PMID- 30651203
OWN - NLM
STAT- MEDLINE
DCOM- 20200730
LR  - 20200730
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 208
DP  - 2019 Jun
TI  - Anxiety in youth at clinical high risk for psychosis: A case study and conceptual 
      model.
PG  - 441-446
LID - S0920-9964(19)30006-4 [pii]
LID - 10.1016/j.schres.2019.01.006 [doi]
AB  - Some individuals identified as being at clinical high risk (CHR) for developing 
      psychosis may suffer substantial anxiety due to a fear of transitioning to 
      psychosis. This can be associated with catastrophic misinterpretation of normal 
      mental experiences, such as a momentary lapse in attention, as markers for 
      psychosis, fueled by hypervigilance for mental experiences that may be perceived 
      as signs of impending psychosis. This anxiety may only worsen due to the 
      self-stigma triggered by admission to a psychiatric CHR clinic, independent of 
      whether or not the individual transitions to psychosis. Based on a clinical case 
      study, we propose a cognitive model for this anxiety, an extension of Clark's 
      model of panic. Our model accounts for causal factors of this distress, such as 
      self-stigma and maladaptive core beliefs. It also includes maintaining factors 
      such as hypervigilance for mental experiences and catastrophic misinterpretation 
      of normal mental experiences as anomalous and portending eventual psychosis. We 
      outline assessment and treatment guidelines and offer suggestions for how this 
      model could be empirically validated. We suggest that treatment with this model, 
      under the neural diathesis-stress framework, may have the potential to lower the 
      risk of transition to psychosis and that assessment for such anxiety should be 
      part of standard CHR care.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Baer, L H
AU  - Baer LH
AD  - Prevention and Early Intervention Program for Psychosis, Douglas Mental Health 
      University Institute, Montreal, Canada; Department of Psychiatry, McGill 
      University, Montreal, Canada. Electronic address: Larry.Baer@camh.ca.
FAU - Shah, J L
AU  - Shah JL
AD  - Prevention and Early Intervention Program for Psychosis, Douglas Mental Health 
      University Institute, Montreal, Canada; Department of Psychiatry, McGill 
      University, Montreal, Canada.
FAU - Lepage, M
AU  - Lepage M
AD  - Prevention and Early Intervention Program for Psychosis, Douglas Mental Health 
      University Institute, Montreal, Canada; Department of Psychiatry, McGill 
      University, Montreal, Canada.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190114
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
MH  - Anxiety/*psychology/therapy
MH  - *Cognitive Behavioral Therapy
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Models, Psychological
MH  - *Prodromal Symptoms
MH  - Psychotic Disorders/prevention & control/*psychology
MH  - Risk
MH  - Self Concept
MH  - *Social Stigma
MH  - Young Adult
OTO - NOTNLM
OT  - Anxiety
OT  - CBT for psychosis
OT  - CHR
OT  - Clinical high risk for psychosis
OT  - Self-stigma
OT  - Stigma stress
EDAT- 2019/01/18 06:00
MHDA- 2020/07/31 06:00
CRDT- 2019/01/18 06:00
PHST- 2018/06/27 00:00 [received]
PHST- 2019/01/04 00:00 [revised]
PHST- 2019/01/05 00:00 [accepted]
PHST- 2019/01/18 06:00 [pubmed]
PHST- 2020/07/31 06:00 [medline]
PHST- 2019/01/18 06:00 [entrez]
AID - S0920-9964(19)30006-4 [pii]
AID - 10.1016/j.schres.2019.01.006 [doi]
PST - ppublish
SO  - Schizophr Res. 2019 Jun;208:441-446. doi: 10.1016/j.schres.2019.01.006. Epub 2019 
      Jan 14.