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Background <p>Negative symptoms are a strong predictor of conversion to a formal psychotic disorder in youth at clinical high-risk for developing psychosis (CHR). Identification of temporally precise mechanisms underlying increases in negative symptoms could enhance early intervention and specifically support the utility of mobile health treatments. Guided by Cognitive Behavioral models of psychopathology, we examine whether a core type of biased thinking—defeatist performance beliefs (DPB)—is a real-world mechanism of negative symptoms as well as a secondary symptom that is common in CHR youth: depressed mood.</p> Methods <p>CHR youth (<i>n</i> = 119) and healthy control (CN; 59) subjects completed ecological momentary assessment surveys assessing DPB, negative symptoms, and depressed mood for six days.</p> Results <p>CHR youth reported elevated DPB in daily life compared to CN. Greater DPB were associated with greater concurrent negative symptoms and depressed mood in daily life. Time-lagged analyses demonstrated that increased DPB at time <i>t</i> led to elevations in negative symptoms and depressed mood at <i>t</i> + 1 above and beyond the effects of the respective symptom at time <i>t;</i> DPB also varied across time of day, study day, day of the week, activity context, and social partners.</p> Conclusions <p>DPB may be a promising shared mechanism contributing to negative symptoms and depressed mood in CHR youth in their daily life. Findings also provide proof-of-concept support for the utility of mobile health treatments targeting DPB by identifying key moments where DPB fluctuate in CHR youths’ everyday environments.</p>

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Elevated defeatist performance beliefs predict state increases in negative symptoms in daily life in clinical high-risk for psychosis youth: implications for mobile health treatments

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月10日

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  • Lauren Luther,
  • Ian M. Raugh,
  • Luca Bela G. Webber,
  • Paul M. Grant,
  • Aaron T. Beck,
  • Vijay A. Mittal,
  • Elaine Walker,
  • Gregory P. Strauss

摘要

Background

Negative symptoms are a strong predictor of conversion to a formal psychotic disorder in youth at clinical high-risk for developing psychosis (CHR). Identification of temporally precise mechanisms underlying increases in negative symptoms could enhance early intervention and specifically support the utility of mobile health treatments. Guided by Cognitive Behavioral models of psychopathology, we examine whether a core type of biased thinking—defeatist performance beliefs (DPB)—is a real-world mechanism of negative symptoms as well as a secondary symptom that is common in CHR youth: depressed mood.

Methods

CHR youth (n = 119) and healthy control (CN; 59) subjects completed ecological momentary assessment surveys assessing DPB, negative symptoms, and depressed mood for six days.

Results

CHR youth reported elevated DPB in daily life compared to CN. Greater DPB were associated with greater concurrent negative symptoms and depressed mood in daily life. Time-lagged analyses demonstrated that increased DPB at time t led to elevations in negative symptoms and depressed mood at t + 1 above and beyond the effects of the respective symptom at time t; DPB also varied across time of day, study day, day of the week, activity context, and social partners.

Conclusions

DPB may be a promising shared mechanism contributing to negative symptoms and depressed mood in CHR youth in their daily life. Findings also provide proof-of-concept support for the utility of mobile health treatments targeting DPB by identifying key moments where DPB fluctuate in CHR youths’ everyday environments.