Psychiatry Investig.  2023 Jul;20(7):625-634. 10.30773/pi.2023.0011.

Validation of the Korean Version of the Community Assessment of Psychic Experiences in General Population

Affiliations
  • 1Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
  • 2Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • 3Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, London, UK
  • 4Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
  • 5NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
  • 6The Traumatic Stress Clinic, St Pancras Hospital, Camden & Islington NHS Foundation Trust, London, UK
  • 7National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
  • 8Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea

Abstract


Objective
The Community Assessment of Psychic Experiences has been widely translated and commonly used as a measure for psychotic experiences and psychosis proneness in clinical and research environments worldwide. This study aimed to establish the psychometric properties (reliability and validity) and factor structure of a Korean version of the Community Assessment of Psychic Experiences (K-CAPE) in the general population.
Methods
A total of 1,467 healthy participants completed K-CAPE and other psychiatric symptom-related scales (Paranoia scale, Patient Health Questionnaire-9, Dissociative Experiences Scale-II, and Oxford-Liverpool Inventory of Feelings and Experiences) via online survey. K-CAPE’s internal reliability was analyzed using Cronbach’s alpha coefficient. Confirmatory factor analysis (CFA) was performed to investigate whether the original three-factor model (positive, negative, and depressive) and other hypothesized multidimensional models (including positive and negative subfactors) were suitable for our data. Exploratory factor analysis (EFA) was conducted to explore better alternative factor solutions with a follow-up CFA. To assess convergent and discriminant validity, we examined correlations between KCAPE subscales with other established measures of psychiatric symptoms.
Results
K-CAPE showed good internal consistency in all original three subscales (all greater than α=0.827). The CFA demonstrated that the multidimensional models exhibited relatively better quality than the original three-dimensional model. Although the model fit indices did not reach their respective optimal thresholds, they were within an acceptable range. Results from the EFA indicated 3–5 factor solutions. In 3-factor solution, “negative-avolition” items were founded to be loaded more consistently with depressive items than with the negative dimension. In 4-factor solution, positive items were divided into two subfactors: “positive-bizarre experiences” and “positive-delusional thoughts,” while negative symptoms were separated into two distinct subfactors in 5-factor solution: “negative-avolition (expressive),” and “negative-social (experiential).” The correlation coefficients between K-CAPE subscales and corresponding measurements were significant (p<0.001), confirming the convergent and discriminant validity.
Conclusion
Our study provides evidence to support the reliability and validity of the K-CAPE and its use as a measure of psychotic symptoms in the Korean population. Although alternative factor structures did not improve the model fit, our EFA findings implicate the use of subfactors to investigate more specific domains of positive and negative symptoms. Given the heterogeneous nature of psychotic symptoms, this may be useful in capturing their different underlying mechanisms.

Keyword

Community assessment of psychic experiences; Psychosis; Validation study; Reliability and validity; Prodromal symptoms
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