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      Negative Life Events and Problematic Internet Use as Factors Associated With Psychotic-Like Experiences in Adolescents


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          Objectives: Psychotic-like experiences (PLEs) and problematic internet use (PIU) are common in adolescents. However, little is known about the association between PLEs and PIU among adolescents. The present study examined the associations between PLEs and PIU and negative life events among adolescents.

          Methods: In total, 1,678 adolescents attending high school were recruited for a cross-sectional survey. They completed self-reported assessments of PLEs using the Prodromal Questionnaire-16 (PQ-16) and measures of depression, anxiety, self-esteem, internet use, and negative life events using the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), the Rosenberg Self-Esteem Scale (RSES), the Korean Scale for Internet Addiction (K-scale), and the Lifetime Incidence of Traumatic Events for Children (LITE-C), including cybersexual harassment and school violence.

          Results: A total of 1,239 subjects (73.8%) scored at least 1 on the PQ-16. The mean total and distress PQ-16 scores were significantly higher in students who used mental health services. The total and distress prodromal questionnaire-16 (PQ-16) scores were positively correlated with the CES-D, STAI-S, STAI-T, LITE-C, and K-scale scores but negatively correlated with the RSES score. Hierarchical linear regression analysis revealed that PLEs were significantly associated with a high K-scale score and the incidence of negative life events, such as LITE-C, cybersexual harassment, and bully–victims.

          Conclusion: Our results demonstrate that PIU and negative life experiences were significantly associated with PLEs in adolescents. Assessment and therapeutic intervention with regard to internet use as a coping strategy for stress are needed to prevent the development of clinical psychotic symptoms.

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          Most cited references 45

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          Cyberbullying: its nature and impact in secondary school pupils.

          Cyberbullying describes bullying using mobile phones and the internet. Most previous studies have focused on the prevalence of text message and email bullying. Two surveys with pupils aged 11-16 years: (1) 92 pupils from 14 schools, supplemented by focus groups; (2) 533 pupils from 5 schools, to assess the generalisability of findings from the first study, and investigate relationships of cyberbullying to general internet use. Both studies differentiated cyberbullying inside and outside of school, and 7 media of cyberbullying. Both studies found cyberbullying less frequent than traditional bullying, but appreciable, and reported more outside of school than inside. Phone call and text message bullying were most prevalent, with instant messaging bullying in the second study; their impact was perceived as comparable to traditional bullying. Mobile phone/video clip bullying, while rarer, was perceived to have more negative impact. Age and gender differences varied between the two studies. Study 1 found that most cyberbullying was done by one or a few students, usually from the same year group. It often just lasted about a week, but sometimes much longer. The second study found that being a cybervictim, but not a cyberbully, correlated with internet use; many cybervictims were traditional 'bully-victims'. Pupils recommended blocking/avoiding messages, and telling someone, as the best coping strategies; but many cybervictims had told nobody about it. Cyberbullying is an important new kind of bullying, with some different characteristics from traditional bullying. Much happens outside school. Implications for research and practical action are discussed.
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            The environment and schizophrenia.

            Psychotic syndromes can be understood as disorders of adaptation to social context. Although heritability is often emphasized, onset is associated with environmental factors such as early life adversity, growing up in an urban environment, minority group position and cannabis use, suggesting that exposure may have an impact on the developing 'social' brain during sensitive periods. Therefore heritability, as an index of genetic influence, may be of limited explanatory power unless viewed in the context of interaction with social effects. Longitudinal research is needed to uncover gene-environment interplay that determines how expression of vulnerability in the general population may give rise to more severe psychopathology.
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              The validity of the 16-item version of the Prodromal Questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population.

              In order to bring about implementation of routine screening for psychosis risk, a brief version of the Prodromal Questionnaire (PQ; Loewy et al., 2005) was developed and tested in a general help-seeking population. We assessed a consecutive patient sample of 3533 young adults who were help-seeking for nonpsychotic disorders at the secondary mental health services in The Hague with the PQ. We performed logistic regression analyses and CHi-squared Automatic Interaction Detector decision tree analysis to shorten the original 92 items. Receiver operating characteristic curves were used to examine the psychometric properties of the PQ-16. In the general help-seeking population, a cutoff score of 6 or more positively answered items on the 16-item version of the PQ produced correct classification of Comprehensive Assessment of At-Risk Mental State (Yung et al., 2005) psychosis risk/clinical psychosis in 44% of the cases, distinguishing Comprehensive Assessment of At-Risk Mental States (CAARMS) diagnosis from no CAARMS diagnosis with high sensitivity (87%) and specificity (87%). These results were comparable to the PQ-92. The PQ-16 is a good self-report screen for use in secondary mental health care services to select subjects for interviewing for psychosis risk. The low number of items makes it quite appropriate for screening large help-seeking populations, thus enhancing the feasibility of detection and treatment of ultra high-risk patients in routine mental health services.

                Author and article information

                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                29 May 2019
                : 10
                1Chonnam National University Medical School , Gwangju, South Korea
                2Gwangju Bukgu Community Mental Health Center , Gwangju, South Korea
                Author notes

                Edited by: Lex Wunderink, GGZ Friesland, Netherlands

                Reviewed by: Michael W. Best, Queen’s University, Canada; Stefanie Julia Schmidt, Universität Bern, Switzerland

                *Correspondence: Sung-Wan Kim, swkim@ 123456chonnam.ac.kr

                This article was submitted to Schizophrenia, a section of the journal Frontiers in Psychiatry

                Copyright © 2019 Lee, Ban, Kim, Kim, Shin, Yoon and Kim

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 66, Pages: 8, Words: 3836
                Original Research


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