Psychotic Experiences in the General Population

Powers, Albert R.

doi:10.1001/jamapsychiatry.2019.2391

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…Some have suggested that all voice-hearing experiences lie on a continuum 23 , while others argue that the experiences of treatment-seeking and non-treatment-seeking voice hearers are fundamentally different 24 , and still others suggest the possibility of multiple, potentially discontinuous continua 25 , perhaps defined by a separable factor coding for overall distress or dysfunction 26 . AVH in treatment-seeking and non-treatment-seeking individuals tend to be similar in terms of low-level acoustic qualities such as loudness, location, duration [27][28][29] , but show key differences in higher level, attributional characteristics such as interpretation of the voices' origins, their perceived malevolence, and their ability to be engaged meaningfully 23,[29][30][31] .…”

Section: Introductionmentioning

confidence: 99%

Voluntary control of auditory hallucinations: phenomenology to therapeutic implications

Swyer

Powers

2020

npj Schizophr

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Auditory verbal hallucinations (AVH) have traditionally been thought to be outside the influence of conscious control. However, recent work with voice hearers makes clear that both treatment-seeking and non-treatment-seeking voice hearers may exert varying degrees of control over their voices. Evidence suggests that this ability may be a key factor in determining health status, but little systematic examination of control in AVH has been carried out. This review provides an overview of the research examining control over AVH in both treatment-seeking and non-treatment-seeking populations. We first examine the relationship between control over AVH and health status as well as the psychosocial factors that may influence control and functioning. We then link control to various cognitive constructs that appear to be important for voice hearing. Finally, we reconcile the possibility of control with the field's current understanding of the proposed cognitive, computational, and neural underpinnings of hallucinations and perception more broadly. Established relationships between control, health status, and functioning suggest that the development of control over AVH could increase functioning and reduce distress. A more detailed understanding of the discrete types of control, their development, and their neural underpinnings is essential for translating this knowledge into new therapeutic approaches.

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Section: Introductionmentioning

confidence: 99%

Voluntary control of auditory hallucinations: phenomenology to therapeutic implications

Swyer

Powers

2020

npj Schizophr

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“…Additionally, if future longitudinal investigations indicate that social anxiety is predictive of worse social functioning or risk for psychosis, then social anxiety may be a useful treatment target. Although treatments for social anxiety have not been explicitly examined within the CHR samples, preliminary work in schizophrenia samples (Michail et al, 2017) and an extensive literature on treatment for social anxiety disorder (Powers, 2019) suggest that cognitive behavioural therapy (CBT) would be a potentially effective treatment option for CHR individuals with social anxiety. The social anxiety‐FER anger bias link in the present study further supports this possibility, as threat‐related cognitive biases are a major target of CBT for social anxiety.…”

Section: Discussionmentioning

confidence: 99%

The relevance of social anxiety for understanding social functioning and facial emotion recognition in individuals at clinical high‐risk for psychosis

Williams

Conley

Mittal

2023

Early Intervention Psych

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AimIndividuals at clinical high risk (CHR) for psychosis often experience poor social functioning and impaired facial emotion recognition (FER); however, the impact of frequently comorbid symptoms upon these processes is underexplored. In particular, social anxiety is characteristic of this population and also related to poor social functioning and FER biases, such as misinterpreting neutral faces as negative or threatening; however, little is known about how social anxiety relates to these processes in CHR individuals. The present study examined the overlap of social anxiety, social functioning, and FER accuracy and bias.MethodParticipants (CHR N = 62, healthy controls N = 52) completed the self‐report Social Interaction Anxiety Scale (SIAS), Penn Emotion Recognition‐40 (ER‐40) behavioural task, and interviewer‐rated Global Functioning Scale‐Social (GFS‐S). The ER‐40 was used to assess both FER accuracy (e.g., overall number of correct responses) and bias (e.g., mislabelling neutral faces as angry).ResultsConsistent with previous research, relative to controls, CHR participants had more social anxiety (d = −1.07), poorer social functioning (d = −1.62), and performed more poorly on the FER task (e.g., d = −.37). Within CHR participants, social anxiety was related to an anger detection bias (r = .28), above and beyond positive symptom severity, which in turn was related to FER accuracy (r = .26) and social functioning (r = −.28).ConclusionThese findings suggest that ongoing work examining social processes within CHR individuals needs to account for social anxiety and that social anxiety may be a useful preventive intervention target.

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“…What explains this broad range of PLE prevalence? Despite extensive research, the clinical significance of PLEs remains unclear (Powers, 2019). PLEs are considerably more common than psychotic disorders, with a median prevalence of 5–9% among adults and youth (Kelleher et al, 2012; Linscott & van Os, 2013; McGrath et al, 2015), and are often transient and non-distressing (Hanssen, Bak, Bijl, Vollebergh, & van Os, 2005; McGrath et al, 2015).…”

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confidence: 99%

Clinical significance of psychotic-like experiences across U.S. ethnoracial groups

et al. 2023

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Background Prevalence of psychotic-like experiences (PLEs) – reports of hallucinations and delusional thinking not meeting criteria for psychotic disorder – varies substantially across ethnoracial groups. What explains this range of PLE prevalence? Despite extensive research, the clinical significance of PLEs remains unclear. Are PLE prevalence and clinical severity differentially associated across ethnoracial groups? Methods We examined the lifetime prevalence and clinical significance of PLEs across ethnoracial groups in the Collaborative Psychiatric Epidemiology Surveys (N = 11 139) using the Composite International Diagnostic Interview (CIDI) psychosis symptom screener. Outcomes included mental healthcare use (inpatient, outpatient), mental health morbidity (self-perceived poor/fair mental health, suicidal ideation or attempts), and impairment (role interference). Individuals with outcome onsets prior to PLE onset were excluded. We also examined associations of PLEs with CIDI diagnoses. Cox proportional-hazards regression and logistic regression modeling identified associations of interest. Results Contrary to previous reports, only Asian Americans differed significantly from other U.S. ethnoracial groups, reporting lower lifetime prevalence (6.7% v. 8.0–11.9%) and mean number (0.09 v. 0.11–0.18) of PLEs. In multivariate analyses, PLE clinical significance showed limited ethnoracial variation among Asian Americans, non-Caribbean Latinos, and Afro-Caribbeans. In other groups, mental health outcomes showed significant ethnoracial clustering by outcome (e.g. hospitalization and role interference with Caribbean-Latino origin), possibly due to underlying differences in psychiatric disorder chronicity or treatment barriers. Conclusions While there is limited ethnoracial variation in U.S. PLE prevalence, PLE clinical significance varies across U.S. ethnoracial groups. Clinicians should consider this variation when assessing PLEs to avoid exaggerating their clinical significance, contributing to mental healthcare disparities.

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Psychotic Experiences in the General Population

Cited by 6 publications

References 11 publications

Voluntary control of auditory hallucinations: phenomenology to therapeutic implications

Voluntary control of auditory hallucinations: phenomenology to therapeutic implications

The relevance of social anxiety for understanding social functioning and facial emotion recognition in individuals at clinical high‐risk for psychosis

Clinical significance of psychotic-like experiences across U.S. ethnoracial groups

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