Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-18T12:22:21.691Z Has data issue: false hasContentIssue false
  • English
  • Français

The SSQ model of schizophrenic prodromal unfolding revised: An analysis of its causal chains based on the language of directed graphs

Published online by Cambridge University Press:  15 April 2020

D. van Kampen
D. van Kampen*
Affiliation:
Department of Clinical Psychology, Vrije Universiteit, van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
*
*Tel.: +31 20 5988876; fax: +31 20 59888758. E-mail address:[email protected].
Get access

Abstract

Objective

Except in broad outline, little is known about the most likely symptomatic trajectories in prodromal schizophrenia. The aim of this study is to delineate these pathways.

Methods

Taking into account existing clinical knowledge, the causal relationships between the 12 prodrome scales of the Schizotypic Syndrome Questionnaire (SSQ) were examined in a general-population sample by applying the mathematical theory of directed graphs. Use was made of two discovery algorithms implemented in the Tetrad-4 program, as well as of the graphical DAGitty program to test whether a particular model holds.

Results

A promising model was selected that may describe the causal pathways in schizophrenic prodromal unfolding. Testing this model by means of DAGitty, it was shown that the minimal testable implications, listed as conditional independences, and the direct and total effects in the model, identified after correction for bias, were as hypothesized. For practical reasons, a simpler version of the resulting SSQ model, containing only its principal pathways, was provided.

Conclusions

Although resembling an earlier model that was based on a series of LISREL analyses, the present model was believed to provide a more dependable description of schizophrenic prodromal unfolding, as it relies on methods that are less subject to the limitations involved in SEM.

Keywords

SchizophreniaProdromal unfoldingSchizotypyCausal analysisDirected graph theory
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 7 , September 2014 , pp. 437 - 448
Copyright
Copyright © 2013 Elsevier Masson SAS

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allport, G.W.The general and the unique in psychological science. J Personal 1962;30:405–422.CrossRefGoogle ScholarPubMed
Andreasen, N.C.Scale for the assessment of negative symptoms (SANS). Iowa City: University of Iowa Press; 1984.Google Scholar
Auslander, L.A., Perry, W., Jeste, D.V.Assessing disturbed thinking and cognition using the Ego Impairment Index in older schizophrenia patients: paranoid vs. nonparanoid distinction. Schizophr Res 2002;53:199–207.CrossRefGoogle ScholarPubMed
Bleuler, E.Dementia praecox oder Gruppe der Schizophrenieen. In: Aschaffenburg, G. editors. Handbuch der Psychiatrie. Leipzig: Deuticke; 1911.Google Scholar
Bollen, K.A.Structural equations with latent variables. New York: Wiley; 1989.CrossRefGoogle Scholar
Carpenter, W.T.Conceptualizing schizophrenia through attenuated symptoms in the population. Am J Psychiat 2010;167:1911. p. 1013–1016.CrossRefGoogle ScholarPubMed
Chickering, D.M.Optimal structure identification with greedy search. J Machine Learn Res 2002;3:507–554.Google Scholar
Cornblatt, B.A., Lencz, T., Smith, C.W., Correll, C.U., Auther, A.M., Nakayama, E.The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull 2003;29:633–651.CrossRefGoogle ScholarPubMed
Cureton, E.E., D’Agostino, R.B.Factor analysis: an applied approach. Hillsdale, NJ: Lawrence Erlbaum; 1983.Google Scholar
Docherty, J.P., van Kammen, D.P., Siris, S.G., Marder, S.R.Stages of onset of schizophrenic psychosis. Am J Psychiat 1978;135:420–426.Google ScholarPubMed
Dominguez MdG, , Can Saka, M., Lieb, R., Wittchen, H.U., Van Os, J.Early expression of negative/disorganized symptoms predicting psychotic experiences and subsequent clinical psychosis: a 10-year study. Am J Psychiat 2010;167:1075–1082.CrossRefGoogle Scholar
Eells, E.Probabilistic causality. Cambridge, UK: Cambridge University Press; 1991.CrossRefGoogle Scholar
Esterberg, M.L., Goulding, S.M., Walker, E.F.Cluster A personality disorders: schizotypal, schizoid and paranoid personality disorders in childhood and adolescence. J Psychopathol Behav Assessment 2010;32:515–528.CrossRefGoogle Scholar
Fenton, W.S., McGlashan, T.H.Natural history of schizophrenia subtypes I: longitudinal study of paranoid, hebephrenic, and undifferentiated schizophrenia. Arch Gen Psychiat 1991;48:969–977.CrossRefGoogle ScholarPubMed
Fisher, R.A.Statistical methods for research workers. 12th ed.Edinburgh: Oliver & Boyd; 1954.Google Scholar
Glymour, C., Scheines, R., Spirtes, P., Kelly, K.Discovering causal structure: artificial intelligence, philosophy of science, and statistical modeling. New York: Academic; 1987.Google Scholar
Goldstein, M.J., Held, J.M., Cromwell, R.L.Premorbid adjustment and paranoid-non-paranoid status in schizophrenia. Psychol Bull 1968;70:382–386.CrossRefGoogle Scholar
Häfner, H., Maurer, K.Are there two types of schizophrenia? True onset and sequence of positive and negative syndromes prior to first admission. In: Marneros, A.Andreasen, N.C.Tsuang, M.T. editors. Negative versus positive schizophrenia Berlin: Springer; 1991. p. 134–159.CrossRefGoogle Scholar
Häfner, H.et al.IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophr Res 1992;6:209–223.CrossRefGoogle ScholarPubMed
Häfner, H.et al.Onset and early course of schizophrenia. In: Häfner, H.Gattaz, W.F. editors. Search for the causes of schizophrenia, vol. 3 Berlin: Springer; 1995. p. 43–66.CrossRefGoogle Scholar
Hayduk, L.et al.Pearl's d-separation: one more step into causal thinking. Struct Equat Modeling 2003;10:289–311.CrossRefGoogle Scholar
Hitchcock, C.Probabilistic causation. In: Zalta, E.N. editors. The Stanford Encyclopedia of Philosophy (Winter Edition) http://plato.stanford.edu/archives/win2011/entries/causation-probabilistic/.Google Scholar
Hu, L., Bentler, P.M.Cutoff criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Struct Equat Modeling 1999;6:2011. p. 1–55.CrossRefGoogle Scholar
Iacono, W.G.Identifying genetic risk for psychopathology. In: Routh, D.K.DeRubeis, R.J. editors. The science of clinical psychology: accomplishments and future directions Washington: American Psychological Association; 1998. p. 3–22.CrossRefGoogle Scholar
Jöreskog, K.G., Sörbom, D.LISREL-8: structural equation modeling with the SIMPLIS command language. Chicago: Scientific Software International; 1995.Google Scholar
Kraepelin, E.Psychiatrie: Ein Lehrbuch für Studierende und Ärzte. 8th ed.Leipzig: Barth; 1913.Google Scholar
Kretschmer, E.Körperbau und Character: Untersuchungen zum Konstitutionsproblem und zur Lehre von den Temperamenten. Berlin: Springer; 1942.Google Scholar
Kwapil, T.R.Social anhedonia as a predictor of the development of schizophrenia-spectrum disorders. J Abn Psychol 1998;107:558–565.CrossRefGoogle ScholarPubMed
Kyono, T.M.Commentator: a front-end user interface module for graphical and structural equation modeling. Technical report R-364. Los Angeles: Cognitive Systems Laboratory, Department of Computer Science, University of California; 2010.Google Scholar
Lamiell, J.T.Explanation in the psychology of personality. In: Robinson, D.N.Mos, L.P. editors. Annals of theoretical psychology, vol. 6 New York: Plenum; 1990. p. 153–192.CrossRefGoogle Scholar
Li, J., Wang, Z.J.Controlling the false discovery rate of the association/causality structure learned with the PC algorithm. J Machine Learn Res 2009;10:475–514.Google Scholar
Maher, B.A.Anomalous experience and delusional thinking: the logic of explanations. In: Maher, T.F.Maher, B.A. editors. Delusional beliefs New York: Wiley; 1988. p. 15–33.Google Scholar
Markland, D.The golden rule is that there are no golden rules: a commentary on Paul Barrett's recommendations for reporting model fit in structural equation modeling. Personal Individ Diff 2007;42:851–858.CrossRefGoogle Scholar
Markus, K.A.Structural equations and causal explanations: some challenges for causal SEM. Struct Equat Modeling 2010;17:654–676.CrossRefGoogle Scholar
Marsh, H.W., Balla, J.R., McDonald, R.P.Goodness-of-fit indexes in confirmatory factor analysis: the effect of sample size. Psychol Bull 1988;103:391–410.CrossRefGoogle Scholar
Møller, P., Husby, R.The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophr Bull 2000;26:217–232.CrossRefGoogle ScholarPubMed
Pearl, J.Probabilistic reasoning in intelligent systems. San Mateo CA: Morgan and Kaufman; 1988.Google Scholar
Pearl, J.The new challenge: from a century of statistics to an age of causation. Comput Science Statist 1997;29:415–423.Google Scholar
Pearl, J.Causality: Models, reasoning, and inference. Cambridge: Cambridge University Press; 2000.Google Scholar
Pearl, J.Causality: Models, reasoning, and inference. 2nd ed.Cambridge: Cambridge University Press; 2009.CrossRefGoogle Scholar
Pearl, J.The causal foundations of structural equation modeling. In: Hoyle, R.H. editors. Handbook of structural equation modelling New York: Guilford Press; 2012. p. 68–91.Google Scholar
Raine, A.The SPQ: a scale for the assessment of schizotypal personality based on DSM-III-R criteria. Schizophr Bull 1991;17:555–564.CrossRefGoogle ScholarPubMed
Raine, A.Schizotypal personality: neurodevelopmental and psychosocial trajectories. Ann Rev Clin Psychol 2006;2:291–326.CrossRefGoogle ScholarPubMed
Scheines, R.An introduction to causal inference. Carnegie Mellon University, Department of Philosophy, Paper 430. 1997 http://repository.cmu.edu/philosophy/430.Google Scholar
Scheines, R., Spirtes, P., Glymour, C., Meek, C., Richardson, T.The TETRAD project: constraint based aids to causal model specification. Multivar Behav Res 1998;33:65–117.CrossRefGoogle ScholarPubMed
Shipley, B.A new inferential test for path models based on directed acyclic graphs. Struct Equat Modeling 2000;7:206–218.CrossRefGoogle Scholar
Shipley, B.Cause and correlation in biology. A user's guide to path analysis, structural equations and causal inference. Cambridge: Cambridge University Press; 2004.Google Scholar
Shrier, I., Platt, R.W.Reducing bias through directed acyclic graphs. BMC Med Res Methodol 2008;8:70.CrossRefGoogle ScholarPubMed
Sober, E.Two concepts of cause. In: , P.Kitcher, P. editors. PSA 1984, vol. 2 East Lansing, Michigan: Philosophy of Science Association; 1984. p. 405–424.Google Scholar
Spirtes, P., Glymour, C., Scheines, R.Causation, prediction and search. 2nd ed.Cambridge: Massachusetts Institute of Technology Press; 2001.CrossRefGoogle Scholar
Textor, J., Hardt, J., Knüppel, S., DAGitty:, A graphical tool for analyzing causal Diagrams. Epidemiol 2011;5:745.CrossRefGoogle Scholar
Tsuang, M.T., Stone, W.S., Faraone, S.V.Toward reformulating the diagnosis of schizophrenia. Am J Psychiat 2000;157:1041–1050.CrossRefGoogle Scholar
Van Kampen, D.Idiographic complexity and the common personality dimensions Insensitivity, Extraversion, Neuroticism, and Orderliness. Eur J Personal 2000;14:217–243.3.0.CO;2-G>CrossRefGoogle Scholar
Van Kampen, D.Pathways to schizophrenic psychosis: a LISREL-tested model of the unfolding of the schizophrenic prodrome. J Clin Psychol 2005;61:909–938.CrossRefGoogle ScholarPubMed
Van Kampen, D.The Schizotypic Syndrome Questionnaire (SSQ): psychometrics, validation and norms. Schizophr Res 2006;84:305–322.CrossRefGoogle ScholarPubMed
Van Kampen, D.Personality and psychopathology: a theory-based revision of Eysenck's PEN model. Curr Pract Epidemiol Mental Health 2009;5:9–21.CrossRefGoogle ScholarPubMed
Van Kampen, D.The 5-Dimensional Personality Test (5DPT): relationships with two lexically-based instruments and the validation of the Absorption scale. J Personal Assessment 2012;94:92–101.CrossRefGoogle ScholarPubMed
Van Kampen, D., Deijen, J.B.SPEM dysfunction and general schizotypy as measured by the SSQ: a controlled study. BMC Neurol 2009;9:27.CrossRefGoogle ScholarPubMed
Van Kampen, D., Maurer, K., An der Heiden, W., Häfner, H.Prodromal unfolding: the validation of the Schizotypic Syndrome Questionnaire model in a sample of first-episode schizophrenic patients. Early Intervent Psychiat 2009;3:137–150.CrossRefGoogle Scholar
Widiger, T.A.Cluster A personality symptomatology in youth. J Psychopathol Behav Assessment 2010;32:551–556.CrossRefGoogle Scholar
Wilson, J.Causality. In: Sarkar, S.Pfeifer, J. editors. The philosophy of science: an encyclopedia. New York: Routledge; 2006. p. 90–100.Google Scholar
Yung, A.R., McGorry, P.D.The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 1996;22:353–370.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.