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An Examination of Sustained Versus Transient Distressing Psychotic-Like Experiences Using Adolescent Brain Cognitive DevelopmentSM Study Data

By Nicole R. Karcher, Rachel L. Loewy, Mark Savill, Shelli Avenevoli, Rebekah S. Huber, Carolina Makowski, Kenneth J. Sher, Deanna M. Barch

Posted 13 Nov 2020
medRxiv DOI: 10.1101/2020.11.10.20229229

ObjectiveA potential distinguishing factor between more benign and transient psychotic-like experiences (PLEs) versus PLEs that predict risk for psychiatric disorders is whether the PLEs are sustained and distressing (sustained dPLEs). The current study examined associations of both sustained and transient dPLEs with relevant risk factors (e.g., cognition), use of mental health services, and functional correlates (e.g., school performance) in school-age children. MethodThe current study used three Adolescent Brain Cognitive DevelopmentSM study data waves to create sustained dPLE (n=272), transient dPLE (n=244), and control (n=272) groups. Hierarchical linear models examined whether these groups differed in terms of use of mental health services, functional correlates, family history of mental disorders, other symptoms (e.g., parent-rated psychotic symptoms, internalizing, externalizing symptoms), environmental factors (e.g., adverse childhood events [ACEs]), cognitive functioning, developmental milestone delays, and neuroimaging indices. ResultsSeveral factors were more strongly associated with sustained versus transient dPLEs, including use of mental health services (for sustained vs. controls: d=0.38), drop in grades (d=--.30), other symptoms (i.e., parent-rated psychotic, bipolar, internalizing, externalizing, suicidality; 0.33>ds<0.88), ACEs (d=.36), and lower fluid and executive functioning cognitive scores (-0.31>ds<-0.41). For most risk factors, the sustained dPLEs group showed the greatest impairments, followed by the transient group, with the control group showing the least impairments. ConclusionsThese results have implications for understanding the pathogenesis of dPLEs, including indicating that several factors may distinguish transient from persisting dPLEs in children, including higher symptoms and ACEs, lower executive functioning scores, greater use of mental health services, and worsening school performance.

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