Demographic correlates of attenuated positive psychotic symptoms

It is now well established that the utilization of standardized clinical criteria can enhance prediction of psychosis. These criteria are primarily concerned with the presence and severity of attenuated positive symptoms. Because these symptom criteria are used to derive algorithms for designating clinical high risk (CHR) status and for maximizing prediction of psychosis risk, it is important to know whether the symptom ratings vary as a function of demographic factors that have previously been linked with symptoms in diagnosed psychotic patients. Using a sample of 356 CHR individuals from the NAPLS-II multi-site study, we examined the relation of three sex, age, and educational level, with the severity of attenuated positive symptom scores from the Scale of Prodromal Symptoms (SOPS). Demographic factors accounted for little of the variance in symptom ratings (5–6%). Older CHR individuals manifested more severe suspiciousness, and female CHR participants reported more unusual perceptual experiences than male participants. Contrary to prediction, higher educational level was associated with more severe ratings of unusual thought content, but less severe perceptual abnormalities. Overall, sex, age and education were modestly related to unusual thought content and perceptual abnormalities, only, suggesting minimal implication for designating CHR status and predicting psychosis-risk

Editorial: Psychotic-like Experiences: Bolstering Protective Factors in Marginalized Youth

Racial disparities in the prevalence and clinical characteristics of psychotic disorders are well documented. Psychotic-like experiences (PLEs) are subthreshold psychotic symptoms in the absence of overt psychotic illness that are nevertheless distressing and associated with negative outcomes. In the general population, racially and ethnically minoritized individuals are more likely to report PLEs compared to White individuals, consistent with the disparities in psychosis diagnosis.1 However, our understanding of the factors driving observed differences in PLEs is limited. Most of the published research on PLEs has been in adolescents and adults, whereas less is known about racial/ethnic differences in PLEs in children. A better understanding of the factors that drive the racial/ethnic differences in these experiences could inform development of culturally responsive, preventative interventions to mitigate disparities

Managing Fear During Pandemics: Risks and Opportunities

Fear is an emotion triggered by the perception of danger and is a motivator for safety behaviors, including hygienic ones. Within the context of the coronavirus disease-2019 (COVID-19) pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned to manage fear during the COVID-19 pandemic. Particularly, in the current paper, we highlight different factors that determine fear (i.e., proximity, predictability, and controllability), we review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying), and we make recommendations for policies that can promote adequate health behaviors and limit negative consequences of fear during pandemics

Managing Fear During Pandemics: Risks and Opportunities.

Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics

Clinical and functional effects of the COVID-19 pandemic and social distancing on Veterans with psychotic disorders and recently-housed Veterans

Background: The COVID pandemic has upended the daily lives of everyone in the United States, negatively impacting social interactions, work, and living situations. The pandemic could lead to or exacerbate mental health issues, especially in people who are already vulnerable to such effects. Within the Department of Veterans Affairs (VA) healthcare system two populations vulnerable to social and functional disruptions include those who have recently experienced homelessness (recently housed Veterans, RHV) and those who have a psychotic disorder (PSY). Methods and Findings: We conducted phone interviews with PSY (n = 81), RHV (n = 76) and control Veterans (CTL, n = 74) between mid-May – mid-August, 2020 (“current”) and a retrospective assessment relative to January, 2020 (“pre-COVID”). We assessed clinical factors (e.g., depression, anxiety, loneliness) and community integration (e.g., family and social functioning, work) at both time periods, and risk and protective factors (e.g., resilience, uncertainty) for the current period. The two vulnerable groups had higher levels of clinical symptoms and poorer community integration relative to CTL, as expected. Regarding the effect of the pandemic, results showed that all three groups experienced worse clinical outcomes (i.e., increased depression, anxiety, loneliness) currently vs. pre-COVID; there were no significant interactions between group and time period indicating all three groups were equally impacted by the pandemic. For community integration, there was a small but significant decrease in social networks in all three groups currently vs. pre-COVID. RHV showed a small but significant increase in independent living relative to pre-COVID ratings. Finally, RHV had greater levels of intolerance of uncertainty compared to PSY and CTL. Conclusions: Our results indicate that vulnerable and non-vulnerable Veterans were equally negatively impacted by the COVID-19 pandemic. The lack of a disproportionate effect of the pandemic on the vulnerable groups may be due to the availability and utilization of comprehensive VA services available to vulnerable Veterans (e.g., housing and financial support, medical and mental health services), which may have helped to mitigate the impact of the pandemic

Mental Health Ramifications of the COVID-19 Pandemic for Black Americans: Clinical and Research Recommendations

Mental health clinicians and researchers must be prepared to address the unique needs of Black Americans who have been disproportionately affected by the COVID-19 pandemic. Race-conscious and culturally competent interventions that consider factors such as discrimination, distrust of health care providers, and historical and racial trauma as well as protective factors including social support and culturally sanctioned coping strategies are needed. Research to accurately assess and design treatments for the mental health consequences of COVID-19 among Black Americans is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors.

Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status