# Cross-sectional and longitudinal predictors of distressing psychotic-like experiences in childhood and adolescence

> **NIH NIH K23** · WASHINGTON UNIVERSITY · 2022 · $162,963

## Abstract

Project Summary
Research has yet to understand why some with psychotic-like experiences (PLEs; early markers of psychosis
risk) transition to psychosis spectrum disorders whereas others report only transient PLEs. This information will
be critical for understanding the etiology of psychosis spectrum symptoms and for prevention and intervention
efforts for this major public health concern (~90% of individuals with significant PLEs report mental health
diagnoses in adulthood). According to the expanded proneness-persistence-impairment (PPI) model, potential
distinguishing factors between transient PLEs and those transitioning to psychotic disorders is whether they are
sustained and distressing (i.e., sustained dPLEs). Consistent with NIMH Strategic Objective 2, this K23
application will fill critical missing gaps in the literature by characterizing the key risk factors and clinical
significance of early sustained dPLEs. The application will focus on ~11,800 children from the Adolescent Brain
and Cognitive Development study initially aged 9-11-years-old followed annually over the course of the award.
The analyses will test PPI model hypotheses, including investigating the most important factors distinguishing
sustained from transient dPLEs, examining neurobiological correlates (e.g., resting state functional connectivity,
cortical thickness, cognitive functioning), family history of psychosis, motor and speech developmental delays,
and environmental predictors (adverse childhood experiences, cannabis use; Aim 1). Models will also test
whether longitudinal changes in cognitive, neural predictors, and environmental risk factors distinguish sustained
versus transient dPLEs (Aim 2). Lastly, the application will also fill a critical research gap by examining the clinical
significance of sustained dPLEs, examining the social and educational functional impairments, treatment seeking
behavior, and conducting additional data collection when the youth are ages 16 to 18 to assess the base rates
of attenuated psychosis syndrome (APS) among youth endorsing sustained dPLEs (Aim 3). To assess rates of
APS, the applicant and a masters-level clinician will interview a subset of ABCD participants (n=500) and their
parents/caregivers using the Structured Interview of Prodromal Syndromes. Overall, the applicant will implement
rigorous practices, including running all analyses for the aims and hypotheses outlined below on two-thirds of
data and then replicating the exact same models on an untouched one-third of data. Under the mentorship of a
diverse team of experts of developmental psychosis spectrum psychopathology, longitudinal analyses, machine
learning, and neuroimaging analyses, this scientifically rigorous proposal will test hypotheses regarding cross-
sectional and longitudinal predictors of sustained versus transient dPLEs for the future application of early
identification and preventative interventions. The application addresses several gaps in the applicant’s...

## Key facts

- **NIH application ID:** 10476294
- **Project number:** 5K23MH121792-03
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Nicole R. Karcher
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $162,963
- **Award type:** 5
- **Project period:** 2020-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10476294

## Citation

> US National Institutes of Health, RePORTER application 10476294, Cross-sectional and longitudinal predictors of distressing psychotic-like experiences in childhood and adolescence (5K23MH121792-03). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10476294. Licensed CC0.

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