Brain development/Law/Policy School of Medicine

Persistent, distressing psychotic-like experiences associated with impairment in youth

In a new study, researchers examined the association between distressing and persistent psychotic-like experiences (PLEs) in youth and important risk factors for psychopathology. The researchers found that youth who indicate they have persistent, distressing PLEs show impairment in a variety of areas such as cognition and reported psychopathology, highlighting the long-term challenges these children may face and the need for early intervention and support. The study, funded by the National Institutes of Health, appears in Molecular Psychiatry.

“Although we know some children have psychotic-like experiences, it has remained unclear which will go on to develop psychotic disorders later in life,” said Shelli Avenevoli, Ph.D., deputy director of the National Institute of Mental Health (NIMH) and an author on the study. “This study shows that children who have persistent, distressing psychotic-like experiences face significant challenges during development, suggesting the value of early intervention for all children with these experiences, regardless of whether they go on to develop psychotic disorders.”

More than 17% of children between the ages of 9 and 12 experience PLEs, such as mild perceptual abnormalities or delusional thoughts. However, only a small subset of these children will develop psychotic disorders. One factor that could help distinguish clinically relevant PLEs from benign ones is whether the psychotic experiences are persistent and/or distressing. In this study, lead author Nicole Karcher, Ph.D., of the Washington University School of Medicine, St. Louis, and colleagues examined the extent to which persistent and/or distressing PLEs were associated with risk factors for psychosis.

The researchers utilized data from the Adolescent Brain Cognitive Development (ABCD) study, a large-scale research effort that is collecting data on 9 and 10-year-olds across the U.S. The researchers used data collected at three timepoints between Sept. 1, 2016 and Oct. 15, 2018. This included baseline data taken near the beginning of the study period and data collected one and two years later. At each of these timepoints, children were assessed for PLEs and level of distress associated with the experiences.

The researchers used this data to form four groups: a persistent distressing PLEs group, a transient distressing PLEs group, a persistent non-distressing PLEs group, and a transient non-distressing PLEs group. PLEs were considered persistent if they were reported during at least 2 waves of data collection and distress was assessed using a self-report survey.

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