Identifying youth at risk for psychosis using the Behavior Assessment System for Children, Second Edition

Identification of youth at risk for or with early psychosis has become the focus of many research and clinical initiatives, as early intervention may be linked to better long-term outcomes. Efforts to facilitate identification have led to the development of several self-report instruments that intend to quickly assess "attenuated" psychosis, potentially screening people for further evaluation. The widely used Behavior Assessment System for Children, Second Edition (BASC-2) includes the atypicality scale, a scale that may be useful for risk screening as it is designed to recognize emerging symptoms of psychosis. The current study aimed to evaluate the utility of the BASC-2 for identifying youth at high clinical risk or with early psychosis within a sample of 70 help-seeking participants aged 12-22. Atypicality scores were compared to risk status (low-risk, high-risk or early psychosis) as determined by the clinician-administered Structured Interview for Psychosis-Risk Syndromes (SIPS). The relative accuracy of the atypicality scale was evaluated against three self-report screeners specifically designed to identify this population. Results indicate that the BASC-2 atypicality scale may be a useful tool for identifying youth in early stages of psychosis. Moreover, the atypicality scale is comparable if not superior to other specialized risk screening instruments in terms of predictive ability. Given the widespread use of the BASC-2 across educational and mental health settings, evidence for convergent validity between the BASC-2 atypicality scale and SIPS diagnoses has the potential to make screening available to a greater population and facilitate earlier detection and intervention.