Evaluating the Measurement Structure and Correlates of the Prime Screen Among Black and White College Students

Abstract

Self-report measures of attenuated psychosis (AP) and subclinical psychosis experiences (PEs) contribute to the understanding of psychosis across the severity spectrum, and may aid in identification and prevention efforts. Screening tools are an important part of these efforts, facilitating broader scale prevention efforts. Current measures, however, are limited by high false positive rates and lack of accuracy. Psychosocial factors are theorized to impact psychometric properties of AP/PE self-report instruments. Where differences exist, systematic biases may exist that differentially impact measurement validity, particularly for marginalized racial/ethnic groups. Factor analytic techniques and evaluation of criterion validity in large, diverse samples of community participants reporting on a continuum of AP/PEs may aid in detection of measure biases, yet research in this area is limited to date. Building on previous work, the current study evaluated the factor structure and criterion validity of the Prime Screen, a commonly used measure of AP/PEs, in a large sample of Black and White college students. Analyses did not support a two-factor structure for the Prime Screen, with exploratory factor analysis in Black and White participant samples generating differential factor models. Items within each race group were not uniformly related to other measures of pathology and psychosocial or contextual variables, indicating some items may be better measures of AP/PEs than others. Results indicate the need for further work to develop and validate the Prime Screen, highlight limitations of this commonly used measure of AP/PEs for use in diverse populations, and provide some direction for measure revision.