As researchers continue to understand non-clinical psychosis (NCP-brief psychotic-like experiences occurring in 5–7% of the general population; van Os et al., 2009), it is becoming evident that functioning deficits and facial emotion recognition (FER) impairment characterize this phenomenon. However, the extent to which these domains are related remains unclear. Social/role functioning and FER were assessed in 65 adolescents/young adults exhibiting low and high-NCP. Results indicate that FER and social/role functioning deficits were present in the High-NCP group, and that the domains were associated in this group alone. Taken together, findings suggest that a core emotive deficit is tied to broader social/role dysfunction in NCP.
A growing body of evidence indicates that a proportion of individuals in the general population experience subclinical psychotic symptoms, which suggests that psychosis occurs along a continuous phenotype (Kelleher and Cannon, 2011). These fleeting psychotic symptoms (often specifically referenced as psychotic-like symptoms; Kelleher and Cannon, 2011) occur in the absence of formal psychosis, and are indicative of what is broadly termed non-clinical psychosis (NCP; Mittal et al., 2011, Mittal et al., 2012a and Mittal et al., 2012b). Recent research has highlighted the significance of NCP. There is some evidence that individuals experiencing NCP are at heightened risk of developing a psychotic disorder (Welham et al., 2009). In addition, NCP has been linked with a variety of risk factors for schizophrenia such as low socio-economic status, urbanicity, and cannabis use (for a review, see Kelleher and Cannon, 2011). Overall, NCP research is important due to its potential to clarify our understanding of the developmental trajectory of psychosis, and specifically, vulnerability markers associated with the onset of a psychotic disorder (Roddy et al., 2012). Because of NCP's potential to clarify risk for psychosis, and the evidence showing that individuals experiencing NCP show a significantly heightened risk for developing formal psychosis, improving the scientific understanding of NCP should be a priority (Zammit et al., 2009).
Recent research links NCP with several areas of impairment. For example, although NCP is defined by the absence of a formal psychotic disorder, the literature suggests that it is associated with other clinical disorders including depression and anxiety (Yung et al., 2006 and Varghese et al., 2011), as well as behavioral issues such as problematic Internet use (Mittal et al., in press). In further support of these specific findings, there is some evidence to suggest that individuals experiencing NCP in the general population usually have at least one non-psychotic Axis I psychiatric diagnosis (Kelleher et al., 2012). Additionally, Yung et al. (2006) found that in a non-psychotic help-seeking population, NCP symptoms were associated with poorer functioning (functioning was examined in terms of general functioning, peer relationships, and family functioning).
Consistent with these broader areas of dysfunction, a recent study reported facial emotion recognition (FER) deficits in individuals reporting NCP (Roddy et al., 2012). The relationship between NCP and FER is interesting on numerous accounts. First, FER, one domain of social cognition, has been widely acknowledged to be impaired in individuals with a psychotic disorder (Pinkham et al., 2007). Despite the general agreement that deficits exist in emotion recognition in formal psychosis, there is some discrepancy as to when the impairment first develops (i.e., prodromal stage, first episode, etc.; see Green et al., 2011 for a review). It is also worth noting that the only other study (in addition to Roddy et al., 2012) to evaluate NCP and FER did not find a significant relationship between NCP and FER (Thompson et al., 2011). Thus, further evaluation of emotion recognition in an NCP population may help clarify the relationship of psychosis and social cognition from a developmental perspective. Another reason that the study of FER is warranted is due to its relationship with functioning. The ability to correctly recognize and process facial expressions is necessary in order to facilitate behavior and have successful social functioning (Amminger et al., 2012). To date, there is no investigation into this relationship in an NCP population.
There is growing evidence suggesting that deficits and vulnerability markers linked with psychosis are present in NCP (Mittal et al., 2012a and Mittal et al., 2012b); however, the research is still new, and associations between core deficits such as FER and broader processes such as global social/role functioning remain unclear. The present study examined global social/role functioning (GF:S and GF:R, respectively) and FER in 65 non-clinical adolescents/young adults reporting high and low-NCP to determine whether any deficits were present, and if so, the extent to which FER and GF:S/GF:R were related. The current investigation differs from the Yung et al. (2006) study in that we have chosen to examine functioning in regard to specific social and role domains commonly evaluated in psychosis-risk populations (Cornblatt et al., 2007), rather than peer, social, and general functioning. Furthermore, to the authors' knowledge, the only two studies to assess FER in an NCP population evaluated individuals with a mean age ≤ 11.5 (Thompson et al., 2011 and Roddy et al., 2012). The current study attempts to expand on these findings by assessing an older sample (older adolescents and young adults) and examine functioning and FER in the sample.
