The role of Psychotic-Like Experiences in the association between Aberrant Salience and Anxiety: a case-control mediation study

Introduction: Aberrant salience and psychotic-like experiences have been proven to be linked. Moreover, anxiety is a key symptom in psychosis prone subjects and in most psychotic patients. We propose a mediation model that attempts to interpret the role of psychotic-like experiences in the association between aberrant salience and anxiety among healthy controls and psychotic patients. Materials and Methods: Demographic and psychometric data (Aberrant Salience Inventory, Community Assessment of Psychic Experiences, Symptom Check List-90-revised) from 163 controls and 27 psychotic patients was collected. Descriptive statistics, correlations and a mediation analysis with covariates were subsequently performed. Results: Aberrant salience correlated with more frequent positive psychotic-like experiences and higher anxiety levels in both patients and controls. However, positive psychotic-like experiences’ frequency mediated the relationship between aberrant salience and anxiety only among controls. Conclusions: The preservation of insight onto their psychotic-like experiences among controls with high aberrant salience, and its partial or complete loss in psychotic patients seems to be the most probable hypothesis to explain why psychotic-like experiences linked to aberrant salience appear to induce anxiety among the former group but not the latter.