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The study examines the relationship between Asperger's Disorder (AD) and Schizotypal Personality Disorder (SPD), mutually exclusive but similar diagnoses [DSM-IV-TR; American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. Washington, DC: Author]. The literature and comparison of diagnostic criteria suggest that the two disorders may overlap: AD social impairment with SPD interpersonal problems and AD communication deficits with SPD disorganized features. Questionnaire measures of AD and SPD were administered to a large non-clinical adult sample. Consistent with expectations, the Asperger's and Schizotypal questionnaires were positively correlated. Further, the social-interpersonal and communication-disorganized areas were positively correlated, though the relationship between social-interpersonal areas is particularly strong. Future research should continue to explore the relationship between AD and schizotypy to confirm current findings and improve understanding of distinctions between the disorders. [ABSTRACT FROM AUTHOR]

Stress-sensitivity (SS) is considered a psychobiological trait possibly resulting from the interaction of genetic and environmental factors (GxE). This study examined whether the interaction of SS-related genetic markers with interview-based dimensions of childhood adversity predicted longitudinal trajectories of low versus high SS. Participants were nonclinically-ascertained young adults comprising normative and elevated scores on schizotypy. SS trajectories were defined in a previous report based on three prospective assessments (23.5, 25, 28 years-old) of both retrospective (Perceived Stress Scale; PSS) and momentary (Experience Sampling Methodology; ESM) stress ratings. A total of n = 177 and n = 165 participants with PSS and ESM stress-sensitivity trajectories, respectively, as well as genetic data, were included in the study. GxE effects between a SS Polygenic Risk Score (PRS-SS) and a Genetic Risk Score of the Hypothalamic Pituitary Adrenal axis (GRS-HPA) with childhood adversity dimensions (Intrafamilial Adversity, Threat and Deprivation) on SS trajectories were examined. Threat was the most consistent predictor of persistently high SS. PRS-SS moderated the association of Threat with high-PSS. GRS-HPA moderated the effects of all adversity dimensions on high-PSS. The interaction of PRS-SS with Deprivation and GRS-HPA with Intrafamilial Adversity predicted trajectories of momentary social stress, but the effects were driven by those with lower genetic susceptibility. Genetic-HPA-axis moderates the effects of all adversity dimensions on persistent SS trajectories, as well as PRS-SS and Threat, particularly for retrospective stress measure. The findings highlight the complex interplay between GxE factors and suggest that PSS may better capture SS trait. Including biologically-meaningful GRS indexing SS and adversity dimensions in future studies using comprehensive stress measures would enhance our knowledge on high SS susceptibility and its relationship with diverse psychopathological outcomes., (© 2024 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)

Background: According to the dimensional view of psychiatric disorders, psychosis is expressed as a continuum in the general population. However, the investigation of the putative genetic aetiological continuity between its clinical and subclinical phenotypes has yielded mixed results. We aimed to replicate previous findings regarding the association of polygenic risk for schizophrenia with subclinical traits (i.e., schizotypy traits and psychotic-like experiences), and to examine the role of sex in this association in a large nonclinical sample., Methods: The Multidimensional Schizotypy Scale and the Community Assessment of Psychic Experiences were assessed in 919 nonclinical participants. Polygenic Risk Scores for schizophrenia (SZ-PRSs) were computed using the PRS-CS method based on the latest genome-wide association study of schizophrenia. Summary statistics derived from the total GWAS sample and stratified by sex were used. Linear regression analyses tested the associations of the SZ-PRSs with the psychometric variables, both in the total sample and by sex., Results: No associations were found between the SZ-PRSs and the positive, negative or disorganized dimensions of schizotypy in the total sample. Likewise, no associations were found with psychotic-like experiences. However, the sex-stratified analyses revealed a male-specific association with positive schizotypy. Similar results were obtained with the PRSs derived from the sex-stratified summary statistics., Discussion: Our results are consistent with the lack of clear evidence of an association between SZ common genetic risk and its subclinical phenotypes. Nevertheless, the male-specific association found suggests that this PRS might explain better the male phenotype, as reported in previous studies. Future studies should put a focus on the role of sex in this association to unravel its sex specificities., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Neus Barrantes-Vidal reports financial support was provided by Ministry of Science and Innovation (PID2020-119211RB-I00). Neus Barrantes-Vidal and Araceli Rosa report financial support provided by Generalitat de Catalunya Ministry of Research and Universities. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The present study examined three empirically-derived childhood adversity dimensions as predictors of social, psychological, and symptom outcomes across three prospective assessments of a young adult sample. Participants were assessed five times over eight years with semi-structured interviews and questionnaires. The analyses used the dimensions underlying multiple subscales from well-established childhood adversity measures administered at the first two assessment waves (described in a previous report). Outcome data pertain to the last three assessment waves, with sample sizes ranging from 89 to 169. As hypothesized, the childhood adversity dimensions demonstrated overlapping and differential longitudinal associations with the outcomes. Deprivation predicted the negative (deficit-like) dimension of psychosis, while Threat and Intrafamilial Adversity predicted the positive (psychotic-like) dimension. Depression and anxiety symptoms were predicted by different childhood adversity dimensions over time. Furthermore, Threat predicted a smaller and less diverse social network, Intrafamilial Adversity predicted anxious attachment, and Deprivation predicted a smaller social network, anxious and avoidant attachment, perceived social support, and loneliness. The three adversity dimensions combined accounted for moderate to large proportions of variance in several outcomes. These results extend prior work by identifying associations of three meaningful dimensions of childhood adversity with different risk profiles across psychological, social, and psychopathological domains. The findings enhance our understanding of the impact of childhood adversity across young adulthood., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest to be disclosed., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background and Hypothesis: Schizotypy is a useful and unifying construct for examining the etiology, development, and expression of schizophrenia-spectrum psychopathology. The positive, negative, and disorganized schizotypy dimensions are associated with distinct patterns of schizophrenia-spectrum symptoms and impairment. Furthermore, they are differentiated by mean levels of psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, and by temporal dynamics of affect. The schizotypy dimensions were thus hypothesized to be differentiated by the temporal dynamics of schizotypic experiences in daily life., Study Design: The present study employed experience sampling methodology in a large nonclinically ascertained sample (n = 693) to examine the associations of multidimensional schizotypy with psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, as well as with their temporal dynamics (variability, reactivity, inertia, and instability)., Study Results: We replicated the mean-level associations between multidimensional schizotypy and schizotypic experiences in daily life. Furthermore, positive, negative, and disorganized schizotypy demonstrated hypothesized, differential patterns of temporal dynamics of schizotypic experiences. Disorganized schizotypy demonstrated the most robust associations, including intensity, variability, and inertia of disorganized schizotypic experiences. Disorganized schizotypy also moderated reactivity of psychotic-like and disorganized schizotypic experiences following previously reported stress. Positive schizotypy was associated with intensity and variability of psychotic-like experiences. Negative schizotypy was associated with intensity and variability of negative schizotypic experiences., Conclusions: The findings indicate that schizotypy dimensions can be differentiated by both mean levels and temporal patterns of psychotic-like, suspicious, negative, and disorganized schizotypic experiences in daily life, with disorganized schizotypy uniquely characterized by stress reactivity., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Traumatic experiences are associated with increased experiences of positive schizotypy. This may be especially important for People of Color, who experience higher rates of trauma and racial discrimination. No study to date has examined how racial disparities in traumatic experiences may impact schizotypy. Furthermore, of the studies that have examined the relationship between trauma and schizotypy, none have examined racial discrimination as a potential moderator. The present study examined if racial discrimination moderates the relationship between trauma and multidimensional (positive, negative, and disorganized) schizotypy. In a sample of 770 college students, we conducted chi-squared analyses, analyses of variance, and stepwise regressions. We found that Black students experienced significantly higher racial discrimination and trauma than Latinx and Asian students. Furthermore, Black and Latinx students experienced significantly more multidimensional schizotypy items than Asian students. Trauma and racial discrimination explained 8 to 23% of the variance in each dimension of schizotypy. Racial discrimination did not moderate the relationships between trauma and multidimensional schizotypy. Our findings suggest that we need to examine risk factors that may prevent recovery from psychotic disorders. Additionally, disorganized schizotypy showed the most robust associations and may be a critical site of intervention.

Schizophrenia (SZ) is a complex disorder with a highly polygenic inheritance. It can be conceived as the extreme expression of a continuum of traits that are present in the general population often broadly referred to as schizotypy. However, it is still poorly understood how these traits overlap genetically with the disorder. We investigated whether polygenic risk for SZ is associated with these disorder-related phenotypes (schizotypy, psychotic-like experiences, and subclinical psychopathology) in a sample of 253 non-clinically identified participants. Polygenic risk scores (PRSs) were constructed based on the latest SZ genome-wide association study using the PRS-CS method. Their association with self-report and interview measures of SZ-related traits was tested. No association with either schizotypy or psychotic-like experiences was found. However, we identified a significant association with the Motor Change subscale of the Comprehensive Assessment of At-Risk Mental States (CAARMS) interview. Our results indicate that the genetic overlap of SZ with schizotypy and psychotic-like experiences is less robust than previously hypothesized. The relationship between high PRS for SZ and motor abnormalities could reflect neurodevelopmental processes associated with psychosis proneness and SZ., (© 2023. The Author(s).)

Introduction: Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood., Methods: Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in n = 1,156 nonclinically ascertained young adults., Results: Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested., Conclusion: Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nonweiler, Torrecilla, Kwapil, Ballespí and Barrantes-Vidal.)

Current developmental psychopathology models indicate that schizophrenia can be understood as the most extreme expression of a multidimensional continuum of symptoms and impairment referred to as schizotypy. In nondisordered adults, schizotypy predicts risk for developing schizophrenia-spectrum psychopathology. Schizophrenia is associated with disruptions in detecting subtle differences between objects, which is linked to hippocampal dysfunction. These disruptions have been shown in the Mnemonic Similarity Task (MST) when patients are less likely to reject lures that are similar but not identical to studied objects, and instead mistake them for studied items. This pattern of errors may be a behavioral manifestation of impaired pattern separation, a key episodic memory ability associated with hippocampal integrity and overreliance on pattern completion. We examined whether multidimensional schizotypy is associated with such deficits in nondisordered young adults. Participants (n = 230) were assessed for positive, negative, and disorganized schizotypy and completed the MST and a perceptual discrimination task. MST performance showed that a combination of elevated negative and disorganized schizotypy was associated with decreased rejections of similar lures because they were mistakenly identified as studied items. These deficits were not observed in traditional recognition measures within the same task, nor in perceptual discrimination, suggesting that mnemonic discrimination deficits assessed by MST were selective and did not reflect generalized deficits. These findings extend the results obtained in schizophrenia patients and support a multidimensional model of schizophrenia-spectrum psychopathology., (© 2023 The Authors. Hippocampus published by Wiley Periodicals LLC.)

Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impairment, psychopathology, and personality pathology in a sample of 161 young adults. Consistent with past studies, positive, negative, and disorganized schizotypy had distinct and hypothesized associations with symptoms and impairment. Positive schizotypy was associated with prodromal symptoms and schizotypal, paranoid, and borderline personality traits. Negative schizotypy was associated with impaired functioning, negative symptoms, and schizoid, schizotypal, and paranoid traits, as well as any broad personality disorder diagnosis; it was also associated with never having dated. Disorganized schizotypy was associated with impaired functioning, disorganized schizotypic experiences, attentional deficits, and schizotypal, paranoid, borderline, and avoidant personality traits, as well as depression. Overall, we successfully replicated findings from five previous schizotypy interview studies, supporting the construct validity of the multidimensional model of schizotypy and the Multidimensional Schizotypy Scale. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Schizotypy has become an increasingly important construct for elaborating psychotic disorders that vary along the schizophrenic spectrum. However, different schizotypy inventories vary in conceptual approach and measurement. In addition, commonly used schizotypy scales have been seen as qualitatively different from screening instruments for prodromal schizophrenia like the Prodromal Questionnaire-16 (PQ-16). Our study investigated the psychometric properties of three schizotypy questionnaires (the Schizotypal Personality Questionnaire-Brief, Oxford-Liverpool Inventory of Feelings and Experiences, and the Multidimensional Schizotypy Scale) as well as the PQ-16 in a cohort of 383 non-clinical subjects. We initially evaluated their factor structure using Principal Component Analysis (PCA) and used Confirmatory Factor Analysis (CFA) to test a newly proposed composition of factors. PCA results support a three-factor structure of schizotypy that accounts for 71 % of the total variance, but also shows cross-loadings of some schizotypy subscales. CFA of the newly composed schizotypy factors (together with an added neuroticism factor) shows good fit. Analyses including the PQ-16 indicate considerable overlap with measures of trait schizotypy, suggesting that the PQ-16 might not be quantitatively or qualitatively different from schizotypy measurements. Taken together, results indicate that there is good support for a three-factor structure of schizotypy but also that different schizotypy measurements grasp facets of schizotypy differently. This points towards the need for an integrative approach for assessing the construct of schizotypy., Competing Interests: Declaration of competing interest All authors declare no conflict of interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness to perceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Mind-wandering assessment relies heavily on the thought probe technique as a reliable and valid method to assess momentary task-unrelated thought (TUT), but there is little guidance available to help researchers decide how many probes to include within a task. Too few probes may lead to unreliable measurement, but too many probes might artificially disrupt normal thought flow and produce reactive effects. Is there a "Goldilocks zone" for how few thought probes can be used to reliably and validly assess individual differences in mind-wandering propensity? We address this question by reanalyzing two published datasets (Study 1, n = 541; Study 2, ns ≈ 260 per condition) in which thought probes were presented in multiple tasks. Our primary analyses randomly sampled probes in increments of two for each subject in each task. A series of confirmatory factor analyses for each probe "bin" size tested whether the latent correlations between TUT rate and theoretically relevant constructs like working memory capacity, attention-control ability, disorganized schizotypy, and retrospective self-reported mind wandering changed as more probes assessed the TUT rate. TUT rates were remarkably similar across increasing probe-bin sizes and zero-order correlations within and between tasks stabilized at 8-10 probes; moreover, TUT-rate correlations with other latent variables stabilized at about 8 thought probes. Our provisional recommendation (with caveats) is that researchers may use as few as 8 thought probes in prototypical cognitive tasks to gain reliable and valid information about individual differences in TUT rate., (© 2022. The Psychonomic Society, Inc.)

Schizotypy and schizophrenia are associated with disruptions in the experience of affect. Temporal patterns of affect, or affective dynamics, offer unique information about the expression of multidimensional schizophrenia-spectrum psychopathology. The present study employed experience sampling methodology to examine affective intensity, inertia, variability, reactivity, and instability in positive, negative, and disorganized schizotypy in nonclinically ascertained young adults ( n = 275). As hypothesized, disorganized schizotypy demonstrated the most robust associations with affective dynamics and was characterized by elevated intensity, reactivity, and variability of negative affect. Disorganized schizotypy was also associated with instability of negative affect, but this relation was better accounted for by mean negative affect, which was elevated in disorganized schizotypy. Negative schizotypy was characterized by diminished intensity and variability of positive affect as expected, but was unassociated with affective inertia. Finally, as hypothesized, positive schizotypy was associated with elevated intensity and variability of negative affect at the bivariate level, but was unassociated with affective dynamics when including disorganized schizotypy in the model. These findings indicate that the schizotypy dimensions are differentiated by both mean levels and dynamics of affect, and that affective dynamics convey unique information about multidimensional schizotypy beyond mean levels of affect. The findings provide further support for the multidimensional model of schizotypy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Investigating different approaches to operationalizing childhood adversity and how they relate to transdiagnostic psychopathology is relevant to advance research on mechanistic processes and to inform intervention efforts. To our knowledge, previous studies have not used questionnaire and interview measures of childhood adversity to examine factor-analytic and cumulative-risk approaches in a complementary manner. Objective: The first aim of this study was to identify the dimensions underlying multiple subscales from three well-established childhood adversity measures (the Childhood Trauma Questionnaire, the Childhood Experience of Care and Abuse Interview, and the Interview for Traumatic Events in Childhood) and to create a cumulative risk index based on the resulting dimensions. The second aim of the study was to examine the childhood adversity dimensions and the cumulative risk index as predictors of measures of depression, anxiety, and psychosis-spectrum psychopathology. Method: Participants were 214 nonclinically ascertained young adults who were administered questionnaire and interview measures of depression, anxiety, psychosis-spectrum phenomena, and childhood adversity. Results: Four childhood adversity dimensions were identified that captured experiences in the domains of Intrafamilial Adversity , Deprivation , Threat , and Sexual Abuse . As hypothesized, the adversity dimensions demonstrated some specificity in their associations with psychopathology symptoms. Deprivation was uniquely associated with the negative symptom dimension of psychosis (negative schizotypy and schizoid symptoms), Intrafamilial Adversity with schizotypal symptoms, and Threat with depression, anxiety, and psychosis-spectrum symptoms. No associations were found with the Sexual Abuse dimension. Finally, the cumulative risk index was associated with all the outcome measures. Conclusions: The findings support the use of both the empirically-derived adversity dimensions and the cumulative risk index and suggest that these approaches may facilitate different research objectives. This study contributes to our understanding of the complexity of childhood adversity and its links to different expressions of psychopathology.

The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.

Background and Hypothesis: Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype., Study Design: Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions., Study Results: Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found., Conclusions: This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Ambivalence has a prominent role in the historical formulations of schizotypy and schizophrenia, as well as borderline personality disorder. However, it has been overlooked by our current diagnostic nomenclature. The Schizotypal Ambivalence Scale (SAS) is a 19-item self-report scale developed to examine ambivalence relevant to schizotypy and schizophrenia-spectrum disorders. Questionnaire, interview, and ambulatory assessment studies support the construct validity of the measure as a predictor of schizophrenia-spectrum and borderline psychopathology. However, studies have not adequately examined the item properties and factor structure of the scale. To examine the psychometric features of the SAS, the present research applied item response theory and differential item functioning methods using a large sample of adults ( n = 7096). Analyses of dimensionality were consistent with essential unidimensionality, and a 2PL IRT model found good item discrimination, an appropriate range of item difficulty, minimal local dependence, and excellent item fit. Analyses of differential item functioning found essentially no bias for gender on any items and very small effects for two items for racial/ethnic identity. Overall, the analyses reveal many psychometric strengths of the Schizotypal Ambivalence Scale and support its use a single-factor instrument for assessing ambivalence in diverse subgroups of adults.

Schizotypal personality disorder (SPD) first appeared in the American Psychiatric Association diagnostic nosology in 1980, although its roots stretch back more than 100 years under labels such as borderline, ambulatory, and latent schizophrenia. SPD is unique in that it is conceptualized both as stable personality pathology and also as a milder manifestation of schizophrenia-spectrum psychopathology. The categorical operationalization of SPD has remained largely unchanged for the last 40 years, with emphasis on interpersonal deficits, cognitive and perceptual distortions, and odd and eccentric behaviors. The alternative model for personality disorders (AMPD) retained many of the aspects of SPD while offering a hybrid model that includes both disturbances in personality functioning and specific pathological personality traits. The present review examined the empirical literature on the success of the AMPD model in capturing SPD. Although research specifically examining AMPD SPD is limited, there is converging evidence that the six trait facets proposed for the AMPD SPD provide good coverage of SPD and correspond closely to criterion counts from the categorical SPD diagnosis. Furthermore, most studies find that the inclusion of additional facets not proposed for SPD do not account for appreciable variance. However, SPD offers a rather heterogeneous construct, and future studies should consider whether specifying positive, negative, and disorganized traits within the disorder might improve the clarity of the diagnosis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

This study evaluated the psychometric properties and factor structure of the Calgary Depression Scale for Schizophrenia (CDSS) across different levels of the schizotypy continuum. A combined sample of high-schizotypy, at-risk mental states, and patients with first-episode psychosis was assessed for depression and other clinical and functional outcomes. Additionally, experience sampling methodology was used to assess depressive and psychotic-like experiences in daily life. The CDSS exhibited solid internal consistency, validity, and discrimination between depressed and nondepressed participants. Confirmatory factor analyses and the associations of the resulting factors with clinical and functional measures supported a two-factor structure that included general depression and guilt factors. Furthermore, both factors of the CDSS were differentially related to positive and negative symptoms of psychosis in daily life. The CDSS appears to have two underlying psychopathological dimensions and to be a reliable and valid measure for assessing depression across the schizotypy continuum.

Emotion dysregulation is a core feature of bipolar spectrum psychopathology and may confer risk for poor outcomes or progression along the bipolar spectrum. However, previous research on bipolar psychopathology has primarily concentrated on characterizing distinct mood episodes and failed to characterize microlevel dynamics of the experience of emotion. This is the first study to our knowledge to comprehensively examine the extent to which bipolar spectrum psychopathology, as measured by the Hypomanic Personality Scale (HPS), is associated with altered dynamics of positive (PA) and negative affect (NA) across multiple timescales. Young adults (n = 233) oversampled for high HPS scores (>1.5 SD) completed self-report questionnaires and 14 days of experience sampling questionnaires assessing high- and low-arousal NA and PA. Four emotion dynamics (reactivity, variability, instability, inertia) were computed from each participant's time series. As predicted, HPS scores were positively associated with variability and instability of high-arousal NA and PA both within and between days (over and above mean levels of emotions, depression, and neuroticism). Further, HPS scores were associated with large fluctuations in low- but not high-arousal NA and moderated stress reactivity. Specifically, high scorers on the HPS were more likely to report feeling like their emotions were out of control (but not high-intensity NA) when experiencing stress. Contrary to expectation, HPS scores were unassociated with inertia of high-arousal PA. Findings indicated that microlevel emotion dynamics are disrupted across multiple timescales in those high in bipolar spectrum psychopathology. Examining emotion dynamics should enhance understanding of risk for bipolar disorders and facilitate development of mood-monitoring interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: The Hypomanic Personality Scale (HPS) assesses bipolar spectrum psychopathology and risk for bipolar disorders. Despite the developers' intent to create a scale that provides a unitary score, several studies have examined whether the HPS has a multidimensional structure. These models have been unable to identify a replicable multidimensional structure, with models varying from fairly similar to entirely dissimilar, and have suffered from theoretical and methodological concerns., Procedures: We therefore examined the multidimensional structure of the HPS in a large undergraduate and adult sample (n = 5002)., Main Findings: We failed to reproduce factors with equal congruence to those of previously published models., Principle Conclusions: We concluded that the HPS lacks factorial validity in previous research as a multidimensional measure of bipolar spectrum psychopathology. We further recommend the creation of a novel multidimensional assessment of bipolar spectrum psychopathology developed from a theoretically driven, comprehensive model, rather than examining a multidimensional model of a pre-existing measure, such as the HPS., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy was associated with schizotypal and borderline personality traits; negative schizotypy was associated with schizotypal, schizoid, paranoid, and avoidant personality traits; and disorganized schizotypy was associated with paranoid, borderline, and avoidant personality disorder traits. Negative schizotypy predicted broad diagnoses of Cluster A personality disorders. Both negative and disorganized schizotypy predicted the broad diagnosis of any of the 5 personality disorders. The study further examined the association of the schizotypy dimensions with the individual personality disorder criteria to better understand the overall associations. Given the common origins and high comorbidity, we examined whether the schizotypy dimensions explained the association of borderline and schizotypal personality disorder traits. Positive and disorganized schizotypy fully mediated the association between borderline and schizotypal traits. In summary, the study replicated and extended previous findings that the schizotypy dimensions are uniquely associated with personality disorders and traits, as well as impaired functioning, in young adults. The study also provided additional support for the construct validity of the Multidimensional Schizotypy Scale and for the use of psychometric assessment of schizotypy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The assessment of schizotypy and schizophrenia-spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However, studies have not examined the validity of the measurement across different racial groups. The present study examined whether the associations of MSS positive, negative, and disorganized schizotypy subscales with interview-assessed ratings of functioning, schizophrenia-spectrum personality traits, and depressive disorders were generally comparable across nonclinically ascertained samples of Black (n = 46), Asian (n = 87), and White (n = 116) young adults. Consistent with previous findings, all three schizotypy subscales were associated with impairment and schizotypal and paranoid traits. Negative schizotypy was associated with schizoid traits, and disorganized schizotypy was associated with depressive disorders. These associations were comparable across the racial groups, supporting the use of the MSS in these groups. Culturally and empirically valid assessments are essential for providing accurate assessments across racial/ethnic groups and reducing the risk of overpathologizing people of color. The present findings support the cross-cultural validity of the MSS; however, future studies should expand upon these findings by including more diverse samples and longitudinal designs., (© 2021 John Wiley & Sons, Ltd.)

Introduction: Although sleep disturbances are well documented in bipolar spectrum disorders (BSDs), significantly less research has examined whether these disturbances are present in those at risk for developing BSDs or with subsyndromal symptoms. The present study examined associations between risk for BSDs, as measured by the Hypomanic Personality Scale (HPS), and sleep assessed using experience sampling. We assessed whether intraindividual variability in sleep was associated with affect, cognition, and behavior in daily life and potential directionality of these relationships., Methods: 233 young adults oversampled for high scores on the HPS completed 14 days of experience sampling assessing total sleep time (TST), bed/rise time, sleep quality, affect (negative and positive affect), cognition (difficulty concentrating, racing thoughts), and behavior (impulsivity) in daily life. We used Dynamic Structural Equation Modeling (DSEM) to assess within-person links between sleep and bipolar spectrum psychopathology., Results: HPS scores were associated with less TST, later bedtime, and more variable TST and bedtime. Variability in TST was associated with negative affect, difficulty concentrating/racing thoughts, and impulsivity. Within-person decreases in sleep were associated with next day increases in negative affect, stress, difficulty concentrating, and racing thoughts., Limitations: Measurement of sleep was limited. Future studies should examine both objective measures of sleep (e.g., actigraphy) and fragmentation in sleep., Conclusions: Risk for BSD was associated with similar patterns of sleep disruptions as seen in BSDs. Important dynamic links between sleep and bipolar spectrum psychopathology emerged indicating that sleep is an important target for improving symptoms of BSDs in daily life.

Leading theoretical models of psychosis implicate a wide range of psychological factors in the development of positive symptoms. Ambulatory assessment allows us to repeatedly assess people's mental experiences within and across days to explore putative moment-to-moment prospective relationships that impact the onset and exacerbation of positive symptoms. This study used experience sampling methodology to examine the putative temporal associations of both risk and protective factors (negative emotional states, stress, self-esteem, and social appraisals) with the experience of paranoia and other positive psychotic-like experiences (PLE) in daily-life. A combined sample of 178 participants including 65 high-schizotypy, 74 at-risk mental states for psychosis, and 39 first-episode psychosis individuals was assessed repeatedly over seven consecutive days. Sadness, anxiety, stress, and negative social appraisals predicted higher levels of subsequent paranoia and PLE. In contrast, self-esteem and subjective appraisals of social support and social closeness predicted lower levels of paranoia and PLE. Most findings did not vary across subclinical, at-risk, and clinical levels of psychosis expression. Results support psychological models of psychosis and provide new evidence to disentangle psychological factors involved in the mechanistic pathways to positive symptoms. The findings can help the design of ecological momentary interventions delivered in real-time aimed at buffering psychological mechanisms that promote psychotic symptoms and strengthening causal mechanisms that protect from the development of positive symptoms. Finally, findings suggest that highly similar psychological mechanisms are implicated in the development of psychotic experiences across nonclinical, subclinical, and clinical expressions of schizotypy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-report scales are popular tools for measuring anhedonic experiences and motivational deficits, but how well do they reflect clinically significant anhedonia? Seventy-eight adults participated in face-to-face structured diagnostic interviews: 22 showed clinically significant anhedonia, and 18 met criteria for depression. Analyses of effect sizes comparing the anhedonia and depression groups to their respective controls found large effects, as expected, for measures of depressive symptoms, but surprisingly weak effect sizes (all less than d =.50) for measures of general, social, or physical anhedonia, behavioral activation, and anticipatory and consummatory pleasure. Measures of Neuroticism and Extraversion distinguished the anhedonic and depressed groups from the controls at least as well as measures of anhedonia and motivation. Taken together, the findings suggest that caution is necessary when extending self-report findings to populations with clinically significant symptoms.

Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients' SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients' SE mediated the effect of relatives' EE on patients' positive symptoms and paranoia; (2) patients' perceived EE mediated the effect of relatives' EE on patients' SE; (3) patients' SE mediated between patients' perceived EE and patients' symptomatology; and (4) patients' perceived EE and patients' SE serially mediated the effect of relatives' EE on patients' positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients' perceived EE mediated the link between relatives' EE and patients' negative, but not positive, SE; (2) patients' negative SE mediated the effect of patients' perceived EE on positive symptoms and paranoia; (3) the association of relatives' EE with positive symptoms and paranoia was serially mediated by an increased level of patients' perceived EE leading to increases in negative SE; (4) high levels of patients' distress moderated the effect of relatives' EE on symptoms through patients' perceived EE and negative SE. Findings emphasize that patients' SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients' negative SE and symptoms., Competing Interests: The authors have declared that no competing interests exist.

Background : Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explicit self-esteem discrepancies in three non-clinical groups with different psychopathological traits and a control group. Methods: Participants with elevated trait-paranoia ( n = 41), depressive symptoms ( n = 34), a combination of both traits ( n = 32), and a control group ( n = 71) were assessed on implicit and explicit self-esteem, self-schemas, depression, and paranoia. A dimensional approach with the total sample ( n = 208) was also used to complement the information provided by the group approach. Results: All groups presented similar and positive levels of implicit self-esteem. Trait-paranoia participants had similar levels of explicit self-esteem and self-schemas compared with the control group. However, the group with a combination of trait-paranoia and depressive symptoms showed the lowest levels of positive self-schemas and self-esteem. Furthermore, this group and the control group displayed implicit/explicit self-esteem discrepancies, although in opposite directions and with different implications. The dimensional approach revealed associations of trait-paranoia and depressive symptoms with poor explicit self-esteem and self-schemas but not with implicit self-esteem. Conclusions: Trait-paranoia participants showed different self-representations depending on whether depressive symptoms were present or not. The interaction between subclinical neurotic and psychotic traits entailed a detrimental self-representation that might increase the risk for psychopathology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Monsonet, Ballespí, Sheinbaum, Valiente, Espinosa, Kwapil and Barrantes-Vidal.)

Research on effort and motivation commonly assesses how the sympathetic branch of the autonomic nervous system affects the cardiovascular system. The cardiac pre-ejection period (PEP), assessed via impedance cardiography, is a common outcome, but assessing PEP requires identifying subtle points on cardiac waveforms. The present research examined the psychometric value of the RZ interval (RZ), which has recently been proposed as an indicator of sympathetic activity, for effort research. Also known as the initial systolic time interval (ISTI), RZ is the time (in ms) between the ECG R peak and the dZ/dt Z peak. Unlike PEP, RZ involves salient waveform points that are easily and reliably identified. Data from two experiments evaluated the suitability of RZ for effort paradigms and compared it to a popular automated PEP method. In Studies 1 (n = 89) and 2 (n = 71), participants completed a standard appetitive task in which each correct response earned a small amount of cash. As expected, incentives significantly affected PEP and RZ in both experiments. PEP and RZ were highly correlated (all rs ≥ 0.89), and RZ consistently yielded a larger effect size than PEP. In Study 3, a quantitative synthesis of the experiments indicated that the effect size of RZ's response to incentives (Hedges's g = 0.432 [0.310, 0.554]) was roughly 15% larger than PEP's effect size (g = 0.376 [0.256, 0.496]). RZ thus appears promising for future research on sympathetic aspects of effort-related cardiac activity.

Affective dysregulation is present in those with subsyndromal symptoms of hypomania and mania and prospectively predicts the development of bipolar spectrum disorders. A crucial, understudied area related to the experience and regulation of emotion in this population is emotional awareness - emotional clarity (Clarity) and attention to emotion (Attention). We examined whether scores on the Hypomanic Personality Scale (HPS) were associated with deficits in emotional awareness and whether these deficits were associated with heightened intensity and instability of negative (NA) and positive affect (PA). Young adults (n=233), oversampled for high HPS scores completed self-reports and 14 days of experience sampling assessing high and low arousal NA and PA. HPS scores were associated with low Clarity and unassociated with Attention. High HPS scores were associated with greater high and low arousal NA intensity and instability only for those at low and mean levels of Attention. In contrast, there was a significant indirect association between HPS scores and intensity of high and low arousal NA and PA, as well as instability of high arousal NA, through low Clarity. Results highlighted that individual differences exist in the extent to which facets of emotional awareness differentially link scores on the HPS to emotional outcomes., (Copyright © 2021. Published by Elsevier B.V.)

Numerous studies have implicated involvement of the hippocampus in the etiology and expression of schizophrenia-spectrum psychopathology, and reduced hippocampal volume is one of the most robust brain abnormalities reported in schizophrenia. Recent studies indicate that early stages of schizophrenia are specifically characterized by reductions in anterior hippocampal volume; however, studies have not examined hippocampal volume reductions in subclinical schizotypy. The present study was the first to examine the associations of positive, negative, and disorganized schizotypy dimensions with hippocampal subfield volumes in a large sample (n = 195) of nonclinically ascertained young adults, phenotyped using the Multidimensional Schizotypy Scale (MSS). Hippocampal subfields were analyzed from high-resolution 3 Tesla structural magnetic resonance imaging scans testing anatomical models, including anterior vs posterior regions and the cornu ammonis (CA), dentate gyrus (DG), and subiculum subfields separately for the left and right hemispheres. We demonstrate differential spatial effects across anterior vs posterior hippocampus segments across different dimensions of the schizotypy risk phenotype. The interaction of negative and disorganized schizotypy robustly predicted left hemisphere volumetric reductions for the anterior and total hippocampus, and anterior CA and DG, and the largest reductions were seen in participants high in negative and disorganized schizotypy. These findings extend previous early psychosis studies and together with behavioral studies of hippocampal-related memory impairments provide the basis for a dimensional neurobiological hippocampal model of schizophrenia risk. Subtle hippocampal subfield volume reductions may be prevalent prior to the onset of detectable prodromal clinical symptoms of psychosis and play a role in the etiology and development of such conditions., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The present study assessed the construct validity of the Multidimensional Schizotypy Scale (MSS). Specifically, it assessed the associations of the MSS positive, negative, and disorganized schizotypy subscales with interview-rated symptoms and impairment in 177 young adults. As hypothesized, the MSS positive schizotypy subscale was associated with interview-rated positive symptoms, and schizotypal and paranoid personality traits. Negative schizotypy was associated with interview-rated negative symptoms, and schizotypal and schizoid traits, and elevated rates of schizophrenia-spectrum personality disorders. Disorganized schizotypy was associated with disorganized symptoms and attentional deficits. All three subscales were associated with impaired functioning. This was the first study to evaluate the validity of the MSS using interview measures. The findings indicate that the schizotypy dimensions are associated with unique patterns of symptoms and impairment, and support the validity of the MSS.

Background: No studies have examined the association between self-esteem and paranoia developmentally across the critical stages of psychosis emergence. The present study fills this gap and extends previous research by examining how different dimensions, measures, and types of self-esteem relate to daily-life paranoia across at-risk mental states for psychosis (ARMS) and first episode of psychosis (FEP) stages. Furthermore, the moderation effects of momentary anxiety and momentary perceived social support on the association between momentary self-esteem and paranoia were examined., Design: This study used a multilevel, cross-sectional design., Methods: One-hundred and thirteen participants (74 ARMS and 39 FEP) were assessed repeatedly over seven consecutive days on levels of momentary paranoia, self-esteem, anxiety and perceived social support using experience sampling methodology. Measures of trait and implicit self-esteem were also collected., Results: Global momentary and trait self-esteem, and their positive and negative dimensions, were related to daily-life paranoia in both ARMS and FEP groups. Conversely, implicit self-esteem was not associated with daily-life paranoia in either group. Anxiety negatively moderated the association between positive self-esteem and lower paranoia, whereas both feeling close to others and feeling cared for by others strengthened this association. However, only feeling cared for by others moderated the association between negative self-esteem and higher paranoia., Conclusions: Different types, measures and dimensions of self-esteem are differentially related to paranoia in early psychosis and are influenced by contextual factors in daily-life. This yields a more complex picture of these associations and offers insights that might aid psychological interventions., Practitioner Points: Different measures (trait and momentary) and dimensions (positive and negative) of explicit self-esteem are distinctly related to paranoia across risk and first-episode stages of psychosis. Explicit, but not implicit, self-esteem is associated with real-life paranoia in incipient psychosis. Anxiety boosted the association of poor self-esteem and paranoia ideation in daily-life. Social closeness, but feeling cared for by others in particular, interacts with self-esteem tempering the expression of paranoia in real life., (© 2020 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Deficits in self-regulation and motivation are central to depression. Using motivational intensity theory (Brehm & Self, 1989), the present research examined how depressive anhedonia influences effort during a piece-rate appetitive task. In piece-rate tasks, people can work at their own pace and are rewarded for each correct response, so they can gain rewards more quickly by expending more effort. A sample of community adults ( n = 78) was evaluated for depressive anhedonia using a structured clinical interview, yielding depressive anhedonia and control groups. Participants completed a self-paced cognitive task, and each correct response yielded a cash reward (3 cents or 15 cents, manipulated within-person). Using impedance cardiography, effort-related physiological activity was assessed via the cardiac pre-ejection period (PEP). The results indicated lower reward responsiveness in the anhedonia group. Compared to the control group, the depressive anhedonia group showed significantly less baseline-to-task change in PEP, and they performed marginally worse on the task. The experiment supports the predictions made by applying motivational intensity theory to depression and offers a useful paradigm for evaluating anhedonic effects on effort while people are striving for appealing rewards.

The present study employed structured diagnostic interviews to assess the construct validity of the brief version of the Multidimensional Schizotypy Scale (MSS-B), which was developed to assess positive, negative, and disorganized dimensions of schizotypy. It was hypothesized that the MSS-B subscales would be associated with differential patterns of symptoms and impairment, comparable to findings for the full-length MSS. A total of 177 young adults completed structured diagnostic interviews assessing symptoms and impairment. As hypothesized, MSS-B positive schizotypy was significantly associated with interview ratings of positive (psychotic-like) symptoms, as well as schizotypal and paranoid personality disorder traits. MSS-B negative schizotypy was associated with interview ratings of negative symptoms, as well as schizoid, paranoid, and schizotypal traits. Furthermore, negative schizotypy predicted Cluster A personality disorder diagnoses. MSS-B disorganized schizotypy was associated with interview ratings of disorganized symptoms. All three schizotypy dimensions were associated with impaired functioning. This was the first study to evaluate the validity of the MSS-B using interview measures, and the pattern of findings for each MSS-B subscale was closely comparable to the findings for the full-length MSS. Contrary to our hypothesis, cannabis use was largely unassociated with psychotic-like symptoms and did not moderate the expression of the schizotypy dimensions. The MSS-B has good psychometric properties, high concordance with the full-length MSS, and good construct validity. Thus, it appears to be a promising brief alternative to traditional schizotypy measures., Competing Interests: The authors have declared that no competing interests exist.