Personality Across the Psychosis Continuum: A Fine-Grained Perspective

Background Personality is associated with the etiology, course and outcome of psychosis. Yet, more specific knowledge on this association, beyond the global domains of the Five-Factor Model, is scarce. One way to investigate this is to study the personality profile of individuals having frequent psychosis-like experiences (PE), but without clinical psychosis or Cluster A personality disorder and compare them to patients with such symptoms.

Methods We included 134 individuals with non-clinical PE, 40 psychotic disorder patients and 126 healthy controls. Participants completed the NEO-PI-R. Domain and facet-level data were compared across groups.

Results As expected, group differences were significant for Neuroticism, Openness and Conscientiousness. Facet-level analyses showed intermediate levels of Depression and Anxiety (N) in individuals with non-clinical PE, together with high Fantasy, Aesthetics and Ideas (O) compared to controls. Notably, they displayed high Angry Hostility (N) and Feelings (O), along with low Trust (A) and Gregariousness (E). Patients showed high Vulnerability and Self-Consciousness (N), and low Competence and Self-discipline (C), while both non-clinical groups showed similar levels.

Conclusions This is the first study to analyze both domain and facet-level data across the psychosis continuum. Our findings show how the facets Hostility and Feelings, low Trust and Gregariousness may be related to general PE proneness, both in non-clinical and clinical individuals alike, while Vulnerability and Self-Consciousness, low Competence and low Self-discipline may differentiate patients from individuals with non-clinical PE. Current results encourage intervention strategies targeting coping and social skills for youth at risk for psychosis.