Department of Psychology, University of Maryland, Baltimore County, Baltimore (Millman, Rakhshan Rouhakhtar, Schiffman); Graduate School of Social Service, Fordham University, New York (DeVylder); School of Social Work, University of Maryland, Baltimore (Smith); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Phalen, Parham, Reeves); Department of Psychiatry, Yale University, New Haven, Connecticut (Woods, Walsh).
Psychiatr Serv. 2019 Oct 1;70(10):907-914. doi: 10.1176/appi.ps.201800536. Epub 2019 Jul 16.
Self-report screening instruments for emerging psychosis have the potential to improve early detection efforts by increasing the number of true positives among persons deemed to be at "clinical high risk" of the disorder, but their practical utility depends on their validity across race. This study sought to examine whether a commonly used self-report screening tool for psychosis risk performed equally among black and white youths in its ability to predict clinical high-risk status.
Black (N=58) and white (N=50) help-seeking individuals ages 12-25 (61% female) were assessed with the Prime Screen and the Structured Interview for Psychosis-Risk Syndromes (SIPS). A logistic regression model estimated race differences in the strength of the relation between Prime Screen scores and SIPS-defined risk status.
Higher Prime Screen scores significantly predicted clinical high-risk status among white (p<.01) but not black participants. Among black youths without clinical high risk, self-reported Prime Screen scores more closely resembled scores for youths (black or white) with clinical high risk than scores of white peers who were also without clinical high risk.
Results suggest that consideration of race or ethnicity and associated cultural factors is important when screening for clinical high-risk status. Findings support the need to develop culturally valid early psychosis screening tools to promote appropriately tailored early intervention efforts.
自我报告的精神病筛查工具具有提高“临床高风险”人群中真阳性率的潜力，从而改善早期检测效果，但它们的实际效用取决于其在不同种族中的有效性。本研究旨在检验一种常用于精神病风险筛查的自我报告工具，其在预测临床高风险状态方面，能否在黑人和白人青少年中表现出相同的效果。
研究纳入了 58 名黑人（61%为女性）和 50 名白人（61%为女性）寻求帮助的 12-25 岁青少年，他们接受了 Prime Screen 和结构化精神病风险综合征访谈（SIPS）的评估。逻辑回归模型估计了 Prime Screen 评分与 SIPS 定义的风险状态之间的关系在黑人和白人青少年中的强度差异。
在白人参与者中（p<.01），较高的 Prime Screen 评分显著预测了临床高风险状态，但在黑人参与者中则不然。在没有临床高风险的黑人青少年中，自我报告的 Prime Screen 评分与有临床高风险的青少年（黑人或白人）的评分更为相似，而与没有临床高风险的白人同龄人相比，他们的评分则更接近正常。
结果表明，在筛查临床高风险状态时，考虑种族或民族以及相关的文化因素非常重要。研究结果支持开发文化上有效的早期精神病筛查工具的必要性，以促进有针对性的早期干预措施。
