The AANEX is a valid multidimensional instrument that provides a detailed assessment of psychotic-like experiences and subjective variables relevant to the development of a need for clinical care.

People with an at-risk mental state display a jumping to conclusions reasoning style, associated with impaired working memory and intolerance of uncertainty. This may underlie a tendency to develop abnormal beliefs and a vulnerability to psychosis.

While psychotic-like experiences themselves are not necessarily distressing, appraisals and responses to anomalies do predict distress, as do factors relating to the social context. This adds support to the cognitive-behavioural models, and continuum models, of positive psychotic symptoms.

This study examined some of the predictions made by cognitive models of psychosis, specifically the potential contribution of appraisals and trauma to the development of "need for care." Two groups reporting psychotic-like experiences with and without a "need for care" were compared on types of experiences, appraisals of these experiences, distress, and trauma. Both groups reported similar overall levels of psychotic-like experiences, but were characterized by distinct types of experiences. The clinical group was more distressed, endorsed more externalizing and personalizing appraisals, and fewer psychological/normalizing apraisals of their experiences than the nonclinical group. Both groups showed high rates of trauma, and interpersonal trauma was associated with more personalizing and fewer psychological/normalizing appraisals. These results suggest that "need for care" is characterized by distress and personalizing appraisals, but not by a higher incidence of trauma. The role of interpersonal trauma, specifically, may be to predispose to a "paranoid" world view.