Deconstructing Psychosis and its Assessment with Relevant R-PAS Measures (1.5 CEs)

In the past decade, the psychopathology research literature, including that on psychosis, has emphasized deconstructing disorders into dimensional components. The first presentation by Mihura provides an overview of the key psychosis components and how R-PAS scores map onto those components and summarizes the literature to date. The 2nd presentation by Mihura et al. explores a streamlined version of the R-PAS Cognitive Scores in specifically targeting the DSM-5 Disorganized Thinking criterion and tested in the last talk by Crittenden et al. The 3rd presentation by O’Gorman et al. uses a sample of 186 psychiatric patients to cross-validate the Scales of Problematic Communication and Thinking (SPCT), a dimensional method of coding disordered thought processes in Rorschach responses. Based on findings of a previous study using the measure, it is anticipated that the SPCT will provide incremental validity over the standard R-PAS Cognitive Codes for predicting diagnostic severity. In the 4th presentation by Buckingham et al. with a sample of 70 VA patients with schizophrenia, schizoaffective, and major depressive disorder, the expected relations between R-PAS and BPRS & SCID measures of disorganized thinking were found but not with negative symptoms and Complexity, hallucinations and FQ-%, or delusions and M-. In hierarchical regression analyses, WSumCog and SevCog predicted clinical ratings of disorganized thinking over the SPCT but not the other way around. Using data from a maximumsecurity inpatient forensic hospital (N = 90), the final presentation by Crittenden et al. evaluates whether automated coding of discourse coherence (using Coh-Metrix) predicts clinician ratings of disorganized thinking on the PANSS and, in addition, provides incremental validity over R-PAS Cognitive Codes and the SPCT. Our initial analyses find the hypothesized R-PAS Severe Cognitive Codes (SevCog) and the SPCT significantly correlated with PANSS Conceptual Disorganization: rs = .364 & .378. SPCT provided incremental validity over WSumCog but not over the hypothesized SevCog score. The new R-PAS disorganized thinking score described in Mihura et al.’s talk was correlated with the PANSS Conceptual disorganization at r = .437 and provides incremental validity over the SPCT in this sample. The last incremental validity step will test whether Rorschach protocols coded by Coh-Metrix Referential Cohesion provide incremental validity over the R-PAS Severe Cognitive Codes, the SPCT, and the new R-PAS disorganized thinking score.

Chair

Joni Mihura | University of Toledo 

Discussant

James H. Kleiger | Private Practice 

Goals & Objectives 

1. Describe the specific symptoms of psychosis assessed by R-PAS. 
2. Describe how the method do assessment used by R-PAS differs from self-report method in regard to assessing psychotic symptoms. 
3. Describe the research support for the main measures of psychotic symptoms in R-PAS.