Intolerance to uncertainty as epiphenomenic sensitization factor for PLES in young adults with social anxiety disorder: mapping a possible pathway to psychosis.

Intolerance to uncertainty as epiphenomenic sensitization factor for PLES in young adults with social anxiety disorder: mapping a possible pathway to psychosis Marco Armando,1,2,3 Paolo Girardi,4 Gabriele Cavaggioni,2 Alice Masillo,4 Valentino Righetti,2 Riccardo Saba,2 Stefano Vicari,1 Maximilian Birchwood,3 Paolo Fiori Nastro2 1Department of Child and Adolescence Psychiatry, Research Hospital IRCCS Bambino Gesù, 4 S. Onofrio square, 2PhD School ‘Early Intervention in Psychosis’, ‘Sapienza’ University Department of Psychiatry, Rome, Italy, 3School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK, 4PhD School of ‘Early Intervention in Psychosis’, Sant’ Andrea Hospital and ‘Sapienza’ University of Rome NESMOS Department, Rome, Italy Introduction: Social anxiety disorder (SaD) is one of the most common diagnoses in the prodromal phases of psychotic symptoms/psychotic onset. Nevertheless, the high incidence of SaD in adolescents and young adults does not allow to discriminate which subjects with this diagnosis are at higher risk of developing psychotic symptoms. Therefore, we investigate if further psychopathological markers are able to discriminate subjects with SaD that are more prone to develop Psychotic Like Experiences (PLEs). The aim of the study is to investigate if Intolerance to Uncertainty (IU) can represent a possible specifi c psychopathological marker of sensitization for PLEs and therefore for psychotic onset in SaD. Method: The study was carried out on a sample of 139 help-seekers young adults (age 19–25) with a SaD (DSM-IV-TR). IU was evaluated using the Intolerance to Uncertainty Scale (IUS). PLEs and negative symptoms were evaluated using the Community Assessment of Psychic Experiences (CAPE), anxiety and depression symptoms were evaluated using Beck Depression Inventory-II and Beck Anxiety Inventory. The sample was splitted into two subsamples (low-IU = 67; high-IU = 64) using the median IUS score as cut-off value. After controlling for the homogeneity of the two subsamples for sociodemographic variables, regression analysis with forward method and Wald test was conducted using low-IU/high-IU as dependent variable. Results: Regression analysis showed that PLEs and negative symptoms are signifi cantly (P < 0.0001) more intense, frequent and distressing in high-IU subsample. Conclusion: This study confi rms that IU increases the risk of developing PLEs and negative symptoms in young adults with SaD.