Psychosis risk screening in youth: A validation study of three self-report measures of attenuated psychosis symptoms

Recent research linking the duration of untreated psychosis to illness course and outcome highlights the need for earlier intervention for individuals with schizophrenia. Early intervention efforts hinge on the ability of clinicians to reliably detect early symptoms and risk factors for psychosis in real-world settings. The Structured Interview for Psychosis Risk Syndromes (SIPS) has emerged as the most frequently utilized tool for diagnosing high-risk status, but this lengthy, clinician-administered instrument is impractical for use in large samples. Brief self-report questionnaires that assess for attenuated symptoms have the potential to quickly and effectively screen many people who may benefit from clinical monitoring or early intervention. This study examined the validity of three recently developed screening tools for attenuated symptoms by administering these tools alongside the SIPS in a sample of adolescents and young adults seeking mental health services. Screening instruments were evaluated as both continuous and dichotomized predictors of psychosis risk. Using screening thresholds recommended by instrument authors as well as thresholds empirically derived within the current sample, the sensitivity, specificity, and positive predictive value of each self-report measure with regard to SIPS diagnosis was obtained. Although all three screeners appear to be useful and valid assessment tools for attenuated symptoms, relative benefits of particular instruments are discussed. The validation of attenuated symptoms screening tools is an important step toward enabling early, wide-reaching identification of individuals on a course toward psychotic illness