Validation of the Chinese version of Community Assessment of Psychic Experiences (CAPE) in an adolescent general population

The Community Assessment of Psychic Experiences (CAPE) is a popular 42-item self-report assessment of psychosis proneness (PP) that has been widely-translated. However, there is as yet no validation of CAPE in non-Western languages. Here, we validated a Chinese translation of CAPE (“CAPE-C”) in a young Chinese community sample. Factor analyses were employed in a sample of 660 individuals (mean age = 18.63) to identify a culturally-sensitive factor structure for CAPE-C (Study 1). Since confirmatory factor analysis (CFA) suggested that CAPE-C did not follow the original factor structure, exploratory factor analysis and follow-up CFA were employed to establish an alternative structure, resulting in a 15-item “CAPE-C15” which retained a three-factor structure tapping positive, negative and depressive symptoms. To demonstrate the specificity of CAPE-C15 as a measure of PP, we conducted regression analyses to examine associations between CAPE-C15 dimensions and other measures of psychotic and depressive symptoms (Study 2). Results confirmed that CAPE-C15 dimensions showed specific associations with relevant symptom dimensions of other measures, but not with irrelevant ones. Finally, to aid interpretation of CAPE-C15 scores, Receiver Operating Characteristic analysis was conducted to establish a cut-off score that could indicate test-takers’ need for clinical attention (Study 3). We found that a cut-off score of 8.18 on CAPE-C15 positive and negative symptom frequency and distress scores distinguished individuals whose PP was within normal ranges from those at psychometric high-risk (sensitivity: 78.6%; specificity: 77.7%). CAPE-C15 will likely prove relevant to researchers and healthcare providers who serve Chinese-speaking adolescents and young adults

Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42):a comparison of student populations in the Netherlands, Nigeria and Norway

BACKGROUND: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students. METHODS: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples. RESULTS: Only CAPE-Pos items pertaining to the dimensions 'strange experiences' and 'paranoia' met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levels of experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples. CONCLUSION: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, if not more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups