Psychotic Experiences Questionnaire. Part 1

Abstract

BACKGROUND: The rationale for the concept of psychotic and psychotic-like experiences, delusions and auditory hallucinations, on the basis of which the Psychotic Experiences Questionnaire was developed. AIM: The purpose of this study is to present the results of testing and validating of a questionnaire that assesses the severity of psychotic experiences. The study aims to determine the content of the experience at different phases of manifestation, including the phase of psychotic-like experiences, as well as metacognitive appraisals of the experience and its relationship to social anxiety. MATERIAL AND METHODS: The sample of 122 respondents includes non-clinical and two clinical groups — with symptoms of the affective spectrum and with symptoms of the psychotic spectrum. To assess the convergent validity of the Questionnaire, the Russian-language Symptom Check List-90-Revised was used. Metacognitive appraisals of psychotic experience and the overall severity of social anxiety (“Social Anxiety and Social Anxiety Disorder Questionnaire”) were measured. RESULTS: The structure of the Questionnaire obtained by cluster analysis was verified by confirmatory factor analysis, and optimal agreement between theoretical and empirical models was demonstrated (CFI=0.998; TLI=0.998; SRMR=0.102; RMSEA=0.02; RMSEA p-value=0.986). Three scales and corresponding subscales (six categories) defining the phases of unfolding of psychotic experience were identified. The high reliability and item consistency of the Questionnaire was determined using Cronbach's alpha coefficient. Convergent validity was assessed using Pearson correlation analysis of the questionnaire scales with the SCL scales — psychoticism, paranoid ideation and obsessive-compulsive symptoms; reliable and adequate statistical relationships were obtained. The role of social anxiety and metacognitive appraisals of psychotic experiences in their actualisation and maintenance is shown. The conceptualisation of thought the emergence of intrusions, “voices” as a dialogical embodiment of the internalised experience of social defeat in re-expanded inner speech is presented. CONCLUSION: The results of approbation and validation of the questionnaire are presented, and the relationships of the psychotic experiences component with its metacognitive appraisals and social anxiety are described. The concept of psychotic experiences is considered a continuum in which disruptions in the usual controllability of mental processes vary range from mild (objectification of thinking) — to moderate (disturbance of self-perception, intrusive phenomena, including “voices”) — to severe (disturbance of the sense of agency, including command “voices”).