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Risk and protective factors for psychotic experiences in adolescence: a population-based study

Published online by Cambridge University Press:  06 February 2020

Elaine M. McMahon*
National Suicide Research Foundation, Cork, Ireland School of Public Health, University College Cork, Ireland
Paul Corcoran
National Suicide Research Foundation, Cork, Ireland School of Public Health, University College Cork, Ireland
Helen Keeley
Child and Adolescent Mental Health Services North Cork, Health Service Executive, Ireland
Mary Clarke
Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Helen Coughlan
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Danuta Wasserman
National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
Christina W. Hoven
Dept of Child and Adolescent Psychiatry, New York State Psychiatric Institute; Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Vladimir Carli
National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
Marco Sarchiapone
Department of Medicine and Health Science, University of Molise, Campobasso, Italy
Colm Healy
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
Mary Cannon
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland Trinity College Institute of Neuroscience, Dublin, Ireland Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
Author for correspondence: Elaine McMahon, Email:



Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of psychiatric disorders. The aims of this study were to examine associations between PEs and a range of factors including psychopathology, adversity and lifestyle, and to investigate mediating effects of coping style and parental support on associations between adversity and PEs in a general population adolescent sample.


Cross-sectional data were drawn from the Irish centre of the Saving and Empowering Young Lives in Europe study. Students completed a self-report questionnaire and 973 adolescents, of whom 522 (53.6%) were boys, participated. PEs were assessed using the 7-item Adolescent Psychotic Symptom Screener.


Of the total sample, 81 (8.7%) of the sample were found to be at risk of PEs. In multivariate analysis, associations were found between PEs and number of adverse events reported (OR 4.48, CI 1.41–14.25; p < 0.011), maladaptive/pathological internet use (OR 2.70, CI 1.30–5.58; p = 0.007), alcohol intoxication (OR 2.12, CI 1.10–4.12; p = 0.025) and anxiety symptoms (OR 4.03, CI 1.57–10.33; p = 0.004). There were small mediating effects of parental supervision, parental support and maladaptive coping on associations between adversity and PEs.


We have identified potential risk factors for PEs from multiple domains including adversity, mental health and lifestyle factors. The mediating effect of parental support on associations between adversity and PEs suggests that poor family relationships may account for some of this mechanism. These findings can inform the development of interventions for adolescents at risk.

Original Article
Copyright © The Author(s) 2020. Published by Cambridge University Press

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