A generalisability theory approach to quantifying changes in psychopathology among ultra-high-risk individuals for psychosis

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Doborjeh, Z, N. Medvedev, O, Doborjeh, M, Singh, B, Sumich, A ORCID: https://orcid.org/0000-0003-4333-8442, Budhraja, S, Goh, WWB, Lee, J, Williams, M, M-K Lai, E and Kasabov, N, 2024. A generalisability theory approach to quantifying changes in psychopathology among ultra-high-risk individuals for psychosis. Schizophrenia, 10: 87. ISSN 2334-265X

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Official URL: https://doi.org/10.1038/s41537-024-00503-y

Abstract

Distinguishing stable and fluctuating psychopathological features in young individuals at Ultra High Risk (UHR) for psychosis is challenging, but critical for building robust, accurate, early clinical detection and prevention capabilities. Over a 24-month period, 159 UHR individuals were assessed using the Positive and Negative Symptom Scale (PANSS). Generalisability Theory was used to validate the PANSS with this population and to investigate stable and fluctuating features, by estimating the reliability and generalisability of three factor (Positive, Negative, and General) and five factor (Positive, Negative, Cognitive, Depression, and Hostility) symptom models. Acceptable reliability and generalisability of scores across occasions and sample population were demonstrated by the total PANSS scale (Gr = 0.85). Fluctuating symptoms (delusions, hallucinatory behaviour, lack of spontaneity, flow in conversation, emotional withdrawal, and somatic concern) showed high variability over time, with 50-68% of the variance explained by individual transient states. In contrast, more stable symptoms included excitement, poor rapport, anxiety, guilt feeling, uncooperativeness, and poor impulse control. The 3-factor model of PANSS and its subscales showed robust reliability and generalisability of their assessment scores across the UHR population and evaluation periods (G = 0.77-0.93), offering a suitable means to assess psychosis risk. Certain subscales within the 5-factor PANSS model showed comparatively lower reliability and generalisability (G = 0.33-0.66). The identified and investigated fluctuating symptoms in UHR individuals are more amendable by means of intervention, which could have significant implications for preventing and addressing psychosis. Prioritising the treatment of fluctuating symptoms could enhance intervention efficacy, offering a sharper focus in clinical trials. At the same time, using more reliable total scale and 3 subscales can contribute to more accurate assessment of enduring psychosis patterns in clinical and experimental settings.

Item Type:	Journal article
Publication Title:	Schizophrenia
Creators:	Doborjeh, Z., N. Medvedev, O., Doborjeh, M., Singh, B., Sumich, A., Budhraja, S., Goh, W.W.B., Lee, J., Williams, M., M-K Lai, E. and Kasabov, N.
Publisher:	Springer
Date:	4 October 2024
Volume:	10
ISSN:	2334-265X
Identifiers:	Number Type 10.1038/s41537-024-00503-y DOI 2251055 Other
Rights:	© the author(s) 2024. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creativecommons.org/licenses/by-nc-nd/4.0/.
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	15 Oct 2024 13:18
Last Modified:	15 Oct 2024 13:20
URI:	https://irep.ntu.ac.uk/id/eprint/52414