Exploring and Connecting the Within-person Factor Structures of Psychosis-related EMA and Clinician-Rated Symptoms

Abstract

These are the slides from a presentation given at HiTOP Conference on 03/28/2025.The transdiagnostic approach to understanding affective and non-affective psychotic disorders highlights the need for examining factor structures. Recent studies have explored transdiagnostic factors across individuals. However, within-person factor structure remains under-investigated. Given the importance of daily symptom tracking in outpatient settings, mapping the transdiagnostic factor structure onto daily affective and symptomatic experiences is crucial. We employed ecological momentary assessment (EMA) of self-reported daily symptoms and monthly clinical interviews to examine how within-person transdiagnostic factors align with clinical factor structures over time. A sample of 70 outpatients with bipolar, psychotic, and related disorders were recruited from McLean Psychiatric Hospital, resulting in 31,869 EMA observations and 965 clinical interviews. Factor analyses identified six latent EMA factors: irritability, positive activation, negative arousal, distress, anxious stress, and social activity; and seven clinical factors: mania, disorganized thinking, affective and cognitive depressive symptoms, interpersonal and intrapersonal negative symptoms, and anxiety. Multilevel modeling will assess associations between EMA and clinical factors. Findings are expected to enhance understanding of within-person transdiagnostic structures in psychotic and related disorders, aiding symptom monitoring and personalized treatments