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Front Psychiatry. 2020 Feb 11;10:967. doi: 10.3389/fpsyt.2019.00967. eCollection 2019.

Beyond Clinical High-Risk State for Psychosis: The Network Structure of Multidimensional Psychosis Liability in Adolescents.

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Department of Educational Sciences, University of La Rioja, Logroño, Spain.
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.
Programa Riojano de Investigación en Salud Mental (PRISMA), Logroño, Spain.
Department of Mental Health, Servicio Riojano de Salud, Logroño, Spain.
Department of Psychology, University of Seville, Seville, Spain.
Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.



The main goal of the present study was to analyze the network structure of schizotypy dimensions in a representative sample of adolescents from the general population. Moreover, the network structure between schizotypy, mental health difficulties, subjective well-being, bipolar-like experiences, suicide ideation and behavior, psychotic-like experiences, positive and negative affect, prosocial behavior, and IQ was analyzed.


The study was conducted in a sample of 1,506 students selected by stratified random cluster sampling. The Oviedo Schizotypy Assessment Questionnaire, the Personal Wellbeing Index-School Children, the Paykel Suicide Scale, the Mood Disorder Questionnaire, the Strengths and Difficulties Questionnaire, the Prodromal Questionnaire-Brief, the Positive and Negative Affect Schedule for Children Shortened Version, and the Matrix Reasoning Test were used.


The estimated schizotypy network was interconnected. The most central nodes in terms of standardized Expected Influence (EI) were 'unusual perceptual experiences' and 'paranoid ideation'. Predictability ranged from 8.7% ('physical anhedonia') to 52.7% ('unusual perceptual experiences'). The average predictability was 36.27%, implying that substantial variability remained unexplained. For the multidimensional psychosis liability network predictability values ranged from 9% (estimated IQ) to 74.90% ('psychotic-like experiences'). The average predictability was 43.46%. The results of the stability and accuracy analysis indicated that all networks were accurately estimated.


The present paper points to the value of conceptualizing psychosis liability as a dynamic complex system of interacting cognitive, emotional, behavioral, and affective characteristics. In addition, provide new insights into the nature of the relationships between schizotypy, as index of psychosis liability, and the role played by risk and protective factors.


clinical high risk; complex dynamic system; network; schizotypal; schizotypy

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