The content of attenuated psychotic symptoms in those at clinical high risk for psychosis

Psychiatry Res. 2014 Nov 30;219(3):506-12. doi: 10.1016/j.psychres.2014.06.023. Epub 2014 Jun 21.


Recent research has started to focus on identifying individuals who are at clinical high risk of developing psychosis as a means to try and understand the predictors and mechanisms involved in the progress to a full psychotic episode. The aim of the current study was to provide an initial description and prevalence rates of specific content found within attenuated positive symptoms. The Content of Attenuated Positive Symptoms (CAPS) codebook was used by independent raters to determine the presence of content within a sample of written vignettes. Krippendorff's alpha was used to determine inter-rater reliability. Overall, the majority of items fell in or above an acceptable range of reliability. There was heterogeneity present in the types of content endorsed. However, the most commonly endorsed items included being perplexed by reality, increased hypervigilence, being gifted, hearing indistinct and distinct sounds, seeing figures or shadows, something touching the individual, and unpleasant smells. The use of the CAPS codebook is a reliable way to code the content of attenuated positive symptoms. Identifying and monitoring the presence of certain content may provide insight into the presence of other comorbid issues and the potential for future conversion.

Keywords: Clinical high risk; Content analysis; Positive symptoms; Psychotic disorders.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Affect
  • Comorbidity
  • Female
  • Humans
  • Male
  • Pleasure
  • Prevalence
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology*
  • Reproducibility of Results
  • Risk
  • Risk Factors
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Surveys and Questionnaires