Core schema instability in youth at clinical high risk for psychosis: within-person variability as an index of self-belief precision
- 1Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
Abstract
Aim. Core schemas are considered stable traits in clinical high risk (CHR) research. However, unexamined fluctuation may conceal belief changes that precede psychosis emergence. We examined whether schemas possess considerable within-person variability in CHR, and whether that variability exceeds that of controls. Methods. In NAPLS 2, 411 CHR and 194 control participants completed the Brief Core Schema Scales (BCSS) at least three times across 24 months. Random-intercept models identified intraclass correlations in CHR. Bayesian censored location-scale models, correcting for floor scores and mean level differences, compared within-person SD between groups. Results. Within-person variance accounted for 41.3% to 50.6% of BCSS variance in CHR. Latent within-person SD was greater in CHR on all four subscales, most for negative-self (ratio 1.71, 95% CrI [1.50, 1.94]). This variability was largely independent of shared improvement and psychotropic medication effects. Conclusions. Core schemas fluctuate substantially in CHR compared to controls, particularly in negative self-beliefs. Single baseline scores may understate associations between schemas and outcomes.
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BibTeX
@misc{broekhuijse2026core,
title = {{Core schema instability in youth at clinical high risk for psychosis: within-person variability as an index of self-belief precision}},
author = {A. Broekhuijse and A. Saxena and C. Mourgues-Codern and H. Mukhtar and J. Addington and C. E. Bearden and K. S. Cadenhead and D. H. Mathalon and T. H. McGlashan and D. O. Perkins and E. F. Walker and T. D. Cannon and S. W. Woods and E. A. Farina and A. R. Powers},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.27.26366553},
url = {https://www.medrxiv.org/content/10.64898/2026.10.27.26366553v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Core schema instability in youth at clinical high risk for psychosis: within-person variability as an index of self-belief precision
AU - A. Broekhuijse
AU - A. Saxena
AU - C. Mourgues-Codern
AU - H. Mukhtar
AU - J. Addington
AU - C. E. Bearden
AU - K. S. Cadenhead
AU - D. H. Mathalon
AU - T. H. McGlashan
AU - D. O. Perkins
AU - E. F. Walker
AU - T. D. Cannon
AU - S. W. Woods
AU - E. A. Farina
AU - A. R. Powers
PY - 2026
DA - 2026/10/27
PB - medRxiv
DO - 10.64898/2026.10.27.26366553
UR - https://www.medrxiv.org/content/10.64898/2026.10.27.26366553v1
AB - Aim. Core schemas are considered stable traits in clinical high risk (CHR) research. However, unexamined fluctuation may conceal belief changes that precede psychosis emergence. We examined whether schemas possess considerable within-person variability in CHR, and whether that variability exceeds that of controls. Methods. In NAPLS 2, 411 CHR and 194 control participants completed the Brief Core Schema Scales (BCSS) at least three times across 24 months. Random-intercept models identified intraclass correlations in CHR. Bayesian censored location-scale models, correcting for floor scores and mean level differences, compared within-person SD between groups. Results. Within-person variance accounted for 41.3% to 50.6% of BCSS variance in CHR. Latent within-person SD was greater in CHR on all four subscales, most for negative-self (ratio 1.71, 95% CrI [1.50, 1.94]). This variability was largely independent of shared improvement and psychotropic medication effects. Conclusions. Core schemas fluctuate substantially in CHR compared to controls, particularly in negative self-beliefs. Single baseline scores may understate associations between schemas and outcomes.
ER -