The role of psychotic-like experiences in the association between aberrant salience and anxiety: A psychopathological proposal based on a case-control study

Aim: Aberrant salience (AS) and psychotic-like experiences (PLEs) have been proven to be linked. Moreover, anxiety is a key symptom in psychosis-prone subjects and most psychotic patients. We propose a model that attempts to interpret the role of PLEs in the association between AS and anxiety among healthy controls and psychotic patients.Methods: Demographic and psychometric data (Aberrant Salience Inventory, Community Assessment of Psychic Experiences, Symptom Check List-90-revised) from 163 controls and 44 psychotic patients was collected. Descriptive statistics, correlations, a linear regression model and a mediation analysis with covariates were subsequently performed.Results: AS correlated with more frequent positive PLEs and higher anxiety levels in both patients and controls. However, positive PLEs' frequency mediated the relationship between AS and anxiety only among controls.Conclusions: PLEs linked to AS appear to induce anxiety among the control group but not among psychotic patients. The progressive loss of both novelty and insight, which may, respectively, impair the somatic emotional reactivity to PLEs and the ability to recognize some bodily phenomena as the embodied correlates of anxiety, is seen as the most probable theoretical explanation.