The Schizotypal Personality Questionnaire-Brief lacks measurement invariance across three countries
Introduction
Schizotypy is a heterogeneous construct that has been used by researchers and clinicians to describe schizotypal traits, psychosis-proneness, and psychotic-like experiences. Coined by Meehl (1962), it refers to a personality organisation that represents the vulnerability for developing psychotic-spectrum disorders. Expression of schizotypal traits (e.g. hallucinatory and delusional experiences), despite having a transient nature and possibly vanishing over time, can occur in the general population, without necessarily being associated with a mental health condition (Fonseca-Pedrero and Debbané, 2017; Linscott and Van Os, 2013; Van Os et al., 2009). For example, an international study conducted by McGrath et al. (2015) sampling 31261 adults in the community from 18 countries, found that the average life-time prevalence of psychotic experience was 5.8%. Further, evidence from a meta-analysis showed that the risk of conversion to a clinical psychotic outcome among people who report subthreshold psychotic experiences (0.56%) is 3.5 times higher than those without exposure to such experiences (0.16%), particularly the experiences were severe or persistent (Kaymaz et al., 2012). Other longitudinal studies (e.g., Poulton et al., 2000; Zammit et al., 2013) also suggest that adolescents and young adults who report such schizotypal experiences are at greater risk of developing psychosis and related disorders than those who do not. These studies suggest that the presence of schizotypal features may represent a liability to developing symptoms of schizophrenia or transitioning from subclinical impairments to a full-blown psychosis, and this is especially the case if genetic and environmental risk factors are present (e.g. degree of relatedness to family member with schizophrenia, cannabis use) (Linscott and Van Os, 2013; Debbané et al., 2015; Van Os et al., 2009). It is therefore important to identify and address schizotypal traits as early as possible as early detection and intervention may enable prevention of, or reduce the probability of progression in psychosis (Fonseca-Pedrero et al., 2016, Ortuno-Sierra et al., 2013).
The Schizotypal Personality Questionnaire-Brief version (SPQ-B; Raine and Benishay, 1995) is one of the most popular scales used to assess schizotypal traits (Reynolds et al., 2000). Derived from the original 74-item scale developed by Raine (1991), it consists of 22 items, responded to using a Yes/No format, that reflect the diagnostic criteria of schizotypal personality disorder first described in the DSM-III-R (American Psychiatric Association, 1987). These items cover nine distinct domains (i.e. ideas of reference, excessive social anxiety, odd beliefs or magical thinking, unusual perceptual experiences, odd or eccentric behaviour, no close friends, odd speech, constricted affect, and suspiciousness) that are grouped into three factors which relate in part to the three components of schizophrenia: cognitive-perceptual problems (positive symptoms), interpersonal problems (negative symptoms) and disorganization (Raine and Benishay, 1995).
The brevity of the SPQ-B while still capturing the three factors reflected by the larger scale, makes it an attractive screening measure and it has been used both in non-clinical and psychiatric populations (Axelrod et al., 2001, Compton et al., 2007, Compton et al., 2009, Mata et al., 2005). In addition, the SPQ-B has been translated into different languages and validated in a variety of culture contexts, including China (Ma et al., 2010, Ma et al., 2015), Spain (Fonseca-Pedrero et al., 2009, Fonseca-Pedrero et al., 2011b, Fonseca-Pedrero et al., 2011a, Fonseca-Pedrero et al., 2014, Mata et al., 2005), Japan (Ito et al., 2008, Ito et al., 2010), and Turkey (Aycicegi et al., 2005).
Despite these advantages and its widespread use, Stefanis and colleagues (2004) argued that the 'positive' schizotypy factor in Raine’s (1991) three-factor model for the SPQ, which includes items of cognitive-perceptual and paranoid dimensions, should in fact be two independent factors. They suggested a four-factor model that consists of interpersonal, cognitive-perceptual, disorganized, and paranoid factors. While this four-factor structure has been well replicated in both the SPQ and SPQ-B (Cicero, 2015, Cohen et al., 2010, Fonseca-Pedrero et al., 2009, Fonseca-Pedrero et al., 2014, Lahmar et al., 2014, Smallman et al., 2010), there is little evidence to suggest that it is valid across cultures. For example, the four-factor model in the SPQ-B has been replicated in Spanish community samples (Fonseca-Pedrero et al., 2009, Fonseca-Pedrero et al., 2011b), but the original three-factor model (cognitive-perceptual, interpersonal and disorganised) was supported in China (Ma et al., 2015), and a two-factor model was identified by Principal Component Analysis in Turkey and Italy (Aycicegi et al., 2005, Preti et al., 2015).
Only two previous studies have provided evidence of the four-factor model solution of the SPQ across different cultural groups in the same study (Cicero, 2015, Fonseca-Pedrero et al., 2014). Cicero (2015) replicated the four-factor structure within cultural subgroup samples in the United States (i.e. Asian, Caucasian, Pacific Islander, etc.) while Fonseca-Pedrero and colleagues (2014) established measurement invariance for the four-factor model across samples of Spanish and US college students. Although the four-factor structure of SPQ-B has not been replicated in Eastern contexts, past evidence of measurement invariance across diverse ethnic groups demonstrated in Cicero’s study infers that a four-factor model may apply in both Western and Eastern cultures.
In relation to culture, Cohen et al. (2015) suggested that it is important to assess schizotypy in different cultures as social and affective functioning has the potential to vary considerably across cultures. In fact, previous studies have demonstrated variation in schizotypal traits and psychotic-like experiences across countries (Cicero, 2015; Linscott and Van Os, 2013). For example, Caucasian respondents have been reported to have lower scores on the SPQ than other ethnic groups on the ‘interpersonal’ schizotypal factor while Chinese respondents tend to report significantly lower SPQ scores than their Caucasian counterparts (Chen et al., 1997, Cicero, 2015). These findings suggest that potential ethnic or cultural factors were at play, which is worth investigation.
The current study aims to examine the measurement invariance of the four-factor structure of the SPQ-B across samples from both Western (i.e., Australia and Chile) and Eastern cultures (i.e., China). In light of Cicero’s (2015) findings in the United States across multiple ethnic groups, we hypothesized that the four-factor structure in the SPQ-B would be invariant across countries. In addition, in line with reported cultural variations in SPQ scores, we further hypothesized that scores would differ between countries.
Section snippets
Participants
Data for the current study were drawn from a larger series of studies examining schizotypal traits and social cognition (e.g., see Prado et al., 2014). The participants were 729 (M = 23.99 years, SD = 9.87 years) non-clinical community sample and university students recruited in Australia, mainland China, and Chile. A total of 304 males (M = 23.58 years, SD = 7.50 years) and 421 females (M = 24.07 years, SD = 11.05 years) took part in the study. Refer to Table 1 for detailed gender and age
Results
The means, standard deviations and the range of scores on the SPQ-B total scale as well as each of the specified subscales across three countries are presented in Table 2.
Discussion
The aim of the present study was to examine measurement invariance of the four-factor structure of the SPQ-B across Australian, Chinese, and Chilean young adult samples. Unexpectedly, the results of multiple CFA models revealed diverse underlying structures the samples (e.g. 4-factor for Australian and 3-factor for both Chinese and Chilean sample). Further, measurement invariance could not be established. These findings help to improve our understanding of expression of schizotypy with regard
Acknowledgment
This research did not receive funding from agencies in the public, commercial, or not-for-profit sectors. All authors made a substantial contribution to this research and the drafting of the manuscript. The first author would like to acknowledge Lanxi Huang and Gabrielle Wu for their assistance in verifying translations.
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