spatial separation (PSS) condition may be a more robust and sensitive index of PPI impairment in CHR individuals. The current study investigated an improved PSSPPI condition in CHR individuals compared with patients with first-episode schizophrenia (FES) and healthy controls (HC) and evaluated the accuracy of PPI in predicting CHR from HC. We included 53 FESs, 55 CHR individuals, and 53 HCs. CHRs were rated on the Structured Interview for Prodromal Syndromes. The measures of perceived spatial co-location PPI (PSCPPI) and PSSPPI conditions were applied using 60- and 120-ms lead intervals. Compared with HC, the CHR group had lower PSSPPI level (Inter-stimulus interval [ISI] = 60 ms, P < .001; ISI = 120 ms, P < .001). PSSPPI showed an effect size (ES) between CHR and HC (ISI = 60 ms, Cohen’s d = 0.91; ISI = 120 ms, Cohen’s d = 0.98); on PSSPPI using 60-ms lead interval, ES grade increased from CHR to FES. The area under the receiver operating characteristic curve for PSSPPI was greater than that for PSCPPI. CHR individuals showed a PSSPPI deficit similar to FES, with greater ES and sensitivity. PSSPPI appears a promising objective approach for preliminary identification of CHR individuals.

scholarly journals Alterations in Emotional Diversity Correspond With Increased Severity of Attenuated Positive and Negative Symptoms in the Clinical High-Risk Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Zachary Anderson ◽  
Tina Gupta ◽  
William Revelle ◽  
Claudia M. Haase ◽  
Vijay A. Mittal
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Medication Use ◽  
Structured Interview ◽  
Clinical High Risk ◽  
Future Studies ◽  
Clinical Interviews ◽  
Clinical Correlates ◽  
Psychosis Risk ◽  
Positive And Negative Symptoms

Background: Alterations in emotional functioning are a key feature of psychosis and are present in individuals with a clinical high-risk (CHR) syndrome. However, little is known about alterations in emotional diversity (i.e., the variety and relative abundance of emotions that humans experience) and clinical correlates in this population.Methods: Individuals meeting criteria for a CHR syndrome (N = 47) and matched healthy controls (HC) (N = 58) completed the modified Differential Emotions Scale (used to derive scores of total, positive, and negative emotional diversity) and clinical interviews (i.e., Structured Interview for Psychosis-Risk Syndromes).Results: Findings showed that the CHR group experienced lower levels of positive emotional diversity compared to HCs. Among the CHR individuals, lower levels of positive and higher levels of negative emotional diversity were associated with more severe attenuated positive and negative symptoms. Analyses controlled for mean levels of emotion and current antipsychotic medication use.Discussion: Results demonstrate that altered emotional diversity (in particular lower levels of positive and higher levels of negative emotional diversity) is a clinically relevant marker in CHR individuals, above and beyond alterations in mean levels of emotional experiences. Future studies may probe sources, downstream consequences, and potential modifiability of decreased emotional diversity in individuals at CHR.

scholarly journals S27. EXAMINING DISCREPANCIES BETWEEN SELF-REPORT AND CLINICIAN-RATED ASSESSMENTS OF PSYCHOSIS RISK: DOES INTERNALIZED STIGMA MATTER?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S41-S41
Author(s):  
LeeAnn Shan ◽  
Zachary B Millman ◽  
Joseph DeLuca ◽  
Mallory J Klaunig ◽  
Pamela Rakhshan Rouhakhtar ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Structured Interview ◽  
Self Report ◽  
Internalized Stigma ◽  
Clinical High Risk ◽  
Negative Stereotypes ◽  
Psychosis Risk

Abstract Background Psychosis is one of the most highly stigmatized mental health conditions (Thornicroft et al., 2009). Compared to those with other mental health concerns, people diagnosed with schizophrenia spectrum disorders are more likely to be perceived by others as dangerous, violent, and unpredictable. As a result, they are often socially marginalized and discriminated against (Crisp et al., 2000; Martin et al., 2007). Individuals at clinical high risk (CHR) for psychosis may be at lower risk for experiencing public stigma, given that their symptoms are often less outwardly visible at this early stage of illness. However, evidence suggests that those at CHR experience high levels of self-stigma, as they may internalize negative stereotypes related to psychosis (Yang et al., 2010; Yang et al., 2015). Internalized stigma can negatively impact help-seeking behavior and has been associated with lower self-esteem and the underreporting of mental health symptoms (Corrigan, 2004; Corrigan, 2007; Saporito, Ryan, & Teachman, 2011; Rüsch, Angermeyer, & Corrigan, 2005). Despite these findings, no studies to-date have examined how internalized stigma may impact reporting of attenuated psychosis symptoms in the CHR population. The current study aims to examine whether discrepancies between self-report and clinician-rated measures of psychosis risk are associated with internalized stigma in a sample of help-seeking adolescents and young adults. We hypothesized that higher levels of self-stigma will predict inconsistencies between self-reported symptom severity and clinician-obtained diagnoses of psychosis risk. Methods Participants will include youth classified as either non-psychosis-related help-seeking controls or at clinical high risk (CHR) for psychosis, as determined by the Structured Interview for Psychosis-Risk Syndromes (SIPS; Miller et al., 2003). The SIPS is administered by trained raters and is currently considered the gold standard tool for diagnosing clinical high-risk syndromes (Thompson et al., 2018). In addition to SIPS diagnoses, psychosis risk will also be assessed using the Prime Screen – Revised (PS-R; Miller et al., 2004), a brief, 12-item self-report questionnaire designed to measure attenuated positive symptoms. Lastly, internalized stigma will be assessed using the Internalized Stigma of Mental Illness Inventory (ISMI; Ritsher, Otilingam, & Grajales, 2003), a 29-item self-report questionnaire designed to measure subjective experiences of stigma in adolescents (e.g., endorsement of negative stereotypes, social withdrawal and feelings of alienation due to mental health problems, etc.). Results Preliminary analyses demonstrate a significant interaction between Prime scores and internalized stigma in predicting SIPS diagnoses. Specifically, higher scores on the Prime were associated with increased odds of being diagnosed as CHR on the SIPS, but only for those participants who endorsed low and mean levels of stigma. For participants who endorsed high levels of stigma, there did not appear to be any relation between Prime scores and SIPS diagnoses. Discussion At the time of submission, participant recruitment is ongoing, and results and discussion will be presented on the final sample. Findings may inform efforts to improve detection and accurate diagnosis of psychosis risk syndromes in individuals at early stages of illness.

scholarly journals The role of a family history of psychosis for youth at clinical high risk of psychosis

2017 ◽  
Vol 13 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Grace Georgopoulos ◽  
Jacqueline Stowkowy ◽  
Lu Liu ◽  
Kristin S. Cadenhead ◽  
Tyrone D. Cannon ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Clinical High Risk ◽  
History Of

scholarly journals Family history of psychosis as a predictor or protective factor of social maladjustment in a population at clinical high risk for psychosis

2014 ◽  
Vol 219 (3) ◽  
pp. 696-699 ◽  
Author(s):  
S. Lucy Poe ◽  
Kelly E. Gill ◽  
Gary Brucato ◽  
Cheryl M. Corcoran ◽  
Ragy R. Girgis
Keyword(s):  
Family History ◽  
High Risk ◽  
Protective Factor ◽  
Clinical High Risk ◽  
Social Maladjustment ◽  
History Of

Calculating individualized risk components using a mobile app-based risk calculator for clinical high risk of psychosis: findings from ShangHai At Risk for Psychosis (SHARP) program

2019 ◽  
pp. 1-8 ◽  
Author(s):  
TianHong Zhang ◽  
LiHua Xu ◽  
HuiJun Li ◽  
Kristen A. Woodberry ◽  
Emily R. Kline ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Structured Interview ◽  
Risk Identification ◽  
Mobile App ◽  
Individual Risk ◽  
Second Phase ◽  
Clinical High Risk ◽  
Risk Calculator ◽  
Psychosis Risk

Abstract Background Only 30% or fewer of individuals at clinical high risk (CHR) convert to full psychosis within 2 years. Efforts are thus underway to refine risk identification strategies to increase their predictive power. Our objective was to develop and validate the predictive accuracy and individualized risk components of a mobile app-based psychosis risk calculator (RC) in a CHR sample from the SHARP (ShangHai At Risk for Psychosis) program. Method In total, 400 CHR individuals were identified by the Chinese version of the Structured Interview for Prodromal Syndromes. In the first phase of 300 CHR individuals, 196 subjects (65.3%) who completed neurocognitive assessments and had at least a 2-year follow-up assessment were included in the construction of an RC for psychosis. In the second phase of the SHARP sample of 100 subjects, 93 with data integrity were included to validate the performance of the SHARP-RC. Results The SHARP-RC showed good discrimination of subsequent transition to psychosis with an AUC of 0.78 (p < 0.001). The individualized risk generated by the SHARP-RC provided a solid estimation of conversion in the independent validation sample, with an AUC of 0.80 (p = 0.003). A risk estimate of 20% or higher had excellent sensitivity (84%) and moderate specificity (63%) for the prediction of psychosis. The relative contribution of individual risk components can be simultaneously generated. The mobile app-based SHARP-RC was developed as a convenient tool for individualized psychosis risk appraisal. Conclusions The SHARP-RC provides a practical tool not only for assessing the probability that an individual at CHR will develop full psychosis, but also personal risk components that might be targeted in early intervention.

Recency and intensification of positive symptoms enhance prediction of conversion to syndromal psychosis in clinical high-risk patients

2019 ◽  
pp. 1-9
Author(s):  
Gary Brucato ◽  
Michael B. First ◽  
Gabriella A. Dishy ◽  
Shana S. Samuel ◽  
Qing Xu ◽  
...  
Keyword(s):  
High Risk ◽  
Help Seeking ◽  
Structured Interview ◽  
Positive Symptom ◽  
First Episode ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Predictive Capacity ◽  
Psychosis Risk ◽  
Risk Patients

Abstract Background Early detection and intervention strategies in patients at clinical high-risk (CHR) for syndromal psychosis have the potential to contain the morbidity of schizophrenia and similar conditions. However, research criteria that have relied on severity and number of positive symptoms are limited in their specificity and risk high false-positive rates. Our objective was to examine the degree to which measures of recency of onset or intensification of positive symptoms [a.k.a., new or worsening (NOW) symptoms] contribute to predictive capacity. Methods We recruited 109 help-seeking individuals whose symptoms met criteria for the Progression Subtype of the Attenuated Positive Symptom Psychosis-Risk Syndrome defined by the Structured Interview for Psychosis-Risk Syndromes and followed every three months for two years or onset of syndromal psychosis. Results Forty-one (40.6%) of 101 participants meeting CHR criteria developed a syndromal psychotic disorder [mostly (80.5%) schizophrenia] with half converting within 142 days (interquartile range: 69–410 days). Patients with more NOW symptoms were more likely to convert (converters: 3.63 ± 0.89; non-converters: 2.90 ± 1.27; p = 0.001). Patients with stable attenuated positive symptoms were less likely to convert than those with NOW symptoms. New, but not worsening, symptoms, in isolation, also predicted conversion. Conclusions Results suggest that the severity and number of attenuated positive symptoms are less predictive of conversion to syndromal psychosis than the timing of their emergence and intensification. These findings also suggest that the earliest phase of psychotic illness involves a rapid, dynamic process, beginning before the syndromal first episode, with potentially substantial implications for CHR research and understanding the neurobiology of psychosis.

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