[Cannabis use in subjects at ultra high risk for psychosis]

Development and initial validation of the cannabis-related psychosis risk literacy scale (CPRL): a multinational psychometric study

BACKGROUND

Public education efforts to address and reduce potential harms from cannabis use in Arab countries are either slow or inexistent, and do not follow the steadily increasing trends of cannabis use in Arab youth. Several decades of research on substance use, it can be suggested that being aware of, and knowing about, psychosis risk related to cannabis can at least limit the consumption of the substance. Motivated by a lack of measures specifically designed to measure literacy about cannabis-related psychosis risk in younger populations, and based on an extensive literature review, we aimed to create and validate a new self-report scale to assess the construct, the Cannabis-related Psychosis Risk Literacy Scale (CPRL), in the Arabic language.

METHOD

A cross-sectional study was carried-out during the period from September 2022 to June 2023, enrolling 1855 university students (mean age of 23.26 ± 4.96, 75.6% females) from three Arab countries (Egypt, Kuwait and Tunisia).

RESULTS

Starting from an initial pool of 20 items, both Exploratory Factor Analysis and Confirmatory Factor Analysis suggested that the remaining 8 items loaded into a single factor. The scale demonstrated good internal consistency, with both McDonald omega and Cronbach's alpha values exceeding 0.7 (omega = 0.85 / alpha = 0.85). The CPRL showed measurement invariance across gender and country at the configural, metric, and scalar levels. Concurrent validity of the CPRL was established by correlations with less favourable attitudes towards cannabis (r = -.14; p <.001). In addition, higher literacy levels were found in students who never used cannabis compared to lifetime users (4.18 ± 1.55 vs. 3.44 ± 1.20, t(1853) = 8.152, p <.001).

CONCLUSION

The newly developed CPRL scale offers a valid and reliable instrument for assessing and better understanding literacy about cannabis-related psychosis risk among Arabic-speaking young adults. We believe that this new scale is suitable as a screening tool of literacy, as an instrument for measuring the effect of public education interventions aimed at promoting cannabis-related psychosis risk literacy among young people, and as a research tool to facilitate future studies on the topic with a wider application.

Schizotypal traits in a large sample of high-school and university students from Tunisia: correlates and measurement invariance of the arabic schizotypal personality questionnaire across age and sex

BACKGROUND

The main goal of the present study was to examine the characteristics of schizotypal traits and their correlations with genetic (i.e., family history of mental illness), demographic (i.e., age, sex), environmental (e.g., income, urbanicity, tobacco/alcohol/cannabis use), and psychological (i.e., personal history of mental illness other than psychosis) factors in Tunisian high-school and university students. Our secondary goal was to contribute the literature by examining the factor structure and factorial invariance of the Arabic Schizotypal Personality Questionnaire (SPQ) across sex and age (adolescents [12-18 years] vs. young adults [18-35 years]) groups.

METHOD

This was a cross-sectional study involving 3166 students: 1160 (36.6%) high-school students (53.0% females, aged 14.9 ± 1.8); and 2006 (63.4%) university students (63.9% females, aged 21.8 ± 2.3). All students were asked to complete a paper-and-pencil self-administered questionnaire containing sociodemographic characteristics as well as the Arabic version of the SPQ.

RESULTS

The total sample yielded total SPQ scores of 24.1 ± 16.6 out of 74. The SPQ yielded good composite reliability as attested by McDonald's omega values ranging from .68 to .80 for all nine subscales. Confirmatory Factor Analysis indicated that fit of the 9-factor model of SPQ scores was acceptable. This model is invariant (at the configural, metric and structural levels) across sex and age. Except for "Odd or eccentric behavior", all schizotypy features were significantly higher among female students compared to males. Multivariable analyses showed that female sex, being a university student, lowest family incomes, tobacco use, and having a personal history of psychiatric illness were significantly associated with higher positive, negative and disorganized schizotypy subscales scores.

CONCLUSION

Future research still needs to confirm our findings and investigate the contribution of the identified factors in the development of clinical psychosis. We can also conclude that the Arabic SPQ is appropriate for measuring and comparing schizotypy across age and sex in clinical and research settings. These findings are highly relevant and essential for ensuring the clinical utility and applicability of the SPQ in cross-cultural research.