Birkenæs Viktoria, Parekh Pravesh, Hegemann Laura, Bakken Nora R, Frei Evgeniia, Jaholkowski Piotr, Smeland Olav B, Susser Ezra, Rodriguez Katrina M, Tesfaye Markos, Andreassen Ole A, Havdahl Alexandra, Sønderby Ida E
Centre for Precision Psychiatry, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
medRxiv. 2024 Apr 18:2024.04.18.24306017. doi: 10.1101/2024.04.18.24306017.
Adolescent self-reported psychotic experiences are associated with mental illness and could help guide prevention strategies. The Community Assessment of Psychic Experiences (CAPE) was developed over 20 years ago. In a rapidly changing society, where new generations of adolescents are growing up in an increasingly digital world, it is crucial to ensure high reliability and validity of the questionnaire.
In this observational validation study, we used unique transgenerational questionnaire and health registry data from the Norwegian Mother, Father, and Child Cohort, a population-based pregnancy cohort. Adolescents, aged ~14 years, responded to the CAPE-16 ( = 18,835) and fathers to the CAPE-9 questionnaire ( = 28,793). We investigated the psychometric properties of CAPE-16 through factor analyses, measurement invariance testing across biological sex, response before/ during the COVID-19 pandemic, and generations (comparison with fathers), and examined associations with later psychiatric diagnoses.
One third (33·4%) of adolescents reported lifetime psychotic experiences. We confirmed a three-factor structure (paranoia, bizarre thoughts, and hallucinations) of CAPE-16, and observed good scale reliability of the distress and frequency subscales (ω = ·86 and ·90). CAPE-16 measured psychotic experiences were invariant to biological sex and pandemic status. CAPE-9 was non-invariant across generations, with items related to understanding of the digital world () prone to bias. CAPE-16 sum scores were associated with a subsequent psychiatric diagnosis, particularly psychotic disorders ( OR = 2·06; 97·5% CI = 1·70-2·46; OR = 1·93; 97·5% CI = 1·63-2·26).
CAPE-16 showed robust psychometric properties across sex and pandemic status, and sum scores were associated with subsequent psychiatric diagnoses, particularly psychotic disorders. These findings suggest that with certain adjustments, CAPE-16 could have value as a screening tool for adolescents in the modern, digital world.
European Union's Horizon 2020 Programme, Research Council of Norway, South-Eastern Norway Regional Health Authority, NIMH, and the KG Jebsen Stiftelsen.
青少年自我报告的精神病性体验与精神疾病相关，有助于指导预防策略。《社区精神体验评估量表》（CAPE）是20多年前编制的。在一个快速变化的社会中，新一代青少年在日益数字化的世界中成长，确保该问卷具有高信度和效度至关重要。
在这项观察性验证研究中，我们使用了来自挪威母亲、父亲和儿童队列（一个基于人群的妊娠队列）的独特的跨代问卷和健康登记数据。约14岁的青少年回答了CAPE - 16问卷（n = 18,835），父亲们回答了CAPE - 9问卷（n = 28,793）。我们通过因子分析、跨生物性别、在新冠疫情之前/期间的回答以及代际（与父亲比较）的测量不变性检验，研究了CAPE - 16的心理测量特性，并检查了与后来精神科诊断的关联。
三分之一（33.4%）的青少年报告有终生精神病性体验。我们确认了CAPE - 16的三因素结构（偏执、怪异想法和幻觉），并观察到痛苦和频率子量表具有良好的量表信度（ω = 0.86和0.90）。CAPE - 16测量的精神病性体验在生物性别和疫情状态方面具有不变性。CAPE - 9在各代之间不具有不变性，与对数字世界理解相关的项目（如……）容易产生偏差。CAPE - 16总分与随后的精神科诊断相关，尤其是精神病性障碍（比值比 = 2.06；97.5%置信区间 = 1.70 - 2.46；比值比 = 1.93；97.5%置信区间 = 1.63 - 2.26）。
CAPE - 16在性别和疫情状态方面显示出稳健的心理测量特性，总分与随后的精神科诊断相关，尤其是精神病性障碍。这些发现表明，经过某些调整后，CAPE - 16可能作为现代数字化世界中青少年的筛查工具具有价值。
欧盟的“地平线2020”计划、挪威研究理事会、挪威东南部地区卫生局、美国国立精神卫生研究所和KG耶布森基金会。
