Fear of annihilation in subjects at risk of psychosis: A pilot study

Most reports on people at risk of psychosis focus on differences in baseline measures between those who go on to develop psychosis and those who remain non-psychotic. Due to the clinical status of subjects in these studies, the aim of the present study is to illuminate clinically important and under-researched characteristics of the group of subjects at risk of psychosis as a whole. This article reports on a cross-sectional study, comparing the level of annihilation anxiety in subjects at risk of psychosis with two control groups: healthy controls and schizophrenia patients. The level of annihilation anxiety is assessed with the Hurvich Experience Inventory-50. The study shows that subjects at risk of psychosis experience annihilation anxiety significantly more than do healthy controls, and at least as much as psychotic patients diagnosed with schizophrenia. This signals the need for immediate clinical intervention in this population. The high level of annihilation anxiety is likely to interfere with the working alliance, thus clinicians should provide an ambience of safety and transparency. In addition, interventions for subjects at risk of psychosis should aim to reduce the level of anxiety, e.g. through psychotherapy. The study warrants further investigations of clinically important characteristics of the group of subjects at risk of psychosis as a whole