Elsevier

Comprehensive Psychiatry

Volume 93, August 2019, Pages 48-55
Comprehensive Psychiatry

Examining the structure of ideas of reference in clinical and community samples

https://doi.org/10.1016/j.comppsych.2019.06.006Get rights and content
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Highlights

  • Ideas of reference to early detection of psychosis and following at-risk mental states

  • REF scale: reliability, validity in a non-help-seeking and in a very young population

  • Similar psychometric indicators were obtained with the consideration of patients.

  • The structure of ideas of reference is similar in adolescents, adults, and in patients.

Abstract

Aims

This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis.

Methods

A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses—154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84.

Results

Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the “causal explanations”, “Songs, newspapers, books” and “laughing and commenting” REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders.

Conclusions

The results provide satisfactory that the REF scale could be used to study psychosis.

Keywords

Referential thinking
Ideas of reference
REF scale
Proneness to psychosis
Schizophrenia

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