Taylor Mark J, Freeman Daniel, Ronald Angelica
Centre for Brain & Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, UK.
Department of Psychiatry, University of Oxford, UK.
Psychiatry Res. 2016 Jul 30;241:35-42. doi: 10.1016/j.psychres.2016.04.021. Epub 2016 Apr 11.
Psychotic experiences of varying severity levels are common in adolescence. It is not known whether beyond a certain severity in the general population, psychotic experiences represent a categorically distinct phenomena to milder psychotic experiences. We employed taxometric analytic procedures to determine whether psychotic experiences in adolescence are taxonic (i.e. categorical) or dimensional. Six different psychotic experiences were assessed in a community sample of approximately 5000 adolescents. Three taxometric procedures were conducted. Across all procedures, there was no evidence of a taxon (i.e. a separate latent population) underlying psychotic experiences in adolescence. Rather, a dimensional structure was supported. The results support the notion that psychotic experiences are continuously distributed throughout the general population, and there is no clear discontinuity between milder and more severe psychotic experiences. Thus, these findings support the use of dimensional approaches to understanding psychotic experiences in etiological studies. In clinical practice, categorical cut-offs are needed: the present findings show that a 'natural' break point is not present for identifying severe psychotic experiences, and it is likely therefore that other criteria (such as general functioning) might better aid decision-making with regards to identifying individuals with severe psychotic experiences in need of care during adolescence.
不同严重程度的精神病性体验在青少年中很常见。目前尚不清楚，在一般人群中，超过一定严重程度后，精神病性体验是否与较轻的精神病性体验属于完全不同的现象。我们采用了分类分析程序来确定青少年期的精神病性体验是类别性的还是维度性的。在一个约5000名青少年的社区样本中评估了六种不同的精神病性体验。进行了三种分类分析程序。在所有程序中，均没有证据表明青少年期的精神病性体验存在一个类别（即一个单独的潜在群体）。相反，支持维度结构。这些结果支持了这样一种观点，即精神病性体验在一般人群中呈连续分布，较轻和较严重的精神病性体验之间没有明显的间断。因此，这些发现支持在病因学研究中使用维度方法来理解精神病性体验。在临床实践中，需要分类界限：目前的研究结果表明，识别严重精神病性体验不存在“自然”的断点，因此，其他标准（如总体功能）可能更有助于在青少年期识别需要护理的严重精神病性体验个体时做出决策。
