Department of Psychological Sciences, Birkbeck, University of London, London, UK.
Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden.
J Child Psychol Psychiatry. 2019 Jul;60(7):784-792. doi: 10.1111/jcpp.13045. Epub 2019 Apr 7.
Psychotic experiences (PEs) such as paranoia and hallucinations, and negative symptoms (NS) such as anhedonia and flat affect are common in adolescence. Psychotic experiences and negative symptoms (PENS) increase risk for later psychiatric outcomes, particularly when they persist. The extent to which genetic and environmental influences contribute to the stability of PENS in mid-to-late adolescence is unknown.
Using the Specific Psychotic Experiences Questionnaire (SPEQ) twice across ~9 months in adolescence, N = 1,448 twin pairs [M = 16.32 (0.68)] reported experiences of paranoia, hallucinations, cognitive disorganization, grandiosity and anhedonia, and their parents reported on a range of NS. Individuals were split into low-scoring, decreasing, increasing and persistent groups for each subscale. Frequencies and mean differences in distress, depression traits and emotional problems were investigated across groups. Longitudinal structural equation modelling was used to estimate the aetiological components underlying the stability of PENS.
Phenotypic stability was moderate for all PENS (r = .59-.69). Persistent PENS across 9 months were associated with greater levels of distress (V = 0.15-0.46, for PEs only), depression traits (d = 0.47-1.67, except grandiosity) and emotional problems (d = 0.47-1.47, except grandiosity and anhedonia) at baseline compared to groups with transitory or low levels of PENS. At both ages PENS were heritable and influenced by shared and nonshared environment. Genetic influences contributed 38%-62% and shared environment contributed 13%-33% to the stability of PENS. Nonshared environment contributed 34%-41% (12% for parent-rated NS). There was strong overlap of genetic and shared environmental influences across time, and lower overlap for nonshared environment. Imperfect stability of PENS was at least partly due to nonshared environmental influences.
When adolescent PENS persist over time, they are often characterized by more distress, and higher levels of other psychopathology. Both genetic and environmental effects influence stability of PENS.
在青春期，偏执和幻觉等精神病症状（PEs）以及快感缺失和情感平淡等阴性症状（NS）较为常见。精神病症状和阴性症状（PENS）增加了以后出现精神疾病的风险，尤其是当它们持续存在时。遗传和环境因素对青春期中后期 PENS 的稳定性的影响程度尚不清楚。
在青春期使用特定的精神病症状问卷（SPEQ）两次，大约间隔 9 个月，1448 对双胞胎（M=16.32（0.68））报告了偏执、幻觉、认知紊乱、夸大和快感缺失的经历，他们的父母报告了一系列的阴性症状。个体被分为每个子量表的低评分、减少、增加和持续组。对不同组别的痛苦、抑郁特质和情绪问题的频率和均值差异进行了调查。使用纵向结构方程模型来估计 PENS 稳定性的病因成分。
所有 PENS 的表型稳定性都在中等水平（r=0.59-0.69）。在 9 个月的时间里，持续性 PENS 与更大的痛苦水平（V=0.15-0.46，仅与 PEs 有关）、抑郁特质（d=0.47-1.67，除了夸大）和情绪问题（d=0.47-1.47，除了夸大和快感缺失）相关，与 PENS 短暂或低水平的组别相比。在两个年龄段，PENS 都是遗传的，受到共享和非共享环境的影响。遗传因素对 PENS 的稳定性有 38%-62%的贡献，共享环境有 13%-33%的贡献，非共享环境有 34%-41%的贡献（父母评定的 NS 为 12%）。遗传和共享环境的影响在时间上有很强的重叠，而非共享环境的重叠较低。PENS 的不完美稳定性至少部分是由于非共享环境的影响。
当青少年的 PENS 随着时间的推移而持续存在时，它们通常表现为更多的痛苦，以及更高水平的其他精神病理学。遗传和环境因素都影响 PENS 的稳定性。
