Evidence that trauma may play a role in the development of a psychotic illness has lead researchers to investigate the relationship between trauma and the content of attenuated psychotic symptoms. Participants in this study were considered to be at clinical high risk for developing psychosis by meeting criteria for attenuated positive symptom syndrome based on the Structured Interview for Prodromal Syndromes. Trained raters used a specifically designed codebook to identify content in the vignettes of 45 participants. Various types of trauma that had occurred before age 16 were assessed, where participants who endorsed more types of trauma were considered to have experienced a greater amount of trauma. Spearman rank correlations revealed significant positive relationships between increased trauma and feeling watched or followed (rho=0.38, p<0.05) and false beliefs of status or power (rho=0.31, p<0.04). Significant negative relationships were observed between increased trauma and hearing nonnegative voices (rho= −0.39, p<0.01) as well as having unusual negative thoughts surrounding the self (rho=−0.31, p<0.05). Although this was a small sample, these findings support the possibility of a meaningful relationship between experiences of trauma and the content of attenuated positive symptoms.

Examining the content of psychotic symptoms may be relevant for understanding symptom development particularly in those in the very early stages of psychosis. The Content of Attenuated Positive Symptoms codebook was developed as a means to overcome methodological issues in the current literature. Three separate samples at clinical high risk of psychosis were used to develop, modify and finalize the codebook. The inter-rater reliability was moderate to excellent. Specific content items were consistently endorsed across samples. This codebook offers a reliable way to assess content in the clinical high-risk population.

No abstract