The impact of age on the validity of psychosis-risk screening in a sample of help-seeking youth

Psychiatry Res. 2019 Apr:274:30-35. doi: 10.1016/j.psychres.2019.02.020. Epub 2019 Feb 10.

Abstract

Self-report screening instruments offer promise in furthering early identification of at-risk youth, yet current efforts are limited by false positive rates. Identifying moderators of accuracy is a potential step towards improving identification and prevention efforts. We investigated the moderating effect of age on self-reported attenuated positive symptoms from the Prime Screen and clinician diagnosed clinical high-risk/early psychosis (CHR/EP) status. Participants (N = 134) were racially diverse, lower-income, help-seeking adolescents and young adults from a primarily urban community. The overall model predicting CHR/EP status was significant, with results suggesting the presence of a trending interaction between age and Prime Screen symptoms. Analyses indicated that number of items endorsed to predict CHR/EP decreased with age (youngest group [M = 12.99] cut off = 6 items; middle age group [M = 14.97] cut off = 3; oldest age group [M = 18.40] cut off = 1). Although younger participants endorsed more risk items on average, follow up analyses suggested that the Prime Screen was a more accurate predictor of clinician-diagnosed-risk among older participants relative to their younger peers. The current study builds on the literature identifying moderators of psychosis-risk screening measure accuracy, highlighting potential limitations of CHR/EP screening tools in younger populations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Patient Acceptance of Health Care / psychology*
  • Prodromal Symptoms
  • Psychiatric Status Rating Scales / standards*
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy
  • Reproducibility of Results
  • Self Report / standards*
  • Young Adult