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Longitudinal Trajectories of Positive and Negative Schizotypy Dimensions

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Longitudinal Trajectories of Positive and Negative Schizotypy Dimensions ADVERTIMENT. Lʼaccés als continguts dʼaquesta tesi queda condicionat a lʼacceptació de les condicions dʼús establertes per la següent llicència Creative Commons: http://cat.creativecommons.org/?page_id=184 ADVERTENCIA. El acceso a los contenidos de esta tesis queda condicionado a la aceptación de las condiciones de uso establecidas por la siguiente licencia Creative Commons: http://es.creativecommons.org/blog/licencias/ WARNING. The access to the contents of this doctoral thesis it is limited to the acceptance of the use conditions set by the following Creative Commons license: https://creativecommons.org/licenses/?lang=en Longitudinal trajectories of positive and negative schizotypy dimensions Anna Racioppi Universitat Autònoma de Barcelona Facultat de Psicologia Departament de Psicologia Clínica i de la Salut Doctorat en Psicologia Clínica i de la Salut Doctoral Thesis Longitudinal trajectories of positive and negative schizotypy dimensions by Anna Racioppi Supervisor and Tutor: Prof. Neus Vidal Barrantes Bellaterra (Barcelona) February 2020 Grant Information This work was supported by the Spanish Ministerio de Economía y Competividad (Plan Nacional I+D PSI2017-87512-C2-01) and the Comissionat per a Universitats i Recerca of the Generalitat de Catalunya (2017SGR1612). A. Racioppi was supported by the Spanish Ministerio de Economía y Competitividad and by the European Social Found (ESF) (BOE-A-2015-6508). CONTENTS 1. INTRODUCTION ...................................................................................................... 1 2. BACKGROUND ......................................................................................................... 5 2.1. A Dimensional Conceptualization of the Psychosis Continuum ........................................5 2.1.1. Schizotypy: a Framework to Study Psychosis Risk .....................................................5 2.1.2. Schizotypal Personality Disorder (SPD) ....................................................................7 2.1.3. Prodromal Symptoms or At Risk Mental States for Psychosis ....................................9 2.1.4. Schizophrenia-Spectrum Disorders .......................................................................... 11 2.2. The Multidimensional Nature of Schizotypy ................................................................... 14 2.2.1. The Assessment of Schizotypy Dimensions ............................................................... 15 2.2.2. Construct Validity of Schizotypy Dimensions ........................................................... 17 2.3. Schizotypy as Predictor of Psychosis Spectrum Psychopathology .................................. 20 2.3.1. Schizotypy as a Marker of Psychosis Proneness in Non-Clinical Samples ............... 20 2.3.2. Schizotypy in Genetically At-Risk Samples ............................................................... 28 2.3.3. Schizotypy and SPD in Clinical At-Risk Samples ..................................................... 30 3. AIMS AND OUTLINE OF THIS THESIS ............................................................ 37 4. EMPIRICAL WORK SECTION 1: A PROSPECTIVE STUDY OF SCHIZOTYPY DIMENSIONS IN A NON-CLINICAL SAMPLE: THE BARCELONA LONGITUDINAL INVESTIGATION OF SCHIZOTYPY (BLISS) ...................................................... 41 Chapter 1: Prediction of Prodromal Symptoms and Schizophrenia-Spectrum Personality Disorder Traits by Positive and Negative Schizotypy: A 3-Year Prospective Study .............. 43 Abstract .............................................................................................................................. 44 Introduction ........................................................................................................................ 45 Method ............................................................................................................................... 50 Results ................................................................................................................................ 53 Discussion .......................................................................................................................... 57 Tables and Figures ............................................................................................................. 65 References .......................................................................................................................... 71 Chapter 2: Schizotypy Dimensions Predict At-Risk Mental States, Schizophrenia-Spectrum Symptoms, and Impairment: A 4.4 Year Prospective Study ................................................... 79 Abstract .............................................................................................................................. 80 Introduction ........................................................................................................................ 81 Method ............................................................................................................................... 85 Results ................................................................................................................................ 88 Discussion .......................................................................................................................... 91 Tables ............................................................................................................................... 101 Supplementary material .................................................................................................... 106 References ........................................................................................................................ 114 SECTION 2: THE PREDICTIVE VALIDITY OF SCHIZOTYPY DIMENSIONS AS MEASURED IN DAILY-LIFE: THE BARCELONA LONGITUDINAL INVESTIGATION OF SCHIZOTYPY (BLISS) .................................................... 123 Chapter 3: Schizotypy Predicts Psychotic-Like, Paranoid, and Negative Symptoms in Daily Life 3 Years Later: an Experience Sampling Methodology Longitudinal Study .................. 125 Abstract ............................................................................................................................ 126 Introduction ...................................................................................................................... 127 Method ............................................................................................................................. 131 Results .............................................................................................................................. 135 Discussion ........................................................................................................................ 140 Tables and Figures ........................................................................................................... 153 References ........................................................................................................................ 170 5. GENERAL DISCUSSION ..................................................................................... 175 5.1. Integration of Findings .................................................................................................. 176 5.2. Implications for Clinical Interventions .......................................................................... 183 5.3. Strengths and Limitations .............................................................................................. 186 5.4. Future Directions ........................................................................................................... 189 5.5. Conclusions ................................................................................................................... 192 References ................................................................................................................... 195 Acknowledgments ....................................................................................................... 217 CURRICULUM VITAE ............................................................................................ 221 1. INTRODUCTION Schizophrenia is one the most severe mental illnesses affecting around 20 million people worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018; Saha, Chant, Welham, & McGrath, 2005). Schizophrenia and related psychotic disorders are listed internationally as one of the leading causes of disability given its considerable burden for those who suffer it, their relatives and the entire society (GBD 2016 Disease and Injury Incidence and Prevalence Collaborators, 2018; Rössler, Salize, van Os, & Riecher-Rössler, 2005; Shah, Mizrahi, & McKenie, 2011). Psychotic disorders are often diagnosed in the late teen years or early adult life, and tend to emerge earlier in males than in females (McGrath, Saha, Chant, & Welham, 2008). Although their lifetime prevalence is approximately a 3% (McGrath, Saha, Chant, & Welham, 2008; Perälä et al., 2007), it is estimated that less than 14% of people who experience a first psychotic episode achieved a sustained recovery within five years after the onset of disease (Robinson, Woerner, McMeniman, Mendelowitz & Bilder, 2004). Recent reviews estimated that the international prevalence of schizophrenia and psychotic disorders in non-institutionalized populations range between 0.33% and 0.75% (Moreno-Küstner, Martín, & Pastor, 2018; Saha, Chant, Welham, & McGrath, 2005).
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