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Raine A, Gur RC, Gur RE, Richmond TS, Hibbeln J, Liu J. Omega-3 Supplementation Reduces Schizotypal Personality in Children: A Randomized Controlled Trial. Schizophr Bull 2024:sbae009. [PMID: 38300759 DOI: 10.1093/schbul/sbae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS Based on a childhood intervention from ages 3 to 5 years that included additional fish consumption and which resulted in reduced schizotypal personality at age 23, we had previously hypothesized that omega-3 could reduce schizotypy. The current study tests the hypothesis that omega-3 supplementation reduces schizotypy in children. STUDY DESIGN In this intention-to-treat, randomized, single-blind, stratified, factorial trial, a community sample of 290 children aged 11-12 years were randomized into Omega-3 Only, Cognitive Behavioral Therapy (CBT) Only, Omega-3 + CBT, and Control groups. Schizotypy was assessed using the SPQ-C (Schizotypal Personality Questionnaire for Children) at 0 months (baseline), 3 months (end of treatment), 6 months (3 months post-treatment), and 12 months (9 months post-treatment). STUDY RESULTS A significant group × time interaction (P = .013) indicated that, compared with Controls, total schizotypy scores were reduced in both Omega-3 Only and Omega-3 + CBT groups immediately post-treatment (d = 0.56 and 0.47, respectively), and also 3 months after supplementation terminated (d = 0.49, d = 0.70). Stronger findings were observed for the interpersonal schizotypy factor, with both omega-3 groups showing reductions 9 months post-treatment compared with the CBT Only group. Schizotypy reductions were significantly stronger for those with higher dietary intake of omega-3 at intake. Sensitivity analyses confirmed findings. CONCLUSIONS Results are unique in the field and suggest that omega-3 can help reduce schizotypal personality in community-residing children. From an epidemiological standpoint, if replicated and extended, these findings could have implications for early prevention of more significant schizotypal features developing later in adolescence. CLINICAL TRIAL REGISTRATION "Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)." ClinicalTrials.gov Identifier: NCT00842439, https://clinicaltrials.gov/ct2/show/NCT00842439.
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Affiliation(s)
- Adrian Raine
- Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Fekih-Romdhane F, Hakiri A, Stambouli M, Cherif W, Away R, Amri A, Cheour M, Hallit S. 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. BMC Psychiatry 2023; 23:447. [PMID: 37340441 DOI: 10.1186/s12888-023-04942-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
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.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia.
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Abir Hakiri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Manel Stambouli
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Wissal Cherif
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Rami Away
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Amani Amri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Deng J, Chen S, Ou Y, Zhang Y, Lin Z, Shen Y, Ye Y. Auditory P300 in individuals with high schizotypy: associations of schizotypal traits with amplitude and latency under different oddball conditions. Front Hum Neurosci 2023; 17:1107858. [PMID: 37275344 PMCID: PMC10232759 DOI: 10.3389/fnhum.2023.1107858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Background The aim of this study was to compare the characteristics of auditory P300 between non-clinical individuals with high and low schizotypal traits, and investigate the relationship between schizotypy and P300 under various oddball conditions. Methods An extreme-group design was adopted. After screening 1,519 young adults using the Schizotypal Personality Questionnaire (SPQ), sixty-three participants were chosen and divided into two groups (schizotypy group: 31 participants; control group: 32 participants). Basic demographic information was assessed and matched between groups. Depression and anxiety indexes were evaluated and controlled. The P300 component was evoked by an auditory oddball paradigm with different frequencies and durations. Results (1) The duration P300 amplitude at PZ site was significantly weaker in the schizotypy group than in the control group [F(1,54) = 7.455, p = 0.009, ηp2 = 0.121]. (2) In the schizotypy group, the latency of frequency P300 at PZ site under large-variant oddball condition was significantly correlated with total SPQ scores (rp = 0.451, p = 0.018) and disorganized dimension scores (rp = 0.381, p = 0.050). (3) In the control group, significantly negative correlations was found between the negative dimension score of SPQ and the frequency P300 amplitudes under small variant condition (PZ: rp = -0.393, p = 0.043; CPZ: rp = -0.406, p = 0.035). In addition, a significant negative relationship was found between disorganized dimension scores and the duration P300 latency at CPZ site under large-variant oddball condition (rp = -0.518, p = 0.006). Moreover, a significant negative association was found between the duration P300 amplitude at CPZ site under small-variant oddball condition and negative factor scores (rp = -0.410, p = 0.034). Conclusion Individuals with high schizotypal traits were likely to have deficient attention and hypoactive working memory for processing auditory information, especially the duration of sounds. P300 effects were correlated with negative and disorganized schizotypy, rather than positive schizotypy. There were diverse patterns of relationship between schizotypal traits and P300 under different oddball conditions, suggesting that characteristics and parameters of target stimuli should be considered cautiously when implementing an auditory oddball paradigm for individuals with schizophrenia spectrum.
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Affiliation(s)
- Jue Deng
- Cognitive Neuroscience and Abnormal Psychology Laboratory, Department of Penalty Execution, Fujian Police College, Fuzhou, China
| | - Siwei Chen
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Yuanhua Ou
- Cognitive Neuroscience and Abnormal Psychology Laboratory, Department of Penalty Execution, Fujian Police College, Fuzhou, China
| | - Yuanjun Zhang
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Ziyue Lin
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Yane Shen
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Yiduo Ye
- School of Psychology, Fujian Normal University, Fuzhou, China
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Women empowerment and access to maternity and reproductive healthcare in Pakistan: cross-validation of a Survey-based Index in Afghanistan (SWEI-A). BMC Womens Health 2022; 22:453. [PMID: 36384773 PMCID: PMC9670496 DOI: 10.1186/s12905-022-02031-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background Despite the obvious violation of women’s rights in Pakistan and the vital necessity for women empowerment, a unified country-specific index measuring women empowerment is not yet available. This study cross-validated a survey-based women empowerment index from Afghanistan to be used in Pakistan. Methods The data for married Pakistani women aged 15–49 in the 2017–18 Pakistan demographic health survey was used to construct the final model using the explanatory and confirmatory factor analyses. The Cronbach’s alpha test examined the internal consistency of the developed index. To assess the convergence validity of the index, the association of each emerged domain with indicators of access to reproductive and maternity care was assessed by Poisson regression analysis adjusting for wealth index. Results The final index had six domains; namely, labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events predicting women empowerment of married Pakistani women with decent reliability (Cronbach’s α = 0.70), and validity (SRSEA&SRMR < 0.05, CFI&TLI > 0.92). The emerged domains were significantly associated with at least one of four indicators for access to reproductive and maternity care; indicative of a favorable convergence validity. Conclusion Pakistan and Afghanistan are associated as brother countries with shared religious and ethnocultural identities in which women are perceived inferior to men and in critical need of empowering efforts. The results of this study reflect upon this resemblance in sociocultural structure by yielding similar domains for women's empowerment in Pakistan building upon an index previously developed for Afghan women. The developed index could inform the design of future policies, interventions, and research recognizing the important indicators of women empowerment in Pakistan and could enhance the comparability of the results across future studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-02031-2.
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Affinity scores: An individual-centric fingerprinting framework for neuropsychiatric disorders. Transl Psychiatry 2022; 12:322. [PMID: 35945206 PMCID: PMC9363458 DOI: 10.1038/s41398-022-02084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
Population-centric frameworks of biomarker identification for psychiatric disorders focus primarily on comparing averages between groups and assume that diagnostic groups are (1) mutually-exclusive, and (2) homogeneous. There is a paucity of individual-centric approaches capable of identifying individual-specific 'fingerprints' across multiple domains. To address this, we propose a novel framework, combining a range of biopsychosocial markers, including brain structure, cognition, and clinical markers, into higher-level 'fingerprints', capable of capturing intra-illness heterogeneity and inter-illness overlap. A multivariate framework was implemented to identify individualised patterns of brain structure, cognition and clinical markers based on affinity to other participants in the database. First, individual-level affinity scores defined each participant's "neighbourhood" across each measure based on variable-specific hop sizes. Next, diagnostic verification and classification algorithms were implemented based on multivariate affinity score profiles. To perform affinity-based classification, data were divided into training and test samples, and 5-fold nested cross-validation was performed on the training data. Affinity-based classification was compared to weighted K-nearest neighbours (KNN) classification. The framework was applied to the Australian Schizophrenia Research Bank (ASRB) dataset, which included data from individuals with chronic and treatment resistant schizophrenia and healthy controls. Individualised affinity scores provided a 'fingerprint' of brain structure, cognition, and clinical markers, which described the affinity of an individual to the representative groups in the dataset. Diagnostic verification capability was moderate to high depending on the choice of multivariate affinity metric. Affinity score-based classification achieved a high degree of accuracy in the training, nested cross-validation and prediction steps, and outperformed KNN classification in the training and test datasets. Affinity scores demonstrate utility in two keys ways: (1) Early and accurate diagnosis of neuropsychiatric disorders, whereby an individual can be grouped within a diagnostic category/ies that best matches their fingerprint, and (2) identification of biopsychosocial factors that most strongly characterise individuals/disorders, and which may be most amenable to intervention.
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Gunn CK, Donahue JJ. Intra- and interpersonal emotion regulation strategies and Schizotypic personality characteristics. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Chen Y, Zhan Y, Qiu Y, Zhao J, Zou L. Odor Identification Ability as a Mediator of Schizotypal Traits and Odor Hedonic Capacity in Non-Clinical Children and Adolescents. Brain Sci 2022; 12:brainsci12050534. [PMID: 35624921 PMCID: PMC9138986 DOI: 10.3390/brainsci12050534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/07/2022] Open
Abstract
Background: Previous studies have investigated the relationship between schizotypal traits and odor identification ability as well as the relationship between schizotypal traits and odor hedonic capacity in adults. However, very little is known about the relationship among these three factors, especially in children and adolescents. The current study aimed to explore the relationship among these three factors in children and adolescents as well as the potential role of odor identification ability. Method: A total of 355 non-clinical children and adolescents (aged 9−16 years) were recruited in the study. They were asked to complete the Universal Sniff Test (U-Sniff), the Chemosensory Pleasure Scale for Children (CPS-C), and the Schizotypal Personality Questionnaire—Child (SPQ-C). Results: The SPQ-C scores were negatively correlated with both the odor identification scores and the odor hedonic scores (p = 0.022 and p < 0.001, respectively). Only the interpersonal−affective factor of the SPQ-C was negatively correlated with the odor identification scores (p = 0.031). The odor identification scores were significantly positively associated with the odor hedonic scores (p < 0.001). Moreover, the relationship between odor hedonic capacity and schizotypal traits, especially the interpersonal−affective factor, was mediated by odor identification ability. Conclusions: Schizotypal traits were negatively correlated with both odor identification ability and odor hedonic capacity in children and adolescents, while odor identification ability was found to mediate the relationship between odor hedonic capacity and schizotypal traits, especially the interpersonal−affective factor. Our study indicated that improving odor identification ability through olfactory training may have a positive influence on odor hedonic capacity in individuals with schizotypal traits.
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Affiliation(s)
- Ying Chen
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Y.C.); (Y.Z.); (Y.Q.); (J.Z.)
| | - Yuyang Zhan
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Y.C.); (Y.Z.); (Y.Q.); (J.Z.)
| | - Yiqi Qiu
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Y.C.); (Y.Z.); (Y.Q.); (J.Z.)
| | - Jiubo Zhao
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Y.C.); (Y.Z.); (Y.Q.); (J.Z.)
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Laiquan Zou
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Y.C.); (Y.Z.); (Y.Q.); (J.Z.)
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Correspondence: ; Tel.: +86-20-62789234
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Havers L, Cardno A, Freeman D, Ronald A. The Latent Structure of Negative Symptoms in the General Population in Adolescence and Emerging Adulthood. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac009. [PMID: 35156042 PMCID: PMC8827402 DOI: 10.1093/schizbullopen/sgac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Negative symptoms predict adverse outcomes within psychotic disorders, in individuals at high-risk for psychosis, and in young people in the community. There is considerable interest in the dimensional structure of negative symptoms in clinical samples, and accumulating evidence suggests a 5-factor structure. Little is known about the underlying structure of negative symptoms in young people despite the importance of this developmental stage for mental health. We used confirmatory factor analysis to test the structure of parent-reported negative symptoms at mean ages 16.32 (SD 0.68, N = 4974), 17.06 (SD 0.88, N = 1469) and 22.30 (SD 0.93, N = 5179) in a community sample. Given previously reported associations between total negative symptoms and genome-wide polygenic scores (GPS) for major depressive disorder (MDD) and schizophrenia in adolescence, we assessed associations between individual subdomains and these GPSs. A 5-factor model of flat affect, alogia, avolition, anhedonia, and asociality provided the best fit at each age and was invariant over time. The results of our linear regression analyses showed associations between MDD GPS with avolition, flat affect, anhedonia, and asociality, and between schizophrenia GPS with avolition and flat affect. We showed that a 5-factor structure of negative symptoms is present from ages 16 to 22 in the community. Avolition was most consistently associated with polygenic liability to MDD and schizophrenia, and alogia was least associated. These findings highlight the value of dissecting negative symptoms into psychometrically derived subdomains and may offer insights into early manifestation of genetic risk for MDD and schizophrenia.
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Affiliation(s)
- Laura Havers
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Alastair Cardno
- Division of Psychological and Social Medicine, University of Leeds, Leeds, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Dong F, Calkins ME, Compton P, Medoff-Cooper B, Barzilay R, Taylor JH, Moore TM, Gur RC, Gur RE, Hodgson NA. Association between traumatic stressful events and schizotypal symptoms among a community-based sample of adolescents: A 2-year longitudinal study. Schizophr Res 2021; 233:44-51. [PMID: 34225026 DOI: 10.1016/j.schres.2021.06.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/30/2021] [Accepted: 06/22/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Traumatic stressful events (TSEs) are among the most studied risk factors for subsequent schizotypal symptoms. However, specificity and aggregate effects of trauma exposure on schizotypal symptoms remain unclear. This study investigates these relationships among a community-based sample of US adolescents. MATERIAL AND METHODS A sub-sample of 426 adolescents (51.6% female) from the Philadelphia Neurodevelopmental Cohort study were selected for longitudinal follow-up based on presence (n = 209) or absence (n = 217) of psychosis spectrum symptoms (PSS). At baseline, they completed assessments of demographic, TSEs, other psychopathology (e.g., PSS, anxiety, depression, and behavioral disorder) and family history of psychopathology. Schizotypal symptom dimensions (cognitive-perceptual, interpersonal and disorganized) were evaluated approximately two years later. RESULTS More than half of adolescents experienced at least one type of TSE. Adolescents with assaultive trauma reported about 1.5 times as many symptoms on all three schizotypal symptom dimensions, compared to adolescents with non-assaultive TSE, adjusting for demographic and family history variables. No statistical significance was found after further adjusting for other baseline psychopathology (p > 0.05). There was a significant aggregate effect of TSEs on cognitive-perceptual symptoms with small effect size (p < 0.001, Cohen's f2 = 0.034). CONCLUSIONS We found evidence of an association between aggregate TSEs and cognitive-perceptual symptoms, but trauma type was not associated with schizotypal symptom dimensions when controlling for potential confounders. Our findings highlight the importance of considering aggregate TSE effects and potential confounds when examining associations between TSEs and schizotypy. Trauma and psychosis spectrum screening may be important in the effort to provide trauma-informed care.
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Affiliation(s)
- Fanghong Dong
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA
| | - Peggy Compton
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Ran Barzilay
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA 19104, USA
| | - Jerome H Taylor
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA 19104, USA
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA 19104, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA 19104, USA
| | - Nancy A Hodgson
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
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