Browsing by Author "DeVylder, Jordan"
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Item Assessing validity of retrospective recall of physical activity in individuals with psychosis-like experiences(Elsevier, 2019-01-15) Andorko, Nicole D.; Rouhakhtar, Pamela Rakhshan; Hinkle, Caroline; Mittal, Vijay A.; McAllister, Maureen; DeVylder, Jordan; Schiffman, JasonPsychosis-like experiences are present in the general population and may indicate risk for more severe forms of psychosis. They are associated with cognitive impairments, potentially impacting ability to accurately complete certain self-report measures. This study investigated whether the presence of psychosis-like experiences was associated with impairments in retrospective reports of physical activity, a measure salient to this population, by comparing post-study questionnaire data on activity level with reports of activity contemporaneously collected through ecological momentary assessment (EMA). Participants (n = 39) were 18–25 years of age and recruited via stratified sampling to maximize representation of a full psychosis-like experience spectrum. Mobile questionnaires were sent six times a day for one week, and included questions probing amount and intensity of activity. Upon completion of the EMA week, participants completed a retrospective recall of the past week's activity. High levels of psychosis-like experiences were associated with poorer recall for past sedentary behavior as evidenced by the moderating effect of psychosis-like experiences on the relation between retrospective and in vivo measured sedentary activity (interaction effect: b = −0.26, t(1) = −2.04, p = 0.05, f2 = 0.08). Findings call into question the validity of retrospective self-reporting of activity level for those experiencing psychosis-like experiences.Item The association between sleep dysfunction and psychosis-like experiences among college students(Elsevier B.V, 2017-02) Andorko, Nicole D.; Mittal, Vijay; Thompson, Elizabeth; Denenny, Danielle; Epstein, Gregory; Demro, Caroline; Wilson, Camille; Sun, Shuyan; Klingaman, Elizabeth A.; DeVylder, Jordan; Oh, Hans; Postolache, Teodor T.; Reeves, Gloria M.; Schiffman, JasonSleep problems are prominent and pervasive clinical issues experienced by many people with psychotic disorders, often causing distress and functional impairment. Sleep problems are also related to psychosis-like experiences (PLE; non-diagnosable phenomenon such as transient perceptual disturbances, unusual thoughts, periodic suspiciousness) in epidemiological studies. Prior studies in this field have used brief measures that precluded the ability to test (1) whether risk for psychosis-like experiences are related to specific sub-types of sleep disturbance, and (2) whether sleep disturbance is specifically related to clinically significant (i.e., distressing) psychosis-like experiences. The current project examined the relation between specific sleep issues, and PLEs and distress associated with PLEs, in a college sample. Participants (N=420) completed the Prodromal Questionnaire-Brief (PQ-B), which assesses PLEs and associated distress, and the Iowa Sleep Disturbances Inventory – extended version (ISDI-E), which assesses thirteen separate disturbed sleep domains. Symptoms of fragmented sleep, sleep hallucinations, and night anxiety significantly correlated with PLEs, and several sleep domains were significantly associated with PLE-related distress.Item Association between sleep, childhood trauma and psychosis-like experiences(Elsevier B.V, 2018-03-09) Andorko, Nicole D.; Millman, Zachary B.; Klingaman, Elizabeth; Medoff, Deborah; Kline, Emily; DeVylder, Jordan; Reeves, Gloria; Schiffman, JasonPsychosis-like experiences (PLEs), or attenuated positive symptoms of psychosis, present along a severity continuum and have been associated with distressing thoughts and impairments in functioning. Although knowledge of the clinical importance of PLEs is expanding, risk factors for their expression are still poorly understood. Sleep disturbances are one known factor that exacerbate PLEs expression and distress, and trauma exposure is associated with occurrence of PLEs, as well as increased risk of later sleep difficulties. This study examined the joint influences of sleep and trauma on PLEs in an undergraduate sample. Self-report questionnaires on presence and distress of PLEs, sleep problems, and occurrence of previous traumatic experiences were completed by participants (N = 409). In order to determine the unique impact of sleep on PLEs, three sets of predictors: sociodemographic, psychosocial (including trauma), and sleep were entered in steps into a hierarchical multiple regression model. In the final model, specific sleep domains uniquely predicted PLEs, while previous trauma exposure, which was a significant predictor when entered in step two with other psychosocial variables, was no longer a significant predictor. Results suggest the possibility that disruptions in sleep following or occurring alongside a traumatic experience may somehow contribute to, or exacerbate the presence of PLEs.Item Childhood pegboard task predicts adult-onset psychosis-spectrum disorder among a genetic high-risk sample(2016-10-05) Rouhakhtar, Pamela Rakhshan; Sorensen, Holger; Mittal, Vijay; DeVylder, Jordan; Jameson, Nicole; Tsuji, Thomas; Ereshefsky, Sabrina; Bentley, Eryn; Mortensen, Erik; Mednick, Sarnoff; Schiffman, JasonItem Childhood pegboard task predicts adult-onset psychosis-spectrum disorder among a genetic high-risk sample(Elsevier, 2016-12-08) Rouhakhtar, Pamela Rakhshan; Sørensen, Holger; DeVylder, Jordan; Mittal, Vijay; Mortensen, Erik L.; Michelsen, Niels M.; Ekstrøm, Morten; Pitts, Steve; Mednick, Sarnoff A.; Schiffman, JasonMotor abnormalities have been established as a core aspect of psychosis-spectrum disorders, with numerous studies identifying deficits prior to clinical symptom presentation. Additional research is needed to pinpoint standardized motor assessments associated with psychosis-spectrum disorders prior to illness onset to enhance prediction and understanding of etiology. With a long history of findings among people with diagnosable psychosis-spectrum disorders, but little research conducted during the premorbid phase, pegboard tasks are a viable and understudied measure of premorbid for psychosis motor functioning. In the current study, examining data from the Copenhagen Perinatal Cohort, the Simultaneous Pegs Test was performed with children (n = 244, aged 10–13) at genetic high risk for psychosis (n = 94) and controls (n = 150). Findings suggest that children who eventually developed a psychosis-spectrum disorder (n = 33) were less likely to successfully complete the task within time limit relative to controls (χ² (2, N = 244) = 6.94, p = 0.03, ϕ = 0.17). Additionally, children who eventually developed a psychosis-spectrum disorder took significantly longer to complete the task relative to controls (χ² (2, N = 244) = 7.06, p = 0.03, ϕ = 0.17). As pegboard performance is thought to tap both diffuse and specific brain networks, findings suggest that pegboard tests may be useful premorbid measures of motor functioning among those on a trajectory towards a psychosis-spectrum disorder.Item Family functioning moderates the impact of psychosis-risk symptoms on social and role functioning(Elsevier, 2019-03-02) Thompson, Elizabeth; Rouhakhtar, Pamela Rakhshan; Pitts, Steve; Demro, Caroline; Millman, Zachary B.; Bussell, Kristin; DeVylder, Jordan; Kline, Emily; Reeves, Gloria M.; Schiffman, JasonBackground Youth at clinical high-risk (CHR) for psychosis often experience difficulties in social and role functioning. Given evidence that family stress and support can impact psychosis-risk symptoms, as well as an individual's ability to fulfill social and role functions, family dynamics are hypothesized to moderate the effect of psychosis-risk symptoms on functioning. Methods Participants at CHR (N = 52) completed the clinician-administered Structured Interview for Psychosis-risk Syndromes (SIPS) and the Family Assessment Device (FAD) General Functioning Scale, a self-report measure of family functioning including cohesion and support. Interviewers rated participants' current social and role functioning using the Global Functioning: Social and Role Scales. Results Regression results indicated that positive symptoms, but not ratings of family functioning, statistically predicted social and role functioning. Perceived family functioning, however, moderated the effect of symptoms on social/role functioning. For individuals who perceived lower levels of family functioning, symptoms were moderately associated with social and role functioning (f2 = 0.17 and f2 = 0.23, respectively). In contrast, psychosis-risk symptoms were not significantly associated with social/role functioning for individuals with higher levels of perceived family functioning. Notably, positive symptoms and perceived family functioning were not associated with one another, suggesting that perceived family functioning did not directly impact symptom severity, or vice versa. Conclusions Findings support the notion that family functioning may be a clinically meaningful factor for individuals at CHR. Although this cross-sectional data limits our discussion of potential mechanisms underlying the pattern of findings, results suggest that familial support may be beneficial for individuals at risk for psychosis.Item From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States(American Psychiatric Association, 2021-05-03) Anglin, Deidre M.; Ereshefsky, Sabrina; Klaunig, Mallory J.; Bridgwater, Miranda A.; Niendam, Tara A.; Ellman, Lauren M.; DeVylder, Jordan; Thayer, Griffin; Bolden, Khalima; Musket, Christie W.; Grattan, Rebecca E.; Lincoln, Sarah Hope; Schiffman, Jason; Lipner, Emily; Bachman, Peter; Corcoran, Cheryl M.; Mota, Natália B.; Ven, Els van derThe authors examine U.S.-based evidence that connects characteristics of the social environment with outcomes across the psychosis continuum, from psychotic experiences to schizophrenia. The notion that inequitable social and economic systems of society significantly influence psychosis risk through proxies, such as racial minority and immigrant statuses, has been studied more extensively in European countries. While there are existing international reviews of social determinants of psychosis, none to the authors‘ knowledge focus on factors in the U.S. context specifically—an omission that leaves domestic treatment development and prevention efforts incomplete and underinformed. In this review, the authors first describe how a legacy of structural racism in the United States has shaped the social gradient, highlighting consequential racial inequities in environmental conditions. The authors offer a hypothesized model linking structural racism with psychosis risk through interwoven intermediary factors based on existing theoretical models and a review of the literature. Neighborhood factors, cumulative trauma and stress, and prenatal and perinatal complications were three key areas selected for review because they reflect social and environmental conditions that may affect psychosis risk through a common pathway shaped by structural racism. The authors describe evidence showing that Black and Latino people in the United States suffer disproportionately from risk factors within these three key areas, in large part as a result of racial discrimination and social disadvantage. This broad focus on individual and community factors is intended to provide a consolidated space to review this growing body of research and to guide continued inquiries into social determinants of psychosis in U.S. contexts.Item Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States(Frontiers, 2023-03-13) Bridgwater, Miranda A.; Petti, Emily; Giljen, Maksim; Akouri-Shan, LeeAnn; DeLuca, Joseph; Rouhakhtar, Pamela Rakhshan; Millar, Caroline; Karcher, Nicole R.; Martin, Elizabeth A.; DeVylder, Jordan; Anglin, Deidre; Williams, Raquel; Ellman, Lauren M.; Mittal, Vijay A.; Schiffman, JasonBackground: Since its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors potentially affecting the screening, assessment, and service utilization of youth at CHR were reviewed from the current literature. Results: Existing literature suggests that contextual factors impact the predictive performance of widely used psychosis-risk screening tools and may introduce systemic bias and challenges to differential diagnosis in clinical assessment. Factors reviewed include racialized identity, discrimination, neighborhood context, trauma, immigration status, gender identity, sexual orientation, and age. Furthermore, racialized identity and traumatic experiences appear related to symptom severity and service utilization among this population. Conclusions: Collectively, a growing body of research from the United States and beyond suggests that considering context in psychosis-risk assessment can provide a more accurate appraisal of the nature of risk for psychosis, render more accurate results improving the field's prediction of conversion to psychosis, and enhance our understanding of psychosis-risk trajectories. More work is needed in the U.S. and across the globe to uncover how structural racism and systemic biases impact screening, assessment, treatment, and clinical and functional outcomes for those at CHR.Item Social work training to reduce duration of untreated psychosis: Methodology and considerations of a web-based training for community providers(Wiley, 2021-05-24) Andorko, Nicole D.; Fitzgerald, John; Roemer, Caroline; Solender, Eric; Petti, Emily; Rouhakhtar, Pamela Rakhshan; McNamara, Karen E.; Smith, Melissa E.; Buchanan, Robert W.; Schiffman, Jason; DeVylder, JordanAim Outcomes for individuals with psychotic disorders can be improved through early intervention services; however, identification continues to be a major problem in connecting individuals with these services. Social workers form a vast majority of the human service and mental health workforce in the United States and therefore have the potential to play a unique role in identifying and referring those who may benefit from specialty early intervention services. Methods The current article describes the methodological design, implementation, and participant recruitment procedures of a large-scale, web-based training program for social workers promoting identification and referral of individuals with emerging symptoms of a mental illness with psychosis in the context of a randomized clinical trial. Results The web-based study enrolled 1384 individuals. More than half of study participants enrolled within the first 3 months of the 14-month recruitment period. Completion of all study components was achieved by 959 individuals (69% of total enrolled), and completion status did not vary significantly by gender, ethnicity, or facility at which the individual was employed. Completion rates varied by race, such that participants identifying as White were more likely to complete the study, while those identifying as Black were less likely. Discussion The results suggest the feasibility of using a web-based training program to engage social workers in early psychosis identification practices. Challenges related to encouraging participants to complete the training and lessons learned during the study recruitment are discussed.Item Validity of a two-item screen for early psychosis(Elsevier B.V., 2018-12) Phalen, Peter L.; Rouhakhtar, Pamela Rakhshan; Millman, Zachary B.; Thompson, Elizabeth; DeVylder, Jordan; Mittal, Vijay; Carter, Evan; Reeves, Gloria; Schiffman, JasonWell-validated screening tools have been developed to identify people at high risk for psychosis, but these are rarely used outside of specialty clinics or research settings. The development of extremely brief and simple screening tools could increase dissemination, especially in settings with low buy-in such as those with low base rates of psychosis and/or time constraints. We sought to identify such a brief measure by modeling participant responses to three psychosis screening questionnaires (Prime Screen; Prodromal Questionnaire-Brief; Youth Psychosis At Risk Questionnaire) in a sample of 139 help-seeking individuals and 335 college students (age range: 12–25). Two screening questions with especially strong information characteristics were identified: "Do you see things that others can't or don't see?" and "Have you ever felt that someone was playing with your mind?" (Alternative two-item screens with similarly strong properties were also identified and validated using uncertainty quantified through Bayesian modeling.) The resulting measure was validated against clinician ratings of psychosis. The screen performed with a sensitivity of 53% and specificity 98% for clinically significant hallucinations or delusions, and sensitivity of 32% and specificity 99% for identifying people in an early phase of psychosis (clinical high risk or first episode psychosis).