The impact of age on the validity of psychosis-risk screening in a sample of help-seeking youth

P. J. Rakhshan Rouhakhtar, Steven C. Pitts, Zachary B. Millman, Nicole D. Andorko, Samantha Redman, Camille Wilson, Caroline Demro, Peter L. Phalen, Barbara Walsh, Scott Woods, Gloria M. Reeves, Jason Schiffman

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Self-report screening instruments offer promise in furthering early identification of at-risk youth, yet current efforts are limited by false positive rates. Identifying moderators of accuracy is a potential step towards improving identification and prevention efforts. We investigated the moderating effect of age on self-reported attenuated positive symptoms from the Prime Screen and clinician diagnosed clinical high-risk/early psychosis (CHR/EP) status. Participants (N = 134) were racially diverse, lower-income, help-seeking adolescents and young adults from a primarily urban community. The overall model predicting CHR/EP status was significant, with results suggesting the presence of a trending interaction between age and Prime Screen symptoms. Analyses indicated that number of items endorsed to predict CHR/EP decreased with age (youngest group [M = 12.99] cut off = 6 items; middle age group [M = 14.97] cut off = 3; oldest age group [M = 18.40] cut off = 1). Although younger participants endorsed more risk items on average, follow up analyses suggested that the Prime Screen was a more accurate predictor of clinician-diagnosed-risk among older participants relative to their younger peers. The current study builds on the literature identifying moderators of psychosis-risk screening measure accuracy, highlighting potential limitations of CHR/EP screening tools in younger populations.

Original languageEnglish (US)
Pages (from-to)30-35
Number of pages6
JournalPsychiatry Research
StatePublished - Apr 2019
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the National Institute of Mental Health (grants R01MH112612 and R34MH110506 ) and the Maryland Department of Health and Mental Hygiene , Behavioral Health Administration through the Center for Excellence on Early Intervention for Serious Mental Illness (OPASS# 14-13717G/M00B4400241 ). The funding sources did not have a role in the writing of this manuscript.

Publisher Copyright:
© 2019 Elsevier B.V.


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