Browsing by Subject "clinical high risk"
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Item Facial Emotion Recognition in Attenuated Psychosis, Depressive, and Anxiety Syndromes: Are Impairments Common or Specific?(2019-01-01) Millman, Zachary B; Schiffman, Jason; Psychology; PsychologyFacial emotion recognition (FER) is often impaired among individuals with schizophrenia or clinical high-risk (CHR) for psychosis, but is also impaired among individuals with depressive and anxiety disorders, diagnoses which themselves are highly prevalent among those at CHR. The transdiagnostic nature of FER impairment and its specificity to any one clinical group remains therefore unknown. A promising approach to addressing this limitation may be to identify unique subgroups of individuals with CHR, depression, or anxiety based on theoretically-relevant FER dimensions, and to evaluate the relation of these subgroups to symptoms, diagnosis, and functioning. In a sample of 263 young adults with CHR, depression/anxiety, or no disorder, a k-means cluster analysis identified three distinct subgroups of participants: those with normal performance, those prone to misclassifying faces as threatening, and those with a generalized deficit plus a tendency to misclassify faces as sad. Despite an even distribution of clinical diagnoses across the clusters, participants in the threat-bias cluster presented with more severe attenuated symptoms of psychosis, more severe anxiety, and poorer social functioning than participants in the normal performance cluster. Participants in the sad-bias cluster presented with more severe attenuated psychotic symptoms than those in the normal performance cluster. The findings suggest the presence of distinct FER-defined subgroups among individuals with CHR, depression/anxiety, or no disorder. Although FER performance profiles appear similar across clinically-defined groups, the unique clinical presentations among FER-defined clusters suggests that certain FER profiles may be transdiagnostic risk factors for psychopathology.Item Individual Differences and Psychosis-Risk Screening: Practical Suggestions to Improve the Scope and Quality of Early Identification(Frontiers Media S.A, 2019-02-14) Schiffman, Jason; Ellman, Lauren M.; Mittal, Vijay A.Approaches to identifying individuals at clinical high-risk (CHR) for psychosis currently do not carefully weigh considerations around individual differences. Effective identification depends on awareness of factors beyond psychopathology as it is reflected in the current literature, such as sensitivity to idiographic circumstances and individual differences. The inability to address contextual factors when employing the status quo method of identification likely contributes to the unacceptably poor accuracy when identifying people at CHR. Individual differences related to factors such as culture, race, comorbidity, and development likely play an important role in accurate identification, and have the potential to improve the validity of approaches intended to identify this population. Tailored approaches to assessment based on an awareness of context, identity, setting, and preferences of clients are possible, and customizing assessment efforts accordingly may be useful for accurate identification of people at CHR. Highlighting the potential for the existing early identification paradigm to marginalize or misunderstand certain groups, we describe how effective identification and ethical diagnosis require sensitivity to individual differences writ large. We suggest that recognizing the importance of these factors advances a more inclusive and accurate approach to identification.Item Telepsychotherapy With Youth at Clinical High Risk for Psychosis: Clinical Issues and Best Practices During the COVID-19 Pandemic(American Psychological Association, 2020-04-22) DeLuca, Joseph S.; Andorko, Nicole D.; Chibani, Doha; Jay, Samantha Y.; Rouhakhtar, Pamela Rakhshan; Petti, Emily; Klaunig, Mallory J.; Thompson, Elizabeth C.; Millman, Zachary B.; Connors, Kathleen M.; Akouri-Shan, LeeAnn; Fitzgerald, John; Redman, Samantha L.; Roemer, Caroline; Bridgwater, Miranda A.; DeVylder, Jordan E.; King, Cheryl A.; Pitts, Steven C.; Reinblatt, Shauna P.; Wehring, Heidi J.; Bussell, Kristin L.; Solomon, Natalee; Edwards, Sarah M.; Reeves, Gloria M.; Buchanan, Robert W.; Schiffman, Jason