TY  - JOUR
AU  - Paetzold, Isabell
AU  - Hermans, Karlijn S F M
AU  - Schick, Anita
AU  - Nelson, Barnaby
AU  - Velthorst, Eva
AU  - Schirmbeck, Frederike
AU  - van Os, Jim
AU  - Morgan, Craig
AU  - van der Gaag, Mark
AU  - de Haan, Lieuwe
AU  - Valmaggia, Lucia
AU  - McGuire, Philip
AU  - Kempton, Matthew
AU  - Myin-Germeys, Inez
AU  - Reininghaus, Ulrich
PY  - 2021
DA  - 2021/11/19
TI  - Momentary Manifestations of Negative Symptoms as Predictors of Clinical Outcomes in People at High Risk for Psychosis: Experience Sampling Study
JO  - JMIR Ment Health
SP  - e30309
VL  - 8
IS  - 11
KW  - ecological momentary assessment
KW  - psychotic disorder
KW  - psychopathology
AB  - Background: Negative symptoms occur in individuals at ultrahigh risk (UHR) for psychosis. Although there is evidence that observer ratings of negative symptoms are associated with level of functioning, the predictive value of subjective experience in daily life for individuals at UHR has not been studied yet. Objective: This study therefore aims to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in individuals at UHR. Methods: Experience sampling methodology was used to measure momentary manifestations of negative symptoms (blunted affective experience, lack of social drive, anhedonia, and social anhedonia) in the daily lives of 79 individuals at UHR. Clinical outcomes (level of functioning, illness severity, UHR status, and transition status) were assessed at baseline and at 1- and 2-year follow-ups. Results: Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at the 2-year follow-up (b=−4.62, P=.01). Higher levels of anhedonia were associated with poorer functioning at the 1-year follow-up (b=5.61, P=.02). Higher levels of social anhedonia were associated with poorer functioning (eg, disability subscale: b=6.36, P=.006) and greater illness severity (b=−0.38, P=.045) at the 1-year follow-up. In exploratory analyses, there was evidence that individuals with greater variability of positive affect (used as a measure of blunted affective experience) experienced a shorter time to remission from UHR status at follow-up (hazard ratio=4.93, P=.005). Conclusions: Targeting negative symptoms in individuals at UHR may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis. 
SN  - 2368-7959
UR  - https://mental.jmir.org/2021/11/e30309
UR  - https://doi.org/10.2196/30309
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34807831
DO  - 10.2196/30309
ID  - info:doi/10.2196/30309
ER  -