Measurement Invariance of Commonly Used Psychosis-Screening Scales in US Spanish- and English-Speaking Hispanic Participants

Two of the most commonly used psychosis screening measures are the Prodromal Questionnaire-Brief (PQ-B) and the Youth Psychosis at Risk Questionnaire-Brief (YPARQ-B). Both scales have considerable support for the reliability and validity of their scores for use with English- and Spanish-speaking participants, with measurement equivalence established across a subset of demographic characteristics. However, measurement invariance has not been examined across several important demographic variables, including native language, language of the scales used with Hispanic participants, education, occupation, income, birth country, and generation status. In the present study, (N = 1,191) measurement invariance was examined for each of these variables across three samples (ns = 505, 714, and 126). The PQ-B total scores and YPARQ-B were found to demonstrate configural and scalar invariance, while PQ-B Distress scores displayed configural, metric, and scalar invariance across most tested demographic variables. Psychosis scores were associated with social determinants of health (SDoH) including major and everyday experiences of discrimination, food insecurity, financial insecurity, acculturation, and ethnic identity. The associations between psychosis and SDoH were mostly consistent across groups. Compared to White-non-Hispanic participants, Hispanic participants had higher scores on all psychosis measures and tended to have higher scores on discrimination, food and housing insecurity, affirmation aspects of ethnic identity, and acculturative stress. Despite differences in psychosis levels, the groups did not differ in history of treatment. Overall, these results provide strong evidence that the PQ-B and YPARQ provide equivalent, nonbiased, valid, and reliable scores in Hispanic and Non-Hispanic participants in both English and Spanish. Public Significance Statement Two commonly used psychosis measures displayed measurement invariance across a range of demographic variables including language, race, ethnicity, gender, age, and education. These scales can be used in both English- and Spanish-speaking Hispanic populations to screen for psychosis and yield equivalent scores.

Automated summary

Two commonly used psychosis screening measures, PQ-B and YPARQ-B, have been found to be reliable and valid in English- and Spanish-speaking participants. However, they have not been tested for measurement invariance across important demographic variables. In this study, measurement invariance was examined for variables including native language, education, income, and birth country. The results showed that PQ-B and YPARQ-B demonstrated configural and scalar invariance, and PQ-B Distress scores displayed configural, metric, and scalar invariance. These measures are also associated with social determinants of health and showed consistent associations across different groups.