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Psychotic‐spectrum symptoms, cumulative adversity exposure and substance use among high‐risk girls
Author(s) -
Lansing Amy E.,
Plante Wendy Y.,
FennemaNotestine Christine,
Golshan Shahrokh,
Beck Audrey N.
Publication year - 2018
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12533
Subject(s) - psychology , stressor , clinical psychology , psychiatry , paranoia , psychosis , mental health , poison control , medicine , medical emergency
Aim Psychotic‐spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high‐risk girls’ mental health, we assessed: (1) psychotic‐spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C‐TALE) and adversity‐indicators (symptoms, maladaptive coping, stressor‐reactivity); and SAU risk‐factors; and (3) relationships among psychotic‐spectrum symptoms, adversity‐indicators and SAU risk‐factors. Methods We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls. Results Girls’ psychotic‐spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU‐independent), interpersonal sensitivity, schizoid traits and paranoia (over‐interpretation, anger over‐reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C‐TALE‐types) were common. Mean loss (4) and trauma (8) onset‐age occurred before SAU‐onset (12). Significant positive correlations were found among psychotic‐spectrum symptoms, stressor‐reactivity, C‐TALE, adversity‐indicators; and number of SAU‐types; and a negative correlation occurred between psychotic‐spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU‐types, stressor‐reactivity and adversity‐related numbing individually had the largest associations with total psychotic‐spectrum symptoms ( b = 2.6‐4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity , amplifying potential health‐disparities. No racial/ethnic differences emerged on psychotic‐spectrum symptoms. Conclusions This symptom constellation during adolescence likely interferes with social and academic functioning. Whether representing a prodromal phase, trauma‐response or cross‐diagnostic psychopathology, accurate early detection and appropriate treatment of psychotic‐spectrum symptoms are warranted to improve functional outcomes in vulnerable populations.