LATENT PROFILE ANALYSIS AND CONVERSION TO PSYCHOSIS: CHARACTERIZING SUBGROUPS TO ENHANCE RISK PREDICTION

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  • March 20, 2019
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  • Healey, Kristin
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
Abstract
  • Background: Groups at clinical high risk (CHR) of developing psychosis are heterogeneous, composed of individuals presenting with several different clusters of diagnostic symptoms (e.g., affective symptoms, anxiety symptoms, subpsychotic symptoms). It is likely that there are subgroups within those at CHR, each associated with different constellations of symptoms and associated probabilities of conversion. Method: Latent Profile Analysis (LPA) has shown promise in identifying subgroups with clinically useful profiles of risk indicators among CHR individuals. The current study used a LPA model to ascertain subgroups in a combined sample of CHR (n = 171) and help-seeking controls (HSC; n = 100). Indicators in the LPA model included baseline Scale of Prodromal Symptoms (SOPS), total depressive symptoms (CDSS), and neurocognitive performance. Subgroups were further characterized using covariates measuring demographic and clinical features. General linear mixed models for repeated measures were used to examine within group change over time and longitudinal subgroup comparisons on a measure of social functioning. Results: LPA resulted in three classes: class 1 (mild) had the lowest transition risk (5.6%), the lowest scores across SOPS symptoms and depression scores, and intact neurocognitive performance; class 2 (positive-depressive) had a transition risk of 14.2%, the highest positive symptoms, mild or lesser negative symptoms, and moderate depression; class 3 (negative-neurocognitive) had the highest transition risk (29.3%), the highest negative symptoms, neurocognitive impairment, and social cognitive impairment. Classes 2 and 3 evidenced similarly poor social functioning. Conclusions: Results support a subgroup approach to the research, assessment, and treatment of help seeking individuals. Three classes emerged with good separation on a majority of indicator variables, including a class that may be an early manifestation of the deficit subtype. Development of efficacious treatments for early neurocognitive deficits and negative symptoms are indicated. Results underline the profound social dysfunction across help seeking individuals and need for improved treatments.
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  • In Copyright
Advisor
  • Penn, David L.
  • Addington, Jean
  • Abramowitz, Jonathan
  • Gates, Kathleen
  • Youngstrom, Eric
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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