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Assessing cross-national invariance of the Community Assessment of Psychic Experiences (CAPE)

  • Baptiste Pignon (a1) (a2) (a3) (a4), Hugo Peyre (a5) (a6), Aziz Ferchiou (a1) (a2) (a3) (a4), Jim van Os (a7) (a8), Bart P. F. Rutten (a7), Robin M. Murray (a8), Craig Morgan (a9), Marion Leboyer (a1) (a2) (a3) (a4), Franck Schürhoff (a1) (a2) (a3) (a4), Andrei Szöke (a1) (a2) (a3) (a4) and EU-GEI WP2 Group Author (a1) (a2) (a3) (a4) (a5) (a6) (a7) (a8) (a9)...



The Community Assessment of Psychic Experiences (CAPE) is a 42-item self-report questionnaire that has been developed and validated to measure the dimensions of psychosis in the general population. The CAPE has a three-factor structure with dimensions of positive, negative and depression. Assessing the cross-national equivalence of a questionnaire is an essential prerequisite before pooling data from different countries. In this study, our aim was to investigate the measurement invariance of the CAPE across different countries.


Data were drawn from the European Union Gene-Environment Interaction (EU-GEI) study. Participants (incident cases of psychotic disorder, controls and siblings of cases) were recruited in Brazil, France, Italy, the Netherlands, Spain and UK. To analyse the measurement invariance across these samples, we tested configural invariance (i.e. identical structures of the factors), metric invariance (i.e. equivalence of the factor loadings) and scalar invariance (i.e. equivalence of the thresholds) of the three CAPE dimensions using multigroup categorical confirmatory factor analysis methods.


The configural invariance model fits well, providing evidence for identical factorial structure across countries. In comparison with the configural model invariance, the fit indices were very similar in the metric and scalar invariance models, indicating that factor loadings and thresholds did not differ across the six countries.


We found that, across six countries, the CAPE showed equivalent factorial structure, factor loadings and thresholds. Thus, differences observed in scores between individuals from different countries should be considered as reflecting different levels of psychosis.


Corresponding author

Author for correspondence: Baptiste Pignon, E-mail:


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Asparouhov, T and Muthén, BO (2010) Weighted Least Squares Estimation With Missing Data. Mplus Technical Appendix. Available on
Barrantes-Vidal, N, Grant, P and Kwapil, TR (2015) The role of schizotypy in the study of the etiology of schizophrenia spectrum disorders. Schizophrenia Bulletin 41(suppl. 2), S408S416.
Brenner, K, Schmitz, N, Pawliuk, N, Fathalli, F, Joober, R, Ciampi, A and King, S (2007) Validation of the English and French versions of the Community Assessment of Psychic Experiences (CAPE) with a Montreal community sample. Schizophrenia Research 95, 8695.
Chen, FF (2007) Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal 14, 464504.
Chen, FF (2008) What happens if we compare chopsticks with forks? The impact of making inappropriate comparisons in cross-cultural research. Journal of Personality and Social Psychology 95, 10051018.
Davidov, E, Meuleman, B, Cieciuch, J, Schmidt, P and Billiet, J (2014) Measurement equivalence in cross-national research. Annual Review of Sociology 40, 5575.
European Network of National Networks studying Gene-Environment Interactions in Schizophrenia (EU-GEI) (2014) Identifying gene-environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations. Schizophrenia Bulletin 40, 729736.
Fonseca-Pedrero, E, Paino, M, Lemos-Giráldez, S and Muñiz, J (2012) Validation of the Community Assessment Psychic Experiences -42 (CAPE-42) in Spanish college students and patients with psychosis. Actas Espanolas De Psiquiatria 40, 169176.
Fonseca-Pedrero, E, Ortuño-Sierra, J, Sierro, G, Daniel, C, Cella, M, Preti, A, Mohr, C and Mason, OJ (2015) The measurement invariance of schizotypy in Europe. European Psychiatry: The Journal of the Association of European Psychiatrists 30, 837844.
Fonseca-Pedrero, E, Ortuño-Sierra, J, Lucas-Molina, B, Debbané, M, Chan, RCK, Cicero, DC, Zhang, LC, Brenner, C, Barkus, E, Linscott, RJ, Kwapil, T, Barrantes-Vidal, N, Cohen, A, Raine, A, Compton, MT, Tone, EB, Suhr, J, Bobes, J, Fumero, A, Giakoumaki, S, Tsaousis, I, Preti, A, Chmielewski, M, Laloyaux, J, Mechri, A, Lahmar, MA, Wuthrich, V, Larøi, F, Badcock, JC, Jablensky, A, Barron, D, Swami, V, Tran, US and Voracek, M (2017) Brief assessment of schizotypal traits: a multinational study. Schizophrenia Research. Corrected proofs online, doi: 10.1016/j.schres.2017.10.043.
Hanssen, M, Peeters, F, Krabbendam, L, Radstake, S, Verdoux, H and van Os, J (2003) How psychotic are individuals with non-psychotic disorders? Social Psychiatry and Psychiatric Epidemiology 38, 149154.
Hong, S, Malik, ML and Lee, M-K (2003) Testing configural, metric, scalar, and latent mean invariance across genders in sociotropy and autonomy using a non-western sample. Educational and Psychological Measurement 63, 636654.
Jongsma, HE, Gayer-Anderson, C, Lasalvia, A, Quattrone, D, Mulè, A, Szöke, A, Selten, J-P, Turner, C, Arango, C, Tarricone, I, Berardi, D, Tortelli, A, Llorca, P-M, de Haan, L, Bobes, J, Bernardo, M, Sanjuán, J, Santos, JL, Arrojo, M, Del-Ben, CM, Menezes, PR, Murray, RM, Rutten, BP, Jones, PB, van Os, J, Morgan, C and Kirkbride, JB (2017) Treated incidence of psychotic disorders in the multinational EU-GEI study. JAMA Psychiatry 75, 3646.
Kaymaz, N, Drukker, M, Lieb, R, Wittchen, H-U, Werbeloff, N, Weiser, M, Lataster, T and van Os, J (2012) Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychological Medicine 42, 22392253.
Konings, M, Bak, M, Hanssen, M, Van Os, J and Krabbendam, L (2006) Validity and reliability of the CAPE: a self-report instrument for the measurement of psychotic experiences in the general population. Acta Psychiatrica Scandinavica 114, 5561.
Linscott, RJ and van Os, J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine 43, 11331149.
Mark, W and Toulopoulou, T (2016) Psychometric properties of ‘community assessment of psychic experiences’: review and meta-analyses. Schizophrenia Bulletin 42, 3444.
Marsh, HW (2007) Application of confirmatory factor analysis and structural equation modeling in sport/exercise psychology. In Tenenbaum, G and Eklund, RC (eds), Handbook of Sport Psychology, 3rd Edn. New York: Wiley, pp. 774798.
Marsh, HW, Morin, AJS, Parker, PD and Kaur, G (2014) Exploratory structural equation modeling: an integration of the best features of exploratory and confirmatory factor analysis. Annual Review of Clinical Psychology 10, 85110.
Mellenbergh, GJ (1989) Item bias and item response theory. International Journal of Educational Research 13, 127143.
Meredith, W (1993) Measurement invariance, factor analysis and factorial invariance. Psychometrika 58, 525543.
Millsap, RE (1997) Invariance in measurement and prediction: their relationship in the single-factor case. Psychological Methods 2, 248.
Millsap, RE and Everson, HT (1993) Methodology review: statistical approaches for assessing measurement bias, methodology review: statistical approaches for assessing measurement bias. Applied Psychological Measurement 17, 297334.
Mossaheb, N, Becker, J, Schaefer, MR, Klier, CM, Schloegelhofer, M, Papageorgiou, K and Amminger, GP (2012) The Community Assessment of Psychic Experience (CAPE) questionnaire as a screening-instrument in the detection of individuals at ultra-high risk for psychosis. Schizophrenia Research 141, 210214.
Nelson, MT, Seal, ML, Pantelis, C and Phillips, LJ (2013) Evidence of a dimensional relationship between schizotypy and schizophrenia: a systematic review. Neuroscience and Biobehavioral Reviews 37, 317327.
Ortuño-Sierra, J, Badoud, D, Knecht, F, Paino, M, Eliez, S, Fonseca-Pedrero, E and Debbané, M (2013) Testing measurement invariance of the schizotypal personality questionnaire-brief scores across Spanish and Swiss adolescents. PLoS ONE 8, e82041.
Peters, ER, Joseph, SA, Garety, PA (1999) Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia Bulletin 25, 553576.
Putnick, DL and Bornstein, MH (2016) Measurement invariance conventions and reporting: the state of the art and future directions for psychological research. Developmental Review: DR 41, 7190.
Schlier, B, Jaya, ES, Moritz, S and Lincoln, TM (2015) The Community Assessment of Psychic Experiences measures nine clusters of psychosis-like experiences: a validation of the German version of the CAPE. Schizophrenia Research 169, 274279.
Schnabel, DBL, Kelava, A, van de Vijver, FJR and Seifert, L (2015) Examining psychometric properties, measurement invariance, and construct validity of a short version of the Test to Measure Intercultural Competence (TMIC-S) in Germany and Brazil. International Journal of Intercultural Relations 49, 137155.
Schürhoff, F, Laguerre, A, Szöke, A, Méary, A and Leboyer, M (2005) Schizotypal dimensions: continuity between schizophrenia and bipolar disorders. Schizophrenia Research 80, 235242.
Steenkamp, J-BEM and Baumgartner, H (1998) Assessing measurement invariance in cross-national consumer research. Journal of Consumer Research 25, 7890.
Stefanis, NC, Hanssen, M, Smirnis, NK, Avramopoulos, DA, Evdokimidis, IK, Stefanis, CN, Verdoux, H and Van Os, J (2002) Evidence that three dimensions of psychosis have a distribution in the general population. Psychological Medicine 32, 347358.
Stefanis, NC, Delespaul, P, Henquet, C, Bakoula, C, Stefanis, CN and Van Os, J (2004) Early adolescent cannabis exposure and positive and negative dimensions of psychosis. Addiction (Abingdon, England) 99, 13331341.
van Os, J (2014) The many continua of psychosis. JAMA Psychiatry 71, 985986.
van Os, J, Marsman, A, van Dam, D, Simons, CJP and GROUP Investigators (2017) Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder. Schizophrenia Bulletin 43, 316324.
Verdoux, H, Sorbara, F, Gindre, C, Swendsen, JD and van Os, J (2003) Cannabis use and dimensions of psychosis in a nonclinical population of female subjects. Schizophrenia Research 59, 7784.
Wigman, JTW, Vollebergh, WAM, Raaijmakers, QAW, Iedema, J, van Dorsselaer, S, Ormel, J, Verhulst, FC and van Os, J (2011) The structure of the extended psychosis phenotype in early adolescence: a cross-sample replication. Schizophrenia Bulletin 37, 850860.
Wigman, JTW, Wardenaar, KJ, Wanders, RBK, Booij, SH, Jeronimus, BF, van der Krieke, L, Wichers, M and de Jonge, P (2017) Dimensional and discrete variations on the psychosis continuum in a Dutch crowd-sourcing population sample. European Psychiatry: The Journal of the Association of European Psychiatrists 42, 5562.
Yung, AR, Buckby, JA, Cotton, SM, Cosgrave, EM, Killackey, EJ, Stanford, C, Godfrey, K and McGorry, PD (2006) Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression, and disability. Schizophrenia Bulletin 32, 352359.
Yung, AR, Nelson, B, Baker, K, Buckby, JA, Baksheev, G and Cosgrave, EM (2009) Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia. The Australian and New Zealand Journal of Psychiatry 43, 118128.


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