Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T14:53:08.346Z Has data issue: false hasContentIssue false

Risk and protective factors for psychotic experiences in adolescence: a population-based study

Published online by Cambridge University Press:  06 February 2020

Elaine M. McMahon*
Affiliation:
National Suicide Research Foundation, Cork, Ireland School of Public Health, University College Cork, Ireland
Paul Corcoran
Affiliation:
National Suicide Research Foundation, Cork, Ireland School of Public Health, University College Cork, Ireland
Helen Keeley
Affiliation:
Child and Adolescent Mental Health Services North Cork, Health Service Executive, Ireland
Mary Clarke
Affiliation:
Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Helen Coughlan
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Danuta Wasserman
Affiliation:
National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
Christina W. Hoven
Affiliation:
Dept of Child and Adolescent Psychiatry, New York State Psychiatric Institute; Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Vladimir Carli
Affiliation:
National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
Marco Sarchiapone
Affiliation:
Department of Medicine and Health Science, University of Molise, Campobasso, Italy
Colm Healy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Mary Cannon
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland Trinity College Institute of Neuroscience, Dublin, Ireland Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
*
Author for correspondence: Elaine McMahon, Email: [email protected]

Abstract

Background

Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of psychiatric disorders. The aims of this study were to examine associations between PEs and a range of factors including psychopathology, adversity and lifestyle, and to investigate mediating effects of coping style and parental support on associations between adversity and PEs in a general population adolescent sample.

Method

Cross-sectional data were drawn from the Irish centre of the Saving and Empowering Young Lives in Europe study. Students completed a self-report questionnaire and 973 adolescents, of whom 522 (53.6%) were boys, participated. PEs were assessed using the 7-item Adolescent Psychotic Symptom Screener.

Results

Of the total sample, 81 (8.7%) of the sample were found to be at risk of PEs. In multivariate analysis, associations were found between PEs and number of adverse events reported (OR 4.48, CI 1.41–14.25; p < 0.011), maladaptive/pathological internet use (OR 2.70, CI 1.30–5.58; p = 0.007), alcohol intoxication (OR 2.12, CI 1.10–4.12; p = 0.025) and anxiety symptoms (OR 4.03, CI 1.57–10.33; p = 0.004). There were small mediating effects of parental supervision, parental support and maladaptive coping on associations between adversity and PEs.

Conclusion

We have identified potential risk factors for PEs from multiple domains including adversity, mental health and lifestyle factors. The mediating effect of parental support on associations between adversity and PEs suggests that poor family relationships may account for some of this mechanism. These findings can inform the development of interventions for adolescents at risk.

Type
Original Article
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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

Armando, M., Nelson, B., Yung, A. R., Ross, M., Birchwood, M., Girardi, P., & Fiori Nastro, P. (2010). Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophrenia Research, 119, 258265.CrossRefGoogle Scholar
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67, 588597.CrossRefGoogle Scholar
Byrne, B. M., Stewart, S. M., & Lee, P. W. (2004). Validating the beck depression inventory-II for Hong Kong community adolescents. International Journal of Testing, 4, 199216.CrossRefGoogle Scholar
Carli, V., Wasserman, C., Wasserman, D., Sarchiapone, M., Apter, A., Balazs, J., … Hoven, C. W. (2013). The saving and empowering young lives in Europe (SEYLE) randomized controlled trial (RCT): Methodological issues and participant characteristics. BMC Public Health, 13, 479.CrossRefGoogle ScholarPubMed
Catalan, A., Angosto, V., Diaz, A., Valverde, C., de Artaza, M. G., Sesma, E., … Gonzalez-Torres, M. A. (2017). Relation between psychotic symptoms, parental care and childhood trauma in severe mental disorders. Psychiatry Research, 251, 7884.CrossRefGoogle ScholarPubMed
Chisholm, K. E., Wigman, J. T. W., Hallett, D., Woodall, T., Mahfouda, S., Reniers, R., … Lin, A. (2018). The role of coping in the association between subclinical psychotic experiences and functioning: A within study replication in two independent adolescent samples. Schizophrenia Research, 201, 9197.CrossRefGoogle ScholarPubMed
Coughlan, H., Healy, C., Ni Sheaghdha, A., Murray, G., Humphries, N., Clarke, M., & Cannon, M. (2019). Early risk and protective factors and young adult outcomes in a longitudinal sample of young people with a history of psychotic-like experiences. Early Intervention in Psychiatry, 1–14. https://doi.org/10.1111/eip.12855.Google Scholar
Crush, E., Arseneault, L., Jaffee, S. R., Danese, A., & Fisher, H. L. (2017). Protective factors for psychotic symptoms among poly-victimized children. Schizophrenia Bulletin, 44, 691700.CrossRefGoogle Scholar
Crush, E., Arseneault, L., Moffitt, T. E., Danese, A., Caspi, A., Jaffee, S. R., … Fisher, H. L. (2018). Protective factors for psychotic experiences amongst adolescents exposed to multiple forms of victimization. Journal of Psychiatric Research, 104, 3238.CrossRefGoogle ScholarPubMed
Dhondt, N., Healy, C., Clarke, M., & Cannon, M. (2019). Childhood adversity and adolescent psychopathology: Evidence for mediation in a national longitudinal cohort study. British Journal of Psychiatry, 215, 559564.CrossRefGoogle Scholar
Dolphin, L., Dooley, B., & Fitzgerald, A. (2015). Prevalence and correlates of psychotic like experiences in a nationally representative community sample of adolescents in Ireland. Schizophrenia Research, 169, 241247.CrossRefGoogle Scholar
Ered, A., Gibson, L. E., Maxwell, S. D., Cooper, S., & Ellman, L. M. (2017). Coping as a mediator of stress and psychotic-like experiences. European Psychiatry, 43, 913.CrossRefGoogle ScholarPubMed
Falloon, I. R. (2003). Family interventions for mental disorders: Efficacy and effectiveness. World Psychiatry, 2, 2028.Google ScholarPubMed
Fisher, H. L., Caspi, A., Poulton, R., Meier, M. H., Houts, R., Harrington, H., … Moffitt, T. E. (2013). Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: A birth cohort study. Psychological Medicine, 43, 20772086.CrossRefGoogle ScholarPubMed
Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 13371345.CrossRefGoogle ScholarPubMed
Goodman, R., Meltzer, H., & Bailey, V. (1998). The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child & Adolescent Psychiatry, 7, 125130.CrossRefGoogle ScholarPubMed
Healy, C., Brannigan, R., Dooley, N., Coughlan, H., Clarke, M., Kelleher, I., & Cannon, M. (2019). Childhood and adolescent psychotic experiences and risk of mental disorder: A systematic review and meta-analysis. Psychological Medicine, 49, 15891599.CrossRefGoogle ScholarPubMed
Healy, C., Campbell, D., Coughlan, H., Clarke, M., Kelleher, I., & Cannon, M. (2018). Childhood psychotic experiences are associated with poorer global functioning throughout adolescence and into early adulthood. Acta Psychiatrica Scandinavica, 138, 2634.CrossRefGoogle ScholarPubMed
Hennig, T., Jaya, E. S., & Lincoln, T. M. (2017). Bullying mediates between attention-deficit/hyperactivity disorder in childhood and psychotic experiences in early adolescence. Schizophrenia Bulletin, 43, 10361044.Google ScholarPubMed
Jalbrzikowski, M., Sugar, C. A., Zinberg, J., Bachman, P., Cannon, T. D., & Bearden, C. E. (2014). Coping styles of individuals at clinical high risk for developing psychosis. Early Intervention in Psychiatry, 8, 6876.CrossRefGoogle ScholarPubMed
Kaess, M., Durkee, T., Brunner, R., Carli, V., Parzer, P., Wasserman, C., … Wasserman, D. (2014). Pathological internet use among European adolescents: Psychopathology and self-destructive behaviours. European Child & Adolescent Psychiatry, 23, 10931102.CrossRefGoogle ScholarPubMed
Kelleher, I., Connor, D., Clarke, M. C., Devlin, N., Harley, M., & Cannon, M. (2012a). Prevalence of psychotic symptoms in childhood and adolescence: A systematic review and meta-analysis of population-based studies. Psychological Medicine, 42, 18571863.CrossRefGoogle ScholarPubMed
Kelleher, I., Harley, M., Murtagh, A., & Cannon, M. (2011). Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview. Schizophrenia Bulletin, 37, 362369.CrossRefGoogle ScholarPubMed
Kelleher, I., Keeley, H., Corcoran, P., Ramsay, H., Wasserman, C., Carli, V., … Cannon, M. (2013). Childhood trauma and psychosis in a prospective cohort study: Cause, effect, and directionality. American Journal of Psychiatry, 170, 734741.CrossRefGoogle Scholar
Kelleher, I., Lynch, F., Harley, M., Molloy, C., Roddy, S., Fitzpatrick, C., & Cannon, M. (2012b). Psychotic symptoms in adolescence index risk for suicidal behavior: Findings from 2 population-based case-control clinical interview studies. Archives of General Psychiatry, 69, 12771283.CrossRefGoogle ScholarPubMed
Keskinen, E., Marttila, R., Koivumaa-Honkanen, H., Moilanen, K., Keinanen-Kiukaanniemi, S., Timonen, M., … Jaaskelainen, E. (2016). Search for protective factors for psychosis – a population-based sample with special interest in unaffected individuals with parental psychosis. Early Intervention in Psychiatry, 12, 869878.CrossRefGoogle ScholarPubMed
Kohler, U., Karlson, K., & Holm, A. (2011). Comparing coefficients of nested nonlinear probability models. The Stata Journal, 11, 420438.CrossRefGoogle Scholar
Lin, A., Wigman, J. T., Nelson, B., Vollebergh, W. A., van Os, J., Baksheev, G., … Yung, A. R. (2011). The relationship between coping and subclinical psychotic experiences in adolescents from the general population – a longitudinal study. Psychological Medicine, 41, 25352546.CrossRefGoogle ScholarPubMed
Mackie, C. J., Castellanos-Ryan, N., & Conrod, P. J. (2011). Developmental trajectories of psychotic-like experiences across adolescence: Impact of victimization and substance use. Psychological Medicine, 41, 4758.CrossRefGoogle ScholarPubMed
McDowell, I. (2006). Measuring health: A guide to rating scales and questionnaires (3rd edn). Oxford: Oxford University Press.CrossRefGoogle Scholar
McGrath, J. J., Saha, S., Lim, C. C. W., Aguilar-Gaxiola, S., Alonso, J., Andrade, L. H., … Kessler, R. C. & Collaborators, W. H. O. W. M. H. S. (2017). Trauma and psychotic experiences: Transnational data from the World Mental Health Survey. British Journal of Psychiatry, 211, 373380.CrossRefGoogle ScholarPubMed
Mittal, V. A., Dean, D. J., & Pelletier, A. (2013). Internet addiction, reality substitution and longitudinal changes in psychotic-like experiences in young adults. Early Intervention in Psychiatry, 7, 261269.CrossRefGoogle ScholarPubMed
Morgan, C., & Gayer-Anderson, C. (2016). Childhood adversities and psychosis: Evidence, challenges, implications. World Psychiatry, 15, 93102.CrossRefGoogle ScholarPubMed
Niarchou, M., Zammit, S., & Lewis, G. (2015). The Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort as a resource for studying psychopathology in childhood and adolescence: A summary of findings for depression and psychosis. Social Psychiatry and Psychiatric Epidemiology, 50, 10171027.CrossRefGoogle ScholarPubMed
Olatunji, B. O., Deacon, B. J., Abramowitz, J. S., & Tolin, D. F. (2006). Dimensionality of somatic complaints: Factor structure and psychometric properties of the Self-Rating Anxiety Scale. Journal of Anxiety Disorders, 20, 543561.CrossRefGoogle ScholarPubMed
Osman, A., Kopper, B. A., Barrios, F., Gutierrez, P. M., & Bagge, C. L. (2004). Reliability and validity of the Beck depression inventory-II with adolescent psychiatric inpatients. Psychological Assessment, 16, 120.CrossRefGoogle ScholarPubMed
Otero, S., Moreno-Iniguez, M., Paya, B., Castro-Fornieles, J., Gonzalez-Pinto, A., Baeza, I., … Arango-Lopez, C. (2011). Twelve-month follow-up of family communication and psychopathology in children and adolescents with a first psychotic episode (CAFEPS study). Psychiatry Research, 185, 7277.CrossRefGoogle ScholarPubMed
Paalman, C. H., Terwee, C. B., Jansma, E. P., & Jansen, L. M. (2013). Instruments measuring externalizing mental health problems in immigrant ethnic minority youths: A systematic review of measurement properties. PLoS One, 8, e63109.CrossRefGoogle ScholarPubMed
Pelletier-Baldelli, A., Ives, L., & Mittal, V. A. (2015). Increased internet use and poorer ability to manage emotions in youth at high-risk for psychosis. Schizophrenia Research. Cognition, 2, 220226.CrossRefGoogle ScholarPubMed
Pruessner, M., Iyer, S. N., Faridi, K., Joober, R., & Malla, A. K. (2011). Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophrenia Research, 129, 2935.CrossRefGoogle ScholarPubMed
Robustelli, B. L., Newberry, R. E., Whisman, M. A., & Mittal, V. A. (2017). Social relationships in young adults at ultra high risk for psychosis. Psychiatry Research, 247, 345351.CrossRefGoogle ScholarPubMed
Ronning, J. A., Handegaard, B. H., Sourander, A., & Morch, W. T. (2004). The Strengths and Difficulties Self-Report Questionnaire as a screening instrument in Norwegian community samples. European Child & Adolescent Psychiatry, 13, 7382.CrossRefGoogle ScholarPubMed
Schulte-van Maaren, Y. W., Carlier, I. V., Zitman, F. G., van Hemert, A. M., de Waal, M. W., van der Does, A. J., … Giltay, E. J. (2013). Reference values for major depression questionnaires: The Leiden Routine Outcome Monitoring Study. Journal of Affective Disorders, 149, 342349.CrossRefGoogle ScholarPubMed
Sheffield, J. K., Fiorenza, E., & Sofronoff, K. (2004). Adolescents’ willingness to seek psychological help: Promoting and preventing factors. Journal of Youth and Adolescence, 33, 495507.CrossRefGoogle Scholar
Shi, J., Wang, L., Yao, Y., Chen, F., Su, N., Zhao, X., & Zhan, C. (2016). Protective factors in Chinese university students at clinical high risk for psychosis. Psychiatry Research, 239, 239244.CrossRefGoogle ScholarPubMed
Siomos, K. E., Dafouli, E. D., Braimiotis, D. A., Mouzas, O. D., & Angelopoulos, N. V. (2008). Internet addiction among Greek adolescent students. Cyberpsychology & Behavior, 11, 653657.CrossRefGoogle ScholarPubMed
Trauelsen, A. M., Bendall, S., Jansen, J. E., Nielsen, H. G., Pedersen, M. B., Trier, C. H., … Simonsen, E. (2015). Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis. Schizophrenia Research, 165, 5259.CrossRefGoogle ScholarPubMed
Trotta, A., Arseneault, L., Caspi, A., Moffitt, T. E., Danese, A., Pariante, C., & Fisher, H. L. (2019). Mental health and functional outcomes in young adulthood of children with psychotic symptoms: A longitudinal cohort study. Schizophrenia Bulletin, doi: 10.1093/schbul/sbz069. [Epub ahead of print].CrossRefGoogle Scholar
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., … Bentall, R. P. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin, 38, 661671.CrossRefGoogle ScholarPubMed
Wasserman, D., Carli, V., Wasserman, C., Apter, A., Balazs, J., Bobes, J., … Hoven, C. W. (2010). Saving and empowering young lives in Europe (SEYLE): A randomized controlled trial. BMC Public Health, 10, 192.CrossRefGoogle ScholarPubMed
WHO (2009). Global School-Based Student Health Survey, Geneva. Available at http://www.who.int/chp/gshs/en/.Google Scholar
Williams, J., Bucci, S., Berry, K., & Varese, F. (2018). Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clinical Psychology Review, 65, 175196.CrossRefGoogle ScholarPubMed
Yates, K., Lang, U., Cederlof, M., Boland, F., Taylor, P., Cannon, M., … Kelleher, I. (2019). Association of psychotic experiences with subsequent risk of suicidal ideation, suicide attempts, and suicide deaths: A systematic review and meta-analysis of longitudinal population studies. JAMA Psychiatry, 76, 180189.CrossRefGoogle ScholarPubMed
Young, K. S. (1998). Internet addiction: The emergence of a new clinical disorder. Cyberpsychology & Behavior, 1, 237244.CrossRefGoogle Scholar
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371379.CrossRefGoogle ScholarPubMed
Supplementary material: File

McMahon et al. Supplementary Materials

McMahon et al. Supplementary Materials

Download McMahon et al. Supplementary Materials(File)
File 14.3 KB