Youth psychotic-like experiences

Increasingly, clinicians report seeing young people with symptoms of psychosis. Karcher, Merchant, Rappaport & Barch (2023) published “Associations with Youth Psychotic-Like Experiences Over Time: Evidence for trans-symptom and specific cognitive and neural risk factors” in Journal of Psychopathology and Clinical Science. Here’s the abstract and impact statement with some information in bold:

The current study examined whether impairments in cognitive and neural factors at baseline (ages 9–10) predict initial levels or changes in psychotic-like experiences (PLEs) and whether such impairments generalize to other psychopathology symptoms (i.e., internalizing and externalizing symptoms). Using unique longitudinal Adolescent Brain Cognitive Development Study data, the study examined three time points from ages 9 to 13. Univariate latent growth models examined associations between baseline cognitive and neural metrics with symptom measures using discovery (n = 5,926) and replication (n = 5,952) data sets. For symptom measures (i.e., PLEs, internalizing, externalizing), we examined mean initial levels (i.e., intercepts) and changes over time (i.e., slopes). Predictors included neuropsychological test performance, global structural MRI, and several a priori within-network resting-state functional connectivity metrics. Results showed a pattern whereby baseline cognitive and brain metric impairments showed the strongest associations with PLEs over time. Lower cognitive, volume, surface area, and cingulo-opercular within-network connectivity metrics showed associations with increased PLEs and higher initial levels of externalizing and internalizing symptoms. Several metrics were uniquely associated with PLEs, including lower cortical thickness with higher initial PLEs and lower default mode network connectivity with increased PLEs slopes. Neural and cognitive impairments in middle childhood were broadly associated with increased PLEs over time, and showed stronger associations with PLEs compared with other psychopathology symptoms. The current study also identified markers potentially uniquely associated with PLEs (e.g., cortical thickness). Impairments in broad cognitive metrics, brain volume and surface area, and a network associated with information integration may represent risk factors for general psychopathology. 

This study provides support for both shared and specific risk factors for psychopathology. Greater early psychosis spectrum symptoms over time showed specific associations with several lower brain metrics. Across all types of symptoms, there was also evidence for shared associations, including with lower cognitive functioning, with the strongest associations generally found for psychosis spectrum symptoms. 

I like this study because it highlights the underlying brain mechanisms as well as the aspects of cognitive functioning that neuropsychologists assess.