Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway

Margriet Vermeiden, M. Janssens, V.H.M. Thewissen, Esther Akinsola, S.C.T. Peeters, J.S.A.M. Reijnders, N.E. Jacobs, Jim van Os, J.J.E. Lataster*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students.
Methods: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples.
Results: Only CAPE-Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levels
of experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples.
Conclusion: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, if
not more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.
Original languageEnglish
Article number244
Pages (from-to)1-15
Number of pages15
JournalBMC Psychiatry
Volume19
DOIs
Publication statusPublished - 6 Aug 2019

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Norway
Nigeria
Netherlands
Students
Psychotic Disorders
Population
Paranoid Disorders
Statistical Factor Analysis
Multivariate Analysis
Psychology

Keywords

  • Community Assessment of Psychic Experiences
  • Psychosis
  • schizophrenia
  • mental illness
  • stress
  • Epidemiology
  • General population
  • cross-national perspective
  • Cross-cultural comparisons

Cite this

@article{64b1b960245e478e9c55c9e4fe99a6cf,
title = "Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway",
abstract = "Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students.Methods: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples.Results: Only CAPE-Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levelsof experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples.Conclusion: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, ifnot more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.",
keywords = "Community Assessment of Psychic Experiences, Psychosis, schizophrenia, mental illness, stress, Epidemiology, General population, cross-national perspective, Cross-cultural comparisons",
author = "Margriet Vermeiden and M. Janssens and V.H.M. Thewissen and Esther Akinsola and S.C.T. Peeters and J.S.A.M. Reijnders and N.E. Jacobs and {van Os}, Jim and J.J.E. Lataster",
year = "2019",
month = "8",
day = "6",
doi = "10.1186/s12888-019-2210-8",
language = "English",
volume = "19",
pages = "1--15",
journal = "BMC Psychiatry",
issn = "1471-244X",
publisher = "BioMed Central Ltd.",

}

TY - JOUR

T1 - Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42)

T2 - a comparison of student populations in the Netherlands, Nigeria and Norway

AU - Vermeiden, Margriet

AU - Janssens, M.

AU - Thewissen, V.H.M.

AU - Akinsola, Esther

AU - Peeters, S.C.T.

AU - Reijnders, J.S.A.M.

AU - Jacobs, N.E.

AU - van Os, Jim

AU - Lataster, J.J.E.

PY - 2019/8/6

Y1 - 2019/8/6

N2 - Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students.Methods: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples.Results: Only CAPE-Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levelsof experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples.Conclusion: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, ifnot more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.

AB - Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students.Methods: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples.Results: Only CAPE-Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levelsof experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples.Conclusion: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, ifnot more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.

KW - Community Assessment of Psychic Experiences

KW - Psychosis

KW - schizophrenia

KW - mental illness

KW - stress

KW - Epidemiology

KW - General population

KW - cross-national perspective

KW - Cross-cultural comparisons

U2 - 10.1186/s12888-019-2210-8

DO - 10.1186/s12888-019-2210-8

M3 - Article

VL - 19

SP - 1

EP - 15

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

M1 - 244

ER -