26.3 SALIENCE SIGNALING AND THE EMERGENCE OF PSYCHOPATHOLOGY IN YOUTH AT CLINICAL HIGH RISK FOR PSYCHOTIC ILLNESS

Background: Metacognition has been described as the knowledge of our own cognitive processes. Metacognitive deficits are common in schizophrenia, but little is known about metacognition before the onset of full-blown psychosis. Aims: This study aimed to longitudinally characterize metacognition in a sample of individuals at clinical high risk (CHR) for psychosis, and to determine if metacognition was related to later conversion to psychosis. Method: Participants (153 CHR individuals; 68 help seeking controls, HSC) were part of the large multi-site PREDICT study, which sought to determine predictors of conversion to psychosis. They were tested at baseline and 6 months using the Meta-Cognitions Questionnaire (MCQ) that has five sub-scales assessing different domains of metacognition. Results: Results of the mixed-effect models demonstrated significantly poorer scores at baseline for the CHR group compared to the HSC group in Negative beliefs about uncontrollability, Negative beliefs and the overall MCQ score. At the 6-month assessment, no difference was observed in metacognition between the two groups, but both groups showed improvement in metacognition over time. Those who later converted to psychosis had poorer performance on metacognitive beliefs at baseline. Conclusions: A poorer performance in metacognition can be seen as a marker of developing a full blown psychotic illness and confirms the potential value of assessing metacognitive beliefs in individuals vulnerable for psychosis.

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Assessing psychosis risk using quantitative markers of disorganised speech

10.1101/2021.01.04.20248717 ◽

2021 ◽

Author(s):

Sarah E Morgan ◽

Kelly Diederen ◽

Petra E Vértes ◽

Samantha HY Ip ◽

Bo Wang ◽

...

Keyword(s):

High Risk ◽

Language Processing ◽

Graph Connectivity ◽

First Episode ◽

Clinical High Risk ◽

Psychotic Illness ◽

Significant Group ◽

Semantic Coherence ◽

Psychosis Risk ◽

Diagnostic Applications

AbstractRecent work has suggested that disorganised speech might be a powerful predictor of later psychotic illness in clinical high risk subjects. To that end, several automated measures to quantify disorganisation of transcribed speech have been proposed. However, it remains unclear which measures are most predictive of psychosis-onset, how different measures relate to each other and what the best strategies are to elicit disorganised speech from participants. Here, we assessed the ability of twelve automated Natural Language Processing markers to differentiate transcribed speech excerpts from subjects at clinical high risk for psychosis (N=25), first episode psychosis patients (N=16) and healthy control subjects (N=13; N=54 in total). In-line with previous work, several of these measures showed significant differences between groups, including semantic coherence and speech graph connectivity. We also proposed two additional measures of repetition and whether speech was on topic, the latter of which exhibited significant group differences and outperformed the prior, related measure of tangentiality. Most measures examined were only weakly related to each other, suggesting they provide complementary information and that combining different measures could provide additional power to predict the onset of psychotic illness. Finally, we compared the ability of transcribed speech generated using different tasks to differentiate the groups. Speech generated from picture descriptions of the Thematic Apperception Test and a story re-telling task outperformed free speech, suggesting that choice of speech generation method may be an important consideration. Overall, quantitative speech markers represent a promising direction for future diagnostic applications for psychosis risk.

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Clinical and functional characteristics of youth at clinical high-risk for psychosis who do not transition to psychosis

Psychological Medicine ◽

10.1017/s0033291718002258 ◽

2018 ◽

Vol 49 (10) ◽

pp. 1670-1677 ◽

Cited By ~ 25

Author(s):

Jean Addington ◽

Jacqueline Stowkowy ◽

Lu Liu ◽

Kristin S. Cadenhead ◽

Tyrone D. Cannon ◽

...

Keyword(s):

Longitudinal Study ◽

High Risk ◽

Functional Outcomes ◽

Recent Literature ◽

Clinical Symptoms ◽

Detailed Examination ◽

Psychotic Symptoms ◽

Healthy Controls ◽

Clinical High Risk ◽

Psychotic Illness

AbstractBackgroundMuch of the interest in youth at clinical high risk (CHR) of psychosis has been in understanding conversion. Recent literature has suggested that less than 25% of those who meet established criteria for being at CHR of psychosis go on to develop a psychotic illness. However, little is known about the outcome of those who do not make the transition to psychosis. The aim of this paper was to examine clinical symptoms and functioning in the second North American Prodrome Longitudinal Study (NAPLS 2) of those individuals whose by the end of 2 years in the study had not developed psychosis.MethodsIn NAPLS-2 278 CHR participants completed 2-year follow-ups and had not made the transition to psychosis. At 2-years the sample was divided into three groups – those whose symptoms were in remission, those who were still symptomatic and those whose symptoms had become more severe.ResultsThere was no difference between those who remitted early in the study compared with those who remitted at one or 2 years. At 2-years, those in remission had fewer symptoms and improved functioning compared with the two symptomatic groups. However, all three groups had poorer social functioning and cognition than healthy controls.ConclusionsA detailed examination of the clinical and functional outcomes of those who did not make the transition to psychosis did not contribute to predicting who may make the transition or who may have an earlier remission of attenuated psychotic symptoms.

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