Do the Components of Attenuated Positive Symptoms Truly Represent One Construct?

Area of Science:

• Psychiatry
• Clinical Psychology
• Psychometrics

Background:

• Psychosis-risk inventories, such as the Structured Interview for Psychosis-Risk Syndromes (SIPS), use symptom components to create a single severity rating.
• This consolidated rating may obscure crucial clinical details.
• Understanding the distinct contributions of individual symptom components is vital for accurately assessing psychosis risk.

Purpose of the Study:

• To introduce and validate the SIPS Score Separable Components (SSSC) scale.
• To explore the latent structure of psychosis risk symptom components.
• To determine the clinical utility of separable symptom components in individuals at clinical high risk for psychosis.

Main Methods:

• 115 individuals at clinical high risk for psychosis were assessed using the SSSC scale.
• Exploratory factor analysis (EFA) was employed to identify the latent structure of the SSSC.
• Validation analyses included cognitive, functioning, and symptom measures, alongside clinical utility analyses.

Main Results:

• EFA identified three interpretable factors for the SSSC: Conviction, Distress-Impairment, and Frequency/Duration.
• The Conviction factor significantly predicted elevated psychosis risk.
• The Distress-Impairment factor demonstrated excellent validity and was associated with common comorbid symptoms, showing stronger relationships with clinical features than traditional SIPS scores.

Conclusions:

• The SSSC scale offers a valuable supplemental approach to single-severity ratings in psychosis risk assessment.
• It provides enhanced clinical insight and aids in understanding the mechanisms underlying psychosis risk.
• The SSSC has the potential to better capture the heterogeneity observed in individuals at clinical high risk for psychosis.