Impact of language ability in assessing psychosis-risk

Abstract

Psychosis-risk screening tools have demonstrated utility for improving psychosis-risk detection, which in turn lays the groundwork for clinician-administered interviews to elucidate how psychotic symptoms are experienced. Effective screening tool use is reliant upon the individual’s ability to relate abstract and sometimes mystifying experiences, whereas clinician-led diagnostic interviews are a more interactive process. Unfortunately, those at-risk for, or experiencing, psychosis often exhibit higher levels of receptive and expressive language deficits than those not at risk, suggesting the possibility that the screening process may be differentially impacted in the very population of interest. This study first tested whether a measure of overall communication could be parsed into measures of receptive and expressive abilities. Subsequently, it was confirmed that the screening tools were related to clinical interviews of psychosis-risk. Following this, the three measures of communication (overall, receptive ability, and expressive ability) were evaluated as moderators of the association between self-administered screening tools and a clinician-led interview for assessing psychosis-risk. Results first indicated that both screening tool types were effective in screening for psychosis-risk, as validated by the clinical interview. It was also found that a measure of expressive (though not receptive) language ability could be extracted from overall communication, though neither expressive language ability nor overall functional communication moderated the screening tool and interview relations. As communication did not appear to moderate the efficacy of either screening tool, follow up analyses examining the efficacy of screening tools between probe types were not conducted.