Susana Sierra-Baigrie

Symptomatic and functional outcome in youth at ultra-high risk for psychosis: A longitudinal study

The current report assesses the clinical, functioning and demographic data of a cohort enrolled in the P3 prevention program for psychosis; a Spanish National Health System and Ministry of Science funded program. Comparisons are made between those individuals who had converted to psychosis and those who had not at 3years after an average of 24 treatment sessions. Subjects included 61 participants meeting Structured Interview for Prodromal Syndromes criteria, with ages ranging from 17 to 31, and all meeting criteria for ultra-high risk of psychosis. Prospective follow-up data are reported for patients re-evaluated at 1 and 3years. At 1-year follow-up, the conversion rate to psychosis was 18%, but increased to 23% at 3-year follow-up. The converted sample was older than the non-converted sample and more likely to have higher ratings on subsyndromal psychotic (positive and disorganized), negative and general symptoms, and lower levels of functioning at baseline assessment. Analyses of change over time indicated a clear clinical improvement in both clinically stable patients and in those who showed a transient psychotic state over time. No gender differences in symptom or functioning levels at the three follow-up time points were found; however, the interactions among conversionxgenderxSOPS total scorextime points significantly reflect that the growth profiles of the four groups (no conversion males, no conversion females, conversion males and conversion females) in the SOPS total score are not parallel and that, consequently, the four groups involved different patterns of change over time, males experiencing faster and longer deterioration when psychotic symptoms arise.

Measurement invariance of the Schizotypal Personality Questionnaire-Brief across gender and age.

The purpose of this study was to examine the dimensional structure and measurement invariance of the Schizotypal Personality Questionnaire-Brief (SPQ-B) (Raine and Benishay, 1995) across sex and age in a representative sample of nonclinical adolescents and young adults. The sample consisted of 1789 adolescents and young adults (42.1% males), with a mean age of 17.1years (S.D.=2.9). The results indicated that the Likert version of the SPQ-B showed adequate psychometric properties (α total score 0.89). The schizotypal personality models that presented the best fit indices were Raine et al.s (1994) three-factor model and Stefanis et al.s (2004) four-factor model. In addition, the results support the measurement invariance of the SPQ-B across sex and age. When the latent means of the schizotypal dimensions were compared across sex and age, statistically significant differences were found. Consistent with previous literature, schizotypal personality is a multidimensional construct whose structure appears invariant across sex and age. Future studies should examine the invariance of schizotypal personality across cultures, as well as using the SPQ-B as a screening method in the general population to detect individuals at risk for schizophrenia-spectrum disorders, given its rapid and easy administration.

Phenotypic Expression of Schizotypal Traits in an Adolescent Population

The main goal of the present study was to examine the influence of gender and age in the phenotypic expression of schizotypal traits in a community sample of adolescents. The sample was composed of a total of 1,618 participants, 776 (48%) males, with a mean age of 15.9 years (SD = 1.2). The ESQUIZO-Q: Oviedo Schizotypy Assessment Questionnaire was used for the assessment of schizotypal traits, a measure specifically developed for its use in adolescents. The results showed that gender and age were two sociodemographical variables that influenced the expression of schizotypal features. The males in the study obtained higher mean scores than the females in the Negative dimension (Physical and Social Anhedonia); however, the females obtained higher mean scores in Magical Thinking, Lack of Close Friends, and Social Disorganization. With regard to age, the younger adolescents had lower scores in Odd Thinking and Language, Lack of Close Friends, Excessive Social Anxiety, and Social Disorganization compared to the older adolescents. This differential pattern is similar to the one found in patients with schizophrenia and in nonclinical young adults, and these findings improve our understanding about the phenotypic expression of schizotypy during adolescence.

Exploring the relationship between coping strategies and binge eating in nonclinical adolescents.

The aims of the study were to determine the rate of binge eating and examine the relationship between binge eating and coping in nonclinical adolescents. A total of 1913 adolescents completed the Bulimic Investigatory Test, Edinburgh, the Adolescent Coping Scale (ACS), the Youth Self-Report and additional questions regarding the binge-eating episodes. Of the total sample, 6.94% reported bingeing in the last 6 months. The adolescents who binge eat reported a more frequent use of Intropunitive avoidance and Introversion and a less frequent use of Positive-effortful coping compared with those who do not binge eat. However, when the effects of age and depression were controlled in the analysis, the groups only differed in the Positive and Intropunitive avoidance dimensions of coping. Training adolescents on how to cope with stress in a more constructive manner may be a possible strategy for the prevention of maladaptive eating patterns in adolescents.

PW01-171 - Coping strategies in adolescents with psychotic-like experiences

Coping strategies have been defined as the cognitive-behavioral efforts in continuous change made by a subject in order to manage internal and/or external demands which exceed his/her personal resources (Lazarus & Folkman, 1984). Said coping strategies have been extensively investigated in individuals with symptoms of psychosis-proneness. Objectives The main objective of the present study was to compare the coping strategies used by adolescents with and without subclinical psychotic symptoms. Method The sample was composed of 1,713 Spanish adolescents, 881 (51.4%) females, with a mean age of 14.7 years (SD = 1.7). Results The results showed that the adolescents with subclinical psychotic symptoms used Avoidance-type coping strategies more frequently and Positive-type coping strategies less frequently in comparison to the control group. Conclusions These findings indicate a pattern of deficit in the strategies used to cope with stress similar to that of patients with schizophrenia, which is very interesting with a view to establishing lines of intervention within early detection and treatment programs for high-risk individuals aimed at modifying these patterns of deficit in coping with environmental stimuli in these populations.

Examining the Relationship Between Binge Eating and Coping Strategies in Adolescents

Binge eating is a highly distressing symptom which is central to the diagnosis of bulimia nervosa and binge eating disorder (BED) and that has received increasing attention in the last few decades. Numerous studies have analyzed the factors involved in binge eating. Factors such as boredom, body-weight concern, dietary restraint, and low self-esteem have all been identified as possible precursors to binge eating episodes. In addition, the link between coping and binge eating has also been the focus of many investigations. This chapter reviews the literature examining the link between coping and binge eating and describes a study conducted to further explore this relationship in Spanish adolescents as well as examine their concept of binge eating. The results are consistent with previous studies which have shown that binge eating is a fairly frequent behavior in adolescence. The adolescents who reported binge eating used avoidance coping strategies more frequently and positive ones less frequently than those who did not engage in this behavior. On the other hand, adolescents mainly took into account the amount of food eaten when defining a binge with few of them mentioning loss of control in their descriptions. These findings contribute to the advancement in the understanding of this phenomenon, as well as the factors associated with it, in nonclinical populations. In addition, there are implications for the prevention of this behavior in nonclinical adolescents, which can be drawn from the possible link between binge eating and coping. The development of constructive ways to solve daily problems and cope with stressors may be a possible strategy for the prevention of this behavior in adolescents. Future lines of research are also discussed in the chapter

The Assessment of Bulimic Symptomatology: Factorial Structure and Measurement Invariance of the Bulimic Investigatory Test, Edinburgh Across Gender and Age

A wide variety of measurement instruments is available in the literature for the assessment of bulimic symptomatology. Among the most extensively used is the Bulimic Investigatory Test, Edinburgh (BITE) (Henderson and Freeman 1987). This chapter reviews the psychometric and epidemiological studies which have used the BITE as a clinical or research tool. In addition, an empirical study which examined the psychometric properties and measurement invariance of the BITE, in a community nonclinical adolescent Spanish sample, is described. In accordance with previous literature, the results showed that the BITE is a measurement instrument which presents adequate psychometric properties. The level of internal consistency for the Symptom subscale was.95, whereas for the severity subscale it was.70. The analysis of the dimensionality of the BITE using exploratory factor analysis revealed a one-factor solution. In addition, the confirmatory factor analysis showed adequate fit indices for the one-factor solution. This dimensional structure proved to be invariant across the adolescents’ gender and age. Statistically significant differences were found as a function of age and gender when the groups were compared in the latent means. In general terms, the BITE is an adequate instrument for the assessment of bulimic symptomatology in adolescents. Future studies should incorporate the new advances in psychological and educational assessment pertaining to computer adaptive tests as well as examine the measurement invariance of the tests which assess bulimic symptomatology across cultures.

P02-283 - Psychotic-like experiences, emotional and behavioral problems in nonclinical adolescents

Approximately 5 % of adolescents present psychotic symptoms which are not necessarily associated with a psychopathological alteration and that are known as subclinical psychotic-like experiences. Said symptoms have been found to be closely linked to the presence of affective psychopathology, such as high levels of anxiety, stress, dysphoria or depression in this population. Objectives The main objective of this work was to compare the emotional and behavioral problems reported by adolescents with and without psychotic-like symptoms. Method The sample was composed of 1,713 non-clinical adolescents with a mean age of 14.7 years (SD = 1.7), of which 832 (48.6 %) were males. Results The results showed that the participants with psychotic-like symptoms reported a higher number of emotional and behavioral problems compared to the participants who did not inform of said experiences. Conclusions The findings converge with data from previous studies of patients with schizophrenia as well as in schizophrenia-prone individuals, offering support to the dimensional models of psychosis, and have clear implications with a view to establishing primary prevention strategies for these high-risk individuals.