Virtual reality and paranoid ideations in people with an ‘at-risk mental state’ for psychosis

BackgroundVirtual reality provides a means of studying paranoid thinking in controlled laboratory conditions. However, this method has not been used with a clinical groupAimsTo establish the feasibility and safety of using virtual reality methodology in people with an at-risk mental state and to investigate the applicability of a cognitive model of paranoia to this groupMethodTwenty-one participants with an at-risk mental state were assessed before and after entering a virtual reality environment depicting the inside of an underground trainResultsVirtual reality did not raise levels of distress at the time of testing or cause adverse experiences over the subsequent week. Individuals attributed mental states to virtual reality characters including hostile intent. Persecutory ideation in virtual reality was predicted by higher levels of trait paranoia, anxiety, stress, immersion in virtual reality, perseveration and interpersonal sensitivityConclusionsVirtual reality is an acceptable experimental technique for use with individuals with at-risk mental states. Paranoia in virtual reality was understandable in terms of the cognitive model of persecutory delusions

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Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study

Psychological Medicine ◽

10.1017/s0033291713000251 ◽

2013 ◽

Vol 43 (11) ◽

pp. 2311-2325 ◽

Cited By ~ 71

Author(s):

L. R. Valmaggia ◽

D. Stahl ◽

A. R. Yung ◽

B. Nelson ◽

P. Fusar-Poli ◽

...

Keyword(s):

At Risk ◽

Cluster Analysis ◽

Mental State ◽

Latent Class ◽

Mental States ◽

Psychotic Symptoms ◽

Role Functioning ◽

Latent Class Cluster Analysis ◽

At Risk Mental State

BackgroundMany research groups have attempted to predict which individuals with an at-risk mental state (ARMS) for psychosis will later develop a psychotic disorder. However, it is difficult to predict the course and outcome based on individual symptoms scores.MethodData from 318 ARMS individuals from two specialized services for ARMS subjects were analysed using latent class cluster analysis (LCCA). The score on the Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to explore the number, size and symptom profiles of latent classes.ResultsLCCA produced four high-risk classes, censored after 2 years of follow-up: class 1 (mild) had the lowest transition risk (4.9%). Subjects in this group had the lowest scores on all the CAARMS items, they were younger, more likely to be students and had the highest Global Assessment of Functioning (GAF) score. Subjects in class 2 (moderate) had a transition risk of 10.9%, scored moderately on all CAARMS items and were more likely to be in employment. Those in class 3 (moderate–severe) had a transition risk of 11.4% and scored moderately severe on the CAARMS. Subjects in class 4 (severe) had the highest transition risk (41.2%), they scored highest on the CAARMS, had the lowest GAF score and were more likely to be unemployed. Overall, class 4 was best distinguished from the other classes on the alogia, avolition/apathy, anhedonia, social isolation and impaired role functioning.ConclusionsThe different classes of symptoms were associated with significant differences in the risk of transition at 2 years of follow-up. Symptomatic clustering predicts prognosis better than individual symptoms.

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Neuroanatomical correlates of different vulnerability states for psychosis and their clinical outcomes

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.052068 ◽

2009 ◽

Vol 195 (3) ◽

pp. 218-226 ◽

Cited By ~ 60

Author(s):

Nikolaos Koutsouleris ◽

Gisela J. E. Schmitt ◽

Christian Gaser ◽

Ronald Bottlender ◽

Johanna Scheuerecker ◽

...

Keyword(s):

At Risk ◽

Clinical Outcome ◽

Mental State ◽

Grey Matter ◽

Mental States ◽

Grey Matter Volume ◽

Healthy Controls ◽

Imaging Data ◽

Matter Volume ◽

At Risk Mental State

BackgroundStructural brain abnormalities have been described in individuals with an at-risk mental state for psychosis. However, the neuroanatomical underpinnings of the early and late at-risk mental state relative to clinical outcome remain unclear.AimsTo investigate grey matter volume abnormalities in participants in a putatively early or late at-risk mental state relative to their prospective clinical outcome.MethodVoxel-based morphometry of magnetic resonance imaging data from 20 people with a putatively early at-risk mental state (ARMS–E group) and 26 people with a late at-risk mental state (ARMS–L group) as well as from 15 participants with at-risk mental states with subsequent disease transition (ARMS–T group) and 18 participants without subsequent disease transition (ARMS–NT group) were compared with 75 healthy volunteers.ResultsCompared with healthy controls, ARMS–L participants had grey matter volume losses in frontotemporolimbic structures. Participants in the ARMS–E group showed bilateral temporolimbic alterations and subtle prefrontal abnormalities. Participants in the ARMS–T group had prefrontal alterations relative to those in the ARMS–NT group and in the healthy controls that overlapped with the findings in the ARMS–L group.ConclusionsBrain alterations associated with the early at-risk mental state may relate to an elevated susceptibility to psychosis, whereas alterations underlying the late at-risk mental state may indicate a subsequent transition to psychosis.

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Clinical and Functional Outcomes of At-Risk Mental State Among Non-Help Seeking Adolescents

10.21203/rs.3.rs-65345/v1 ◽

2020 ◽

Author(s):

Patrik Švancer ◽

Aneta Dorazilová ◽

Veronika Voráčková ◽

Pavel Knytl ◽

Pavel Mohr ◽

...

Keyword(s):

At Risk ◽

Cognitive Performance ◽

Mental State ◽

Verbal Memory ◽

Visual Memory ◽

Help Seeking ◽

Mental States ◽

Psychotic Symptoms ◽

Negatively Associated ◽

At Risk Mental State

Abstract Background: At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment. The findings are mostly based on research in help-seeking at-risk population. Our study aim was to explore prevalence rates of ARMS, comorbidities, functioning, and cognitive performance among non-help seeking adolescents. Patients and methods: Study subjects were randomly selected high school adolescents. At-risk mental state was assessed with Comprehensive Assessment of At Risk Mental States interview (CAARMS). Kiddie-Schedule for Affective Disorders and Schizophrenia examined comorbidities. Social functioning and quality of life were measured with Social and Occupational Functioning Assessment Scale (SOFAS) and KIDSCREEN 52. Cognitive performance in the domains of visual memory, verbal memory, working memory, and processing speed was assessed with a battery of cognitive tests Results: The total of 82 adolescents was enrolled, 21 of them met the ARMS criteria. No case of threshold psychotic disorder was detected in the study sample. Subthreshold mental disorders were more frequent in the ARMS+ group than in the ARMS- group (OR= 3.05; 95%CI 1.07, 8.67; p=0.03). Lower SOFAS scores were observed in the ARMS+ group compared to the ARMS- group (t= -3.888; p<.001; Cohen’s d = 0.99). In the total sample, CAARMS symptoms intensity was negatively associated with the SOFAS score (β = -.51; R2 = 0.26; p<.001). No significant differences in the KIDSCREEN-52 scores or cognitive functioning were found between the groups. Conclusion: Our findings suggest that non-help seeking adolescents with at-risk mental state have worse level of functioning compared to controls and higher rates of non-psychotic psychiatric comorbidities. Reduction in functioning is negatively associated with the severity of their subsyndromal psychotic symptoms.

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