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Psychotic-like experiences in adolescents enriched for high-risk for developing severe mental illness: change over two-years and associations with neural reward processing and affective symptoms.

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Title: Psychotic-like experiences in adolescents enriched for high-risk for developing severe mental illness: change over two-years and associations with neural reward processing and affective symptoms.
Authors: Dong, Xiaoying (AUTHOR), Gupta, Tina (AUTHOR), Haas, Gretchen (AUTHOR), Eckstrand, Kristen L. (AUTHOR), Silk, Jennifer S. (AUTHOR), Ryan, Neal D. (AUTHOR), Forbes, Erika E. (AUTHOR)
Source: European Archives of Psychiatry & Clinical Neuroscience. Feb2026, Vol. 276 Issue 1, p7-18. 12p.
Subjects: Psychoses, Reward (Psychology), Mental illness, Functional magnetic resonance imaging, Longitudinal method, Adolescent psychopathology, Teenagers, Symptoms
Abstract: Psychotic-like experiences (PLEs) –subclinical experiences or symptoms that resemble psychosis, such as hallucinations and delusional thoughts–often emerge during adolescence and are predictive of serious psychopathology. Understanding PLEs during adolescence is crucial due to co-occurring developmental changes in neural reward systems that heighten the risk for psychotic-related and affective psychopathology, especially in those with a family history of severe mental illness (SMI). We examined associations among PLEs, clinical symptoms, and neural reward function during this critical developmental period. Over two-years, 117 adolescents (aged 13–19 years at baseline) at high-risk (n = 74) or low-risk (n = 43) for SMI based on family history of affective or psychotic disorder completed symptom questionnaires annually and fMRI scanning at study entry during a guessing reward task. We assessed changes in PLEs over two-years and evaluated whether clinical symptoms (anxiety, depression, anhedonia) and response to rewards of the dorsal medial prefrontal cortex (dmPFC) and ventral striatum (VS) predicted PLEs two-years later. PLEs total scores and distress increased over time, with the high-risk group showing a greater rise in PLEs than the low-risk group. Heightened right VS neural activation and higher anxiety at baseline (but not left VS or dmPFC neural activation, depression, or anhedonia) predicted more PLEs at 24-months. Heightened vigilance and sensitivity to external stimuli may be important precursors to the development of PLEs for adolescents. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Psychotic-like experiences (PLEs) –subclinical experiences or symptoms that resemble psychosis, such as hallucinations and delusional thoughts–often emerge during adolescence and are predictive of serious psychopathology. Understanding PLEs during adolescence is crucial due to co-occurring developmental changes in neural reward systems that heighten the risk for psychotic-related and affective psychopathology, especially in those with a family history of severe mental illness (SMI). We examined associations among PLEs, clinical symptoms, and neural reward function during this critical developmental period. Over two-years, 117 adolescents (aged 13–19 years at baseline) at high-risk (n = 74) or low-risk (n = 43) for SMI based on family history of affective or psychotic disorder completed symptom questionnaires annually and fMRI scanning at study entry during a guessing reward task. We assessed changes in PLEs over two-years and evaluated whether clinical symptoms (anxiety, depression, anhedonia) and response to rewards of the dorsal medial prefrontal cortex (dmPFC) and ventral striatum (VS) predicted PLEs two-years later. PLEs total scores and distress increased over time, with the high-risk group showing a greater rise in PLEs than the low-risk group. Heightened right VS neural activation and higher anxiety at baseline (but not left VS or dmPFC neural activation, depression, or anhedonia) predicted more PLEs at 24-months. Heightened vigilance and sensitivity to external stimuli may be important precursors to the development of PLEs for adolescents. [ABSTRACT FROM AUTHOR]
ISSN:09401334
DOI:10.1007/s00406-025-02095-9