Open AccessMomentary Manifestations of Negative Symptoms as Predictors of Clinical Outcomes in People at High Risk for Psychosis: Experience Sampling Study
Author(s) -
Isabell Paetzold,
Karlijn Susanna Francisca Maria Hermans,
Anita Schick,
Barnaby Nelson,
Eva Velthorst,
Frederike Schirmbeck,
Eu-Gei High Risk Study,
Jim van Os,
Craig Morgan,
Mark van der Gaag,
Lieuwe de Haan,
Lucia Valmaggia,
Philip McGuire,
Matthew J. Kempton,
Inez MyinGermeys,
Ulrich Reininghaus
Publication year - 2021
Publication title -
jmir mental health
Language(s) - English
Resource type - Journals
ISSN - 2368-7959
DOI - 10.2196/30309
Subject(s) - anhedonia , experience sampling method , psychosis , psychology , clinical psychology , hazard ratio , affect (linguistics) , social functioning , psychiatry , schizophrenia (object oriented programming) , medicine , confidence interval , distress , social psychology , communication
Background Negative symptoms occur in individuals at ultrahigh risk (UHR) for psychosis. Although there is evidence that observer ratings of negative symptoms are associated with level of functioning, the predictive value of subjective experience in daily life for individuals at UHR has not been studied yet. Objective This study therefore aims to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in individuals at UHR. 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 79 individuals at UHR. Clinical outcomes (level of functioning, illness severity, UHR status, and transition status) were assessed at baseline and at 1- and 2-year follow-ups. Results Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at the 2-year follow-up (b=−4.62, P=.01). Higher levels of anhedonia were associated with poorer functioning at the 1-year follow-up (b=5.61, P=.02). Higher levels of social anhedonia were associated with poorer functioning (eg, disability subscale: b=6.36, P=.006) and greater illness severity (b=−0.38, P=.045) at the 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 (hazard ratio=4.93, P=.005). Conclusions Targeting negative symptoms in individuals at UHR may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis.