Calkins Monica E, Ered Arielle, Moore Tyler M, White Lauren K, Taylor Jerome, Moxam Alexander B, Ruparel Kosha, Wolf Daniel H, Satterthwaite Theodore D, Kohler Christian G, Gur Ruben C, Gur Raquel E
Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Lifespan Brain Institute of Penn and CHOP, Philadelphia, PA, United States.
Schizophr Bull. 2025 Jan 10. doi: 10.1093/schbul/sbae224.
BACKGROUND AND HYPOTHESIS: Improvements in screening tools for early subthreshold psychosis symptoms are needed to facilitate early identification and intervention efforts, especially given the challenges of rapidly differentiating age-appropriate experiences from potential early signs of emerging psychosis. Tools can be lengthy and time-consuming, impacting their utility and accessibility across clinical settings, and age-normed data are limited. To address this gap, we sought to develop and validate a brief, empirically derived, age-normed, subthreshold psychosis screening tool, for public use. STUDY DESIGN: Computerized adaptive test simulation was used to derive a 5-item short form with age norm equivalencies from a 12-item PRIME-Screen-Revised (PRIME-12) administered to 7053 youth (Mage = 15.8, SD = 2.7; 54% female; 33% Black). Concurrent validity was assessed (n = 758) using contemporaneous administration of the PRIME-5 and the Structured Interview for Prodromal Syndromes. Comparability of criterion-related validity of the PRIME-5, PRIME-12, and Scale of Prodromal Symptoms (SOPS) was assessed by relating scores to psychosis-risk-relevant criteria. Finally, self-report versus assessor-administered PRIME total scores were compared (n = 131) to assess their concurrent validity. STUDY RESULTS: Correlations among PRIME-5, PRIME-12, and SOPS were comparable and moderate, supporting their convergent validity. The PRIME-5 also showed comparable criterion-related validity, demonstrating similar relationships with psychosis-risk indicators as the other tools. Self-reported and assessor-administered PRIME-5 were moderately correlated. CONCLUSIONS: Public availability of a brief, age-normed, and validated screening tool-which can be assessor or self-administered-will expedite and improve early identification of youth (age 11 and older) at risk for psychosis.
背景与假设:需要改进早期阈下精神病症状的筛查工具,以促进早期识别和干预工作,尤其是考虑到要快速区分与年龄相符的经历和潜在的精神病早期迹象存在挑战。现有工具可能冗长且耗时,影响其在临床环境中的实用性和可及性,并且年龄标准化数据有限。为填补这一空白,我们试图开发并验证一种简短的、基于实证得出的、年龄标准化的阈下精神病筛查工具,供公众使用。 研究设计:采用计算机化自适应测试模拟,从对7053名青少年(年龄中位数 = 15.8,标准差 = 2.7;54%为女性;33%为黑人)施测的12项修订版PRIME筛查量表(PRIME - 12)中得出一个包含5个条目的简短版本,并给出年龄常模等值。使用PRIME - 5与前驱综合征结构化访谈同时施测来评估同时效度(n = 758)。通过将分数与精神病风险相关标准相关联,评估PRIME - 5、PRIME - 12和前驱症状量表(SOPS)在标准关联效度方面的可比性。最后,比较自我报告与评估者施测的PRIME总分(n = 131)以评估它们的同时效度。 研究结果:PRIME - 5、PRIME - 12和SOPS之间的相关性具有可比性且为中等程度,支持它们的聚合效度。PRIME - 5还显示出可比的标准关联效度,与其他工具一样,与精神病风险指标呈现相似的关系。自我报告和评估者施测的PRIME - 5具有中等程度的相关性。 结论:一种简短的、年龄标准化且经过验证的筛查工具可供公众使用,该工具既可以由评估者施测也可以自我施测,这将加快并改善对有精神病风险的青少年(11岁及以上)的早期识别。
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