Salaminios George, Sprüngli-Toffel Elodie, Michel Chantal, Morosan Larisa, Eliez Stephan, Armando Marco, Fonseca-Pedrero Eduardo, Derome Melodie, Schultze-Lutter Frauke, Debbané Martin
Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Research Department, British Association for Counselling and Psychotherapy, Lutterworth, United Kingdom.
Front Psychiatry. 2023 Sep 21;14:1267656. doi: 10.3389/fpsyt.2023.1267656. eCollection 2023.
Schizotypal traits and disturbances in mentalizing (the capacity to understand the mental states driving one's own and others' behaviors) have been implicated in increased vulnerability for psychosis. Therefore, we explored the associations linking schizotypal traits, mentalizing difficulties and their interactions to clinical high-risk for psychosis (CHR-P), as captured by the Basic Symptoms (BS) approach, during adolescence and young adulthood.
Eighty-seven adolescents and young adults from the general population (46% male, 44% female; age: 14-23 years) were assessed with the Schizophrenia Proneness Interview (SPI-CY/A) for 11 perceptive and cognitive BS, with the Schizotypal Personality Questionnaire (SPQ) for schizotypal traits, and with the Reflective Functioning Questionnaire (RFQ) for self-reported mentalizing abilities. The RFQ evaluates the level of certainty (RFQc scale) and uncertainty (RFQu scale) with which individuals use mental state information to explain their own and others' behaviors.
Logistic regression models showed significant positive effects of the SPQ disorganization scale on perceptive BS and of the SPQ interpersonal scale on cognitive BS. Post-hoc analyses revealed that schizotypal features pertaining to odd speech and social anxiety, respectively, were associated with perceptive and cognitive BS. Furthermore, higher scores on the RFQu scale and lower scores on the RFQc scale independently explained the presence of cognitive BS. Finally, significant interaction effects between RFQc and SPQ odd speech on perceptive BS, and between RFQc and SPQ social anxiety on cognitive BS were found.
Our findings suggest that schizotypal traits and mentalizing significantly relate both independently and through their interactions to the presence of cognitive and perceptive BS included in CHR-P criteria. Furthermore, mentalizing dysfunction may contribute in the relation between schizotypal traits and early state signs of CHR-P. Mentalizing may support both detection and early treatment of CHR-P among adolescents and young adults who present with trait risk for psychosis.
分裂型特质与心理化障碍（即理解驱动自身及他人行为的心理状态的能力）被认为与精神病易感性增加有关。因此，我们探讨了在青少年和青年期，分裂型特质、心理化困难及其相互作用与精神病临床高危状态（CHR-P）之间的关联，CHR-P通过基本症状（BS）方法来衡量。
对87名来自普通人群的青少年和青年（46%为男性，44%为女性；年龄：14 - 23岁）进行评估，使用精神分裂症倾向访谈（SPI-CY/A）评估11种感知和认知性基本症状，使用分裂型人格问卷（SPQ）评估分裂型特质，使用反思功能问卷（RFQ）评估自我报告的心理化能力。RFQ评估个体使用心理状态信息解释自身和他人行为时的确定程度（RFQc量表）和不确定程度（RFQu量表）。
逻辑回归模型显示，SPQ紊乱量表对感知性基本症状有显著正向影响，SPQ人际量表对认知性基本症状有显著正向影响。事后分析表明，分别与言语怪异和社交焦虑相关的分裂型特征与感知性和认知性基本症状有关。此外，RFQu量表得分较高和RFQc量表得分较低独立解释了认知性基本症状的存在。最后，发现RFQc与SPQ言语怪异在感知性基本症状上存在显著交互作用，RFQc与SPQ社交焦虑在认知性基本症状上存在显著交互作用。
我们的研究结果表明，分裂型特质和心理化在CHR-P标准所包含的认知性和感知性基本症状的存在方面，既独立相关又通过它们之间的相互作用显著相关。此外，心理化功能障碍可能在分裂型特质与CHR-P早期状态体征之间的关系中起作用。心理化可能有助于在具有精神病特质风险的青少年和青年中检测和早期治疗CHR-P。
