Accepted for/Published in: JMIR Mental Health
Date Submitted: May 10, 2021
Open Peer Review Period: May 10, 2021 - Jul 5, 2021
Date Accepted: Aug 2, 2021
Date Submitted to PubMed: Nov 22, 2021
(closed for review but you can still tweet)
Momentary manifestations of negative symptoms as predictors of clinical outcomes in people at high risk for psychosis: Findings from the EU-GEI High Risk Study
ABSTRACT
Background:
Negative symptoms occur in individuals at ultra-high risk (UHR) for psychosis. While there is evidence that observer-ratings of negative symptoms are associated with level of functioning, the predictive value of UHR individuals’ subjective experience in daily life has not been studied yet.
Objective:
This study therefore aimed to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in UHR individuals.
Methods:
Experience sampling methodology was used to measure momentary manifestations of negative symptoms (blunted affective experience, lack of social drive, anhedonia, and social anhedonia) in the daily lives of N=79 UHR individuals. Clinical outcomes (level of functioning, illness severity, UHR status, transition status) were assessed at baseline, and at 1- and 2-year follow-up.
Results:
Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at 2-year follow-up (b=-4.62, p=.013). Higher levels of anhedonia were associated with poorer functioning at 1-year follow-up (b=5.61, p=.017). Higher levels of social anhedonia were associated with poorer functioning (e.g. disability subscale: b=6.36, p=.006) and greater illness severity (b=-0.38, p=.045) at 1-year follow-up. In exploratory analyses, there was evidence that individuals with greater variability of positive affect (used as a measure of blunted affective experience) experienced a shorter time to remission from UHR status at follow-up (HR=4.93, p=.005).
Conclusions:
Targeting negative symptoms in UHR individuals may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis.
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