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Comparing psychotic experiences in low-and-middle-income-countries and high-income-countries with a focus on measurement invariance

Published online by Cambridge University Press:  07 October 2020

Edo S. Jaya*
Affiliation:
Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
Caroline Wüsten
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
Behrooz Z. Alizadeh
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
Therese van Amelsvoort
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
Agna A. Bartels-Velthuis
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
Nico J. van Beveren
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Antes Center for Mental Health Care, Rotterdam, The Netherlands Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
Richard Bruggeman
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
Wiepke Cahn
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands Altrecht, General Mental Health Care, Utrecht, The Netherlands
Lieuwe de Haan
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands Arkin, Institute for Mental Health, Amsterdam, The Netherlands
Philippe Delespaul
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
Jurjen J. Luykx
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands Department of Translational Neuroscience, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
Inez Myin-Germeys
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
Rene S. Kahn
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Frederike Schirmbeck
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands Arkin, Institute for Mental Health, Amsterdam, The Netherlands
Claudia J. P. Simons
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
Neeltje E. van Haren
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Rotterdam, The Netherlands
Jim van Os
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
Ruud van Winkel
Affiliation:
Genetic Risk and Outcome of Psychosis (GROUP) Investigators Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
Eduardo Fonseca-Pedrero
Affiliation:
Department of Educational Sciences, University of La Rioja, La Rioja, Spain Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
Emmanuelle Peters
Affiliation:
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK South London and Maudsley NHS Foundation Trust, London, UK
Hélène Verdoux
Affiliation:
University Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
Todd S. Woodward
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
Tim B. Ziermans
Affiliation:
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
Tania M. Lincoln
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
*
Author for correspondence: Edo S. Jaya, E-mail: edo.jaya@ui.ac.id

Abstract

Background

The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias.

Methods

A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses.

Results

MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = −0.42) and underestimation (e.g. magical thinking, d = −0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition.

Conclusion

Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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