Distress, impairment and the extended psychosis phenotype: A network analysis of psychotic experiences in a US general population sample

TY - JOUR

T1 - Distress, impairment and the extended psychosis phenotype: A network analysis of psychotic experiences in a US general population sample

AU - Murphy, Jamie

AU - McBride, Orla

AU - Fried, Eiko

AU - Shevlin, Mark

PY - 2018/7/31

Y1 - 2018/7/31

N2 - It has been proposed that subclinical psychotic experiences (PEs) may causally impact on each other over time and engage with one another in patterns of mutual reinforcement and feedback. This subclinical network of experiences in turn may facilitate the onset of psychotic disorder. PEs however are not inherently distressing, nor do they inevitably lead to impairment. The question arises therefore, whether non-distressing PEs, distressing PEs, or both, meaningfully inform an extended psychosis phenotype. The current study first aimed to exploit valuable ordinal data that captured the absence, occurrence and associated impairment of PEs in the general population to construct a general population based severity network of PEs. The study then aimed to partition the available ordinal data into two sets of binary data to test whether an occurrence network comprised of PE data denoting absence (coded 0) and occurrence/impairment (coded 1) was comparable to an impairment network comprised of binary PE data denoting absence/occurrence (coded 0) and impairment (coded 1). Networks were constructed using state-of-the-art regularized pairwise Markov Random Fields (PMRF). The severity network revealed strong interconnectivity between PEs and nodes denoting paranoia were among the most central in the network. The binary PMRF impairment network structure was similar to the occurrence network, however the impairment network was characterised by significantly stronger PE interconnectivity. The findings may help researchers and clinicians to consider and determine how, when and why an individual might transition from experiences that are non-distressing to experiences that are more commonly characteristic of psychosis symptomology in clinical settings.

AB - It has been proposed that subclinical psychotic experiences (PEs) may causally impact on each other over time and engage with one another in patterns of mutual reinforcement and feedback. This subclinical network of experiences in turn may facilitate the onset of psychotic disorder. PEs however are not inherently distressing, nor do they inevitably lead to impairment. The question arises therefore, whether non-distressing PEs, distressing PEs, or both, meaningfully inform an extended psychosis phenotype. The current study first aimed to exploit valuable ordinal data that captured the absence, occurrence and associated impairment of PEs in the general population to construct a general population based severity network of PEs. The study then aimed to partition the available ordinal data into two sets of binary data to test whether an occurrence network comprised of PE data denoting absence (coded 0) and occurrence/impairment (coded 1) was comparable to an impairment network comprised of binary PE data denoting absence/occurrence (coded 0) and impairment (coded 1). Networks were constructed using state-of-the-art regularized pairwise Markov Random Fields (PMRF). The severity network revealed strong interconnectivity between PEs and nodes denoting paranoia were among the most central in the network. The binary PMRF impairment network structure was similar to the occurrence network, however the impairment network was characterised by significantly stronger PE interconnectivity. The findings may help researchers and clinicians to consider and determine how, when and why an individual might transition from experiences that are non-distressing to experiences that are more commonly characteristic of psychosis symptomology in clinical settings.

KW - psychotic experiences

KW - psychosis phenotype

KW - psychosis continuum

KW - network analysis

KW - epidemiology

KW - schizotypy

U2 - 10.1093/schbul/sbx134

DO - 10.1093/schbul/sbx134

M3 - Article

VL - 44

SP - 768

EP - 777

JO - Schizophrenia Bulletin

T2 - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

SN - 0586-7614

IS - 4

ER -