SA111. Changes in Symptom Content From a Clinical High-Risk State to Conversion
Bibliographic record
Abstract
Background: Recent studies have focused on examining the transition to psychosis from a clinical high-risk (CHR) state. The presence and severity of the attenuated psychotic symptoms has often been the focus of attention, whereas the content of these symptoms has received less attention. Symptom content has been found to be of importance in both those with schizophrenia and those at CHR for psychosis. For example, specific life events, such as different types of trauma, have been found to impact the content of attenuated psychotic symptoms. The aim of the current study was to examine the change in symptom content from baseline to conversion in those at CHR for psychosis. Methods: The sample consisted of 15 participants (9 males and 6 females) who transitioned to a first episode of psychosis from a sample of 135 CHR individuals. Comprehensive clinical vignettes were written at baseline and at the time of conversion to psychosis. These vignettes contained the content elicited from participants based on the Scale of Prodromal Symptoms (SOPS) found within the Structured Interview for Psychosis-Risk Syndromes (SIPS). Raters were trained using the Content of Attenuated Psychotic Symptoms (CAPS) codebook to assess the presence or absence of specific symptom content found within the positive symptoms of unusual thought content, suspicious ideas, grandiose ideas, and perceptual abnormalities. Results: The average number of days from baseline to conversion was 296. Participants were diagnosed with a range of psychotic diagnoses at conversion including psychosis not otherwise specified (n = 8), schizopreniform disorder (n = 2), schizoaffective disorder (n = 1), depression with psychotic features (n = 1), and 3 were undetermined. Two main changes emerged regarding the content of attenuated psychotic symptoms that progressed to full blown psychotic symptoms. First, content that was vague and lacked intensity progressed to more concrete and severe symptom content. For example, the presence of feeling the need to be hypervigilant at baseline progressed to the definite belief that one was being watched. Second, new symptoms appeared whose onset occurred for the first time at conversion. For example, hearing voices telling participants to harm family members appeared at conversion but was absent at baseline. Conclusion: Participants experienced a shift in their symptom content from baseline to conversion. Two main types of changes occurred, including an increase in the severity of symptom content from baseline to conversion and the appearance of new symptoms at conversion only. Not only is it important to assess the increasing severity of symptoms in the CHR population, but it is also important to monitor the change and progression of content within positive symptoms.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".