Aberrant salience predicts fluctuations of paranoia two weeks in advance during a 1-year experience sampling method study in people with psychosis

Abstract

The Experience Sampling Method (ESM) has improved our understanding of psychosis considerably (Myin-Germeys et al., 2018). Not only has ESM shed light on the moment-to-moment variability of psychotic symptoms, it has equally helped to identify micro-level precursor variables that forecast symptom exacerbations a couple of hours in advance. Among others, established ESM-derived precursors are negative affect (Lüdtke et al., 2017) and aberrant salience (Reininghaus et al., 2016), the attribution of novelty and significance to irrelevant stimuli (Kapur, 2003). Learning that these variables precede within-day symptom fluctuations raises the question whether they likewise allow the prediction of larger-scaled symptom deteriorations to target the high rates of relapse in psychosis (Pelayo-Teran et al., 2017). In fact, recent evidence lends support to the idea that ESM and relapse precursors overlap, with negative mood and anxiety being significant predictors in both settings (Buck et al., 2021; Lüdtke et al., 2017).