Skip to main content

Advertisement

SpringerLink
Log in

Assessing Anomalous Perceptual Experiences in Nonpsychiatric Individuals and Outpatients with Psychosis in Taiwan: An Investigation Using the Cardiff Anomalous Perceptions Scale (CAPS)

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

The Cardiff anomalous perceptions scale (CAPS) has been recently designed for the assessment of anomalous perceptual experiences in the general population, and includes dimensions that measure distress, intrusiveness, and frequency. The purpose of this study was to assess the psychometric properties of a Taiwanese version of the CAPS. The English version of the CAPS was translated into Taiwanese (CAPS-T) and the latter was applied to this study. We administered the questionnaire to a consecutive sample of 192 participants with (n = 106; clinical group including schizophrenia and affective psychosis) or without psychotic disorders (n = 86; non-clinical group). In addition to the CAPS-T, the Taiwanese version of the brief psychiatric symptom rating scale (BSRS) measured the severity of the psychopathology. We also tested the psychometric properties of the CAPS-T including construct validity, internal consistency, test–retest reliability, and convergent and discriminative validity. Overall, the CAPS-T showed good construct validity, internal consistency, and stability over time and correlated significantly with the psychoticism subscale of the BSRS. As predicted, the mean differences in CAPS-T scores between participants with or without a psychotic disorder were significant. Convergent and discriminative validity were satisfactory. A score of 5 was found to the best threshold in discriminating between clinical and non-clinical samples. Our findings indicate that the Taiwanese version of the CAPS is a reliable and valid instrument to measure the multidimensionality of perceptual anomalies in general and appears to complement the clinical measures of psychosis proneness in Taiwan.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McGhie A, Chapman J. Disorders of attention and perception in schizophrenia. British Journal of Medical Psychology 34:103–116, 1961

    Article  PubMed  CAS  Google Scholar 

  2. Bunney WE Jr., Hetrick WP, Bunney BG, Patterson JV, Jin Y, Potkin SG, Sandman CA. The structure interview for assessing perceptual anomalities (SIAPA). Schizophrenia Bulletin 25:577–592, 1999

    Article  PubMed  Google Scholar 

  3. Ringel TM, Heidrich A, Jacob CP, Fallgatter AJ. Sensory gating deficit in a subtype of chronic schizophrenic patients. Psychiatry Research 125:237–245, 2004

    Article  PubMed  Google Scholar 

  4. Heitrick WP, Erickson MA, Smith DA. Phenomenological dimensions of sensory gating. Schizophrenia Bulletin 4:1–14, 2010

    Google Scholar 

  5. Braff BL, Geyer MA. Sensorimotor gating and schizophrenia. Archives of General Psychiatry 47:181–188, 1990

    Article  PubMed  CAS  Google Scholar 

  6. Freeman R, Adler LE, Gerhardt GA, Waldo M, Baker N, Rose G, Drebing C, Nagamoto H, Bickford-Wimer P, Franks R. Neurobiological studies of sensory gating in schizophrenia. Schizophrenia Bulletin 13:669–678, 1987

    Article  Google Scholar 

  7. Vohs JL, Cahmbers RA, Krishnan GP. Auditory sensory gating in neonatal ventral hippocampal lesion model of schizophrenia. Neuropsychobiology 60:12–22, 2009

    Article  PubMed  Google Scholar 

  8. Scott J, Chant D, Andrew G, McGrath J. Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample. Psychol Med 36:231–238, 2006

    Article  PubMed  Google Scholar 

  9. van Os J, Linscott RJ, Myin-Germeys I, Delespaul P, Krabbendam L. A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med 39:179–195, 2009

    Article  PubMed  Google Scholar 

  10. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 51:8–19, 1994

    Article  PubMed  CAS  Google Scholar 

  11. Perala J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isomesta E, Pirkola S, Partonen T, Tuulio-Henriksson A, Hintikka J, Kieseppa T, Harkanen T, Koskinen S, Lonnqvist J. Lifetime prevalence of psychotic and bipolar I disorders in the general population. Arch Gen Psychiatry 64:1–28, 2007

    Article  Google Scholar 

  12. van Os J, Hanssen M, Bijl R, Ravelli A. Strauss revised: a psychosis continuum in the general population? Schizophrenia Research 45:11–20, 2000

    Google Scholar 

  13. Kendler KS, Gallagher TJ, Abelson JM, Kessler RC. Lifetime prevalence, demographic risk factors and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archives of General Psychiatry 53:1022–1031, 1996

    Article  PubMed  CAS  Google Scholar 

  14. Rose G. The strategy of preventive medicine. Oxford: Oxford University Press; 1992

    Google Scholar 

  15. APA (American Psychiatric Association). DSM-IV Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington (DC): American Psychiatric Association Press; 2000

  16. World Health Organization. The ICD-10 classifications of mental and behavioral disorders. Geneva: World Health Organization; 1992

    Google Scholar 

  17. Johns LC, van Os J. The continuity of psychotic experiences in the general populations. Clinical Psychology Review 21:1125–1141, 2001

    Article  PubMed  CAS  Google Scholar 

  18. Verdoux H, van OS, J. Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophrenia Research 54:59–65, 2002

    Google Scholar 

  19. Bak M, Delespaul P, Hanssen M, de Graaf R, Vollebergh W, van Os J. How false are “false” positive psychotic symptoms? Schizophrenia Research 62:187–189, 2003

    Article  PubMed  Google Scholar 

  20. Stefanis NC, Hanssen M, Smirnis NK, Avramopoulos DA, Evdokimidis IK, Stefanis CN, Verdoux H, van Os J. Evidence that three dimensions of psychosis have a distribution in the general population. Psychol Med 32:347–358, 2002

    Article  PubMed  CAS  Google Scholar 

  21. van OS J, Hanssen M, Bijl RV, Vollebergh W. Prevalence of psychotic disorders and community level of psychotic symptoms: an urban-rural comparison. Arch Gen Psychiatry 58:663–668, 2001

    Article  PubMed  Google Scholar 

  22. Hanssen M, Maarten B, Bob B, Vollebergh W, van Os J. The incidence and outcome of subclinical psychotic experiences in the general population. Br J Clin Psychology 44:181–191, 2005

    Article  Google Scholar 

  23. Welham J, Scott J, Williams G, Najman J, Bor W, o’Callaghan M, McGrath J. Emotional and behavioural antecedents of young adults who scree positive for non-affective psychosis: a 21-year birth cohort study. Psychol Med 39:625–634, 2009

    Article  PubMed  CAS  Google Scholar 

  24. Poulton R, Caspi A, Moffitt TE, Cannon M, Murray R, Harrington H. Children’s self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatry 57:1053–1058, 2000

    Article  PubMed  CAS  Google Scholar 

  25. Scott J, Martin G, Welham J, Bor W, Najman J, O’callaghan M, Williams G, Aird R, McGrath J. Psychopathology during childhood and adolescence predicts delusional-like experiences in adults: a 21-year birth cohort study. American Journal of Psychiatry 166:567–574, 2009

    Article  PubMed  Google Scholar 

  26. Krawiecka M, Goldberg D, Vaughn M. A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica 55:299–308, 1977

    Article  PubMed  CAS  Google Scholar 

  27. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13:261–276, 1987

    Article  PubMed  CAS  Google Scholar 

  28. Chadwick P, Birchwood M. The omnipotence of voices: a cognitive approach to auditory hallucination. British Journal of Psychiatry 164:190–201, 1994

    Article  PubMed  CAS  Google Scholar 

  29. Miller L. Qualitative changes in hallucinations. American Journal of Psychiatry 153: 265–267, 1996

    PubMed  CAS  Google Scholar 

  30. Carter DM, Mackinnon A, Howard S, Zeegers T, Copolov DL. The development and reliability of the Mental Health Research Institute Unusual Perceptions Schedule (MUPS) An instrument to record auditory hallucinatory experience. Schizophrenia Research 16:157–165, 1995

    Article  PubMed  CAS  Google Scholar 

  31. Haddock G, McCARRON J, Tarrier N, Faragher EB. Scale to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine 29:879–889, 1999

    Article  PubMed  CAS  Google Scholar 

  32. Spauwen J, Krabbendam L, Lieb R, Wittchen H-U, van Os J. Sex differences in psychosis: normal or pathological? Schizophrenia Research 62:45–49, 2003

    Article  PubMed  Google Scholar 

  33. Muller M, Vetter S, Buchli-Kammermann J, Stieglitz R-D, Stettbacher A, Riecher-Rossler A. The self-scree-prodrome as a short screening tool for pre-psychotic states. Schizophrenia Research 123:217–224, 2010

    Article  PubMed  Google Scholar 

  34. Nishida A, Tanii H, Nishimura Y, Kajiki N, Inoue K, Okada M, Sasaki T, Okazaki Y. Associations between psychotic-like experiences and mental health status and other psychopathologies among Japanese early teens. Schizophrenia Research 99:125–133, 2008

    Article  PubMed  Google Scholar 

  35. Kelleher I, Kelleher I, Cannon M. Psychotic-Like Experiences in the general population: characterizing a high-risk group for psychosis. Psychological Medicine 41:1–6, 2011

    Article  PubMed  CAS  Google Scholar 

  36. Young DA, Campbell Z, Zakzanis KK, Weinstein E. A comparison between an interview and a self-report method of insight assessment in chronic schizophrenia. Schizophrenia Research 63:103–109, 2003

    Article  PubMed  Google Scholar 

  37. Marks KA, Fastenau PS, Lysaker PH Bond GR. Self-appraisal of illness questionnaire (SAIQ): relationship to researcher-rated insight and neuropsychological function in schizophrenia. Schizophrenia Research 45:203–211, 2000

    Article  PubMed  CAS  Google Scholar 

  38. Karow A, Pajonk FG, Reimer F, Hirdes F, Osterwald C, Naber D, Mortiz S. The dilemma of insight into illness in schizophrenia: self- and expert-rated insight and quality of life. European Archives of Psychiatry and Clinical Neuroscience 258:152–159, 2008

    Article  PubMed  CAS  Google Scholar 

  39. McEvoy JP, Apperson LJ, Appelbaum PS, Ortlip P, Brecosky J, Hammill K, Geller JL, Roth L. Insight in schizophrenia. Its relationship to acute psychopathology. Journal of Nervous and Mental Disease 177:43–47, 1989

    Article  PubMed  CAS  Google Scholar 

  40. Lappin JM, Morgan KD, Valmaggia LR, Broome MR, Woolley JB, Johns LC, Tabraham P, Bramon E, McGuire PK. Insight in individuals with an At Risk Mental State. Schizophrenia Research 90 (1–3):238–244, 2007

    Article  PubMed  Google Scholar 

  41. Biancosino B, Barbui C, Marmai L, Fagioli F, Sabatelli R, Grassi L. Relationship between self-reported and observer-reported ratings for psychopathology in psychiatric inpatients. Psychopathology 40:418–423, 2007

    Article  PubMed  Google Scholar 

  42. Peters ER, Joseph SA, Garety PA. Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia Bulletin 25:553–576, 1999

    Article  PubMed  CAS  Google Scholar 

  43. Laroi F, Van der Linden M. Metacognitions in proneness towards hallucinations and delusions. Behaviour Research and Therapy 43:1425–1441, 2005

    Article  PubMed  CAS  Google Scholar 

  44. Preti A, Sardu C, Piga A. Mixed-handedness is associated with the reporting of psychotic-like beliefs in a non-clinical Italian sample. Schizophrenia Research 92:15–23, 2007

    Article  PubMed  Google Scholar 

  45. Chadwick P, Birchwood M. The omnipotence of voices II: The beliefs about voices questionnaire (BAVQ). British Journal of Psychiatry 166:773–776, 1995

    Article  PubMed  CAS  Google Scholar 

  46. Bell V, Halligan PW, Ellis HD. The cardiff anomalous perceptions scale (CAPS): a new validated measure of anomalous perceptual experience. Schizophrenia Bulletin 32(2):366–377, 2006

    Article  PubMed  Google Scholar 

  47. Loewy RL, Johnson JK, Cannon TD. Self-report of attenuated psychotic experiences in a college population. Schizophrenia Research 93:144–151, 2007

    Article  PubMed  Google Scholar 

  48. Rossler W, Riecher-Rossler A, Angst J, Murray R, Gamma A, Eich D, van Os J, Gross VA. Psychotic experiences in the general population: a twenty-year prospective community study. Schizophrenia Research 92:1–14, 2007

    Article  PubMed  Google Scholar 

  49. Krzanowski WJ, Hand DJ. ROC curves for continuous data. Chapman & Hall/CRC, Boca Raton; 2009

    Book  Google Scholar 

  50. Lee MB, Lee YJ, Yen LL, Lin MH, Lue BH. Reliability and validity of using a brief psychiatric symptom rating scale in clinical practice. Journal of the Formosan Medical Association 89(12):1081–1087, 1990

    PubMed  CAS  Google Scholar 

  51. Nunnally JC, Bernstien IH. Psychometric theory, 3rd ed. New York: MacGraw-Hill; 1994.

    Google Scholar 

  52. Portney LG, Watkins MP. Foundations of clinical research: applications to practice 2nd ed. Upper Saddle River: Prentice-Hall; 2000

    Google Scholar 

  53. Auquier P, Simeoni MC, Sapin C, Reine G, Aghababian V, Cramer J, Lancon C. Development and validation of a patient-based health-related quality of life questionnaire in schizophrenia: the S-QOL. Schizophrenia Research 63:137–149, 2003

    Article  PubMed  CAS  Google Scholar 

  54. Youden WJ. Index for rating diagnostic tests. Cancer 3:32–35, 1950

    Article  PubMed  CAS  Google Scholar 

  55. Faraggi D. The effect of random measurement error on receiver operating characteristic (ROC) curves. Statistics in Medicine 19:61–70, 2000

    Article  PubMed  CAS  Google Scholar 

  56. Reiser B. Measuring the effectiveness of diagnostic markers in the presence of measurement error through the use of ROC curves. Statistics in Medicine 19:2115–2129, 2000

    Article  PubMed  CAS  Google Scholar 

  57. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143:29–36, 1982

    PubMed  CAS  Google Scholar 

  58. Hosmer, DW, Lemeshow S. Applied logistic regression, 2nd edn. Willey, New York; 1989.

    Google Scholar 

  59. Claridge G, McCreery C, Mason O, Bentall R, Boyle G, Slade P, Popplewel ID. The factor structure of “schizotypal” traits: a large replication study. British Journal of Clinical Psychology 35:103–115, 1996

    Article  PubMed  Google Scholar 

  60. Venables P, Bailes K. The structure of schizotypy, its relation to subdiagnoses of schizophrenia and to sex and age. British Journal of Clinical Psychology 33:277–294, 1994

    Article  PubMed  Google Scholar 

  61. Raine A. Sex differences in schizotypal personality in nonclinical population. Journal of Abnormal Psychology 101:361–364, 1992

    Article  PubMed  CAS  Google Scholar 

  62. Armando M, Nelson B, Yung AR, Ross M, Birchwood M, Girardi P, Nastro PF. Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophrenia Research 119(1–3):258–265, 2010

    Article  PubMed  Google Scholar 

  63. Brett CMC, Johns LC, Peters EP, McGuire PK. The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomalies. Psychological Medicine 39:939–950, 2009

    Article  PubMed  CAS  Google Scholar 

  64. Bak M, Myin-Germeys I, Delespaul P, Vollebergh W, de Graaf R, van Os J. Do different psychotic experiences differentially predict need for care in the general population? Comprehensive Psychiatry 46(3):192–199, 2005

    Article  PubMed  Google Scholar 

  65. Hanssen M, Krabbendam L, de Graaf R, Vollebergh W, de Graaf R, van Os J. Role of distress in delusion formation. British Journal of Psychiatry 48:s55–s58, 2005

    Article  Google Scholar 

  66. Murphy J, Shevlin M, Houston J, Adamson G. A population based analysis of subclinical psychosis and help-seeking behavior. Schizophrenia Bulletin; 2010 (in press)

  67. Rivas T, Bersabe R, Jimenez M, Berrocal C. The eating attitudes test (EAT-26): reliability and validity in Spanish female samples. Spanish Journal of Psychology 13(2):1044–1056, 2010

    Article  PubMed  Google Scholar 

  68. Hanssen M, Krabbendam L, Vollema M, Delespaul P, van Os J. Evidence for instrument and family-specific variation of sub clinical psychosis dimensions in the general population. Journal of Abnormal Psychology 115:5–14, 2006

    Article  PubMed  CAS  Google Scholar 

  69. Rocchi-Marco BL, Sisti D, Manca S, Siddi S, Mura T, Preti A. Latent class analysis of delusion-proneness: exploring the latent structure of the Peters et al. Delusions Inventory. Journal of Nervous and Mental Disease 196(8):620–629, 2008

    Article  CAS  Google Scholar 

  70. Shevlin M, Murphy J, Dorahy MJ, Adamson G. The distribution of positive psychosis-like symptoms in the population: a latent class analysis of the national comorbidity survey. Schizophrenia Research 89:101–109, 2007

    Article  PubMed  Google Scholar 

  71. Hanssen MS, Bijl RV, Vollebergh W, van Os J. Self-reported psychotic expressions in the general population: a valid screening tool for DSM-III-R psychotic disorders? Acta Psychiatrica Scandinavica 10:369–377, 2003

    Article  Google Scholar 

  72. Jung HY, Chang JS, Yi JS, Hwang S, Shin HK, Kim JH, Cho IH, Kim YS. Measuring psychosis proneness in nonclinical Korea population: is the Peters et al. Delusions Inventory useful for assessing high-risk individuals? Comprehensive Psychiatry 49:201–210, 2008

    Google Scholar 

  73. Nishida A, Tanii H, Nishimura Y, Kajiki N, Inoue K, Okada M, Sasaki T, Okazaki Y. Associations between psychotic-like experiences and mental health status and other psychopathologies among Japanese early teens. Schizophrenia Research 99:125–133, 2008

    Article  PubMed  Google Scholar 

  74. Kelleher I, Kelleher I, Cannon M. Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychological Medicine 41:1–6, 2011

    Article  PubMed  CAS  Google Scholar 

  75. Lincoln TM. Relevant dimensions of delusions: continuous the continuum versus category debate. Schizophrenia Research 93:211–220, 2007

    Article  PubMed  Google Scholar 

  76. Lincoln TM, Ziegler M, Lullmann E, Muller MJ, Rief W. Can delusions be self-assessed? Concordance between self- and observer-rated delusions in schizophrenia. Psychiatry Research 178:249–254, 2010

    Article  PubMed  Google Scholar 

  77. Jovanovski D, Zakzanis KK, Atia M, Campbell Z, Young DA. A comparison between a researcher-rated and a self-reported method of insight assessment in chronic schizophrenia revisited. Journal of Nervous and Mental Disease 195(2):165–169, 2007

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The author declares that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Songshan Armed Forces General Hospital, Taipei, Taiwan, ROC

    Yu-Chen Kao & Chien-Wen Lu

  2. Department of Psychiatry, Taipei Tzu Chi General Hospital, New Taipei City, Taiwan, ROC

    Tzong-Shi Wang

  3. Department of Physiology and Biophysics, National Defense Medical Center, No. 161, Section 6, Min-Chuan East Road, Taipei, 114, Taiwan, ROC

    Yia-Ping Liu

  4. School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC

    Yu-Chen Kao

Authors
  1. Yu-Chen Kao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tzong-Shi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chien-Wen Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yia-Ping Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yia-Ping Liu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kao, YC., Wang, TS., Lu, CW. et al. Assessing Anomalous Perceptual Experiences in Nonpsychiatric Individuals and Outpatients with Psychosis in Taiwan: An Investigation Using the Cardiff Anomalous Perceptions Scale (CAPS). Psychiatr Q 84, 137–157 (2013). https://doi.org/10.1007/s11126-012-9234-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-012-9234-2

Keywords

Search

Navigation