Biol Psychiatry Cogn Neurosci Neuroimaging. 2025 Oct 31:S2451-9022(25)00332-5. doi: 10.1016/j.bpsc.2025.10.017. Online ahead of print.
ABSTRACT
BACKGROUND: It is important to unveil factors that differentiate persistent and distressing psychosis-like experiences (PLEs) in youth from more normative transient, non-distressing PLEs, as the former have been associated with greater symptom, cognitive, and functional impairment and psychopathology risk, including psychosis. This study examined (a) whether certain baseline latent profiles can differentiate PLE groups (persistent/transient, distressing/non-distressing) and (b) whether baseline profile membership predicts psychopathology symptoms and academic/social functioning at follow-up.
METHODS: Latent profile analyses were conducted on the Adolescent Brain Cognitive Development study baseline sample (N = 11,724; mean age = 9.91; 47.8% female) using biological, cognitive, clinical, sociodemographic indicators. Generalized mixed effects models predicted PLE group, grades, several mental health symptoms, mental health treatment-seeking, and social problems at follow-up.
RESULTS: From the final six-latent-profile solution, two profiles emerged as potentially pertinent to the emergence of clinically relevant PLEs. Both profiles were characterized by higher externalizing symptoms, goal-motivated behavior, and likelihood of psychosis family history, but one profile had broader psychopathology elevations including affective dysregulation, while the other profile had low neurocognitive scores, brain patterns more like those found in schizophrenia, and greater socioeconomic disadvantage. At follow-up, both profiles were linked to more persistent distressing PLEs than the other profiles, and showed shared and differential associations with outcomes.
CONCLUSIONS: The two profiles most predictive of persistent distressing PLEs may represent youth at risk for psychosis through different pathways, a neurodevelopmental pathway linked to cognitive and environmental vulnerability and an affective pathway associated with genetic risk, stress reactivity, and emotion dysregulation.
PMID:41177252 | DOI:10.1016/j.bpsc.2025.10.017
