Table of Contents
Abstract
The Early Psychotic Symptoms Screening Scale, also known as EPSy, was formulated by Babinet, Demily, and Michael in 2023. It serves as a screening instrument designed to evaluate the prodromal signs of psychotic symptoms in children within the age range of 4 to 13 years. The scale was developed in two distinct versions: one for assessing the child’s present behavior and another retrospective version for evaluating the child’s behavior at the age of two. The development of the questions was a comprehensive process, drawing from multiple established sources. These include questionnaires that measure schizotypal characteristics in children, such as The Melbourne Assessment Schizotypy in Kids (MASK) by Jones et al. (2015), and tools for assessing child anxiety, like The Screen for Child Anxiety Related Emotional Disorders (SCARED) by Birmaher et al. (1997). Additionally, the item generation was informed by interviews conducted with families of patients and with professionals, including psychiatrists, child psychiatrists, psychologists, and nurses, who are considered experts in childhood psychiatric disorders. To ensure the clinical relevance of the items, discussions were held with these expert professionals to confirm that the questions aligned with real-world clinical presentations. This meticulous process initially yielded 24 items. Data for the scale’s validation were gathered through two separate studies involving samples of French-speaking children. Subsequent factor analysis led to the refinement of the scale, resulting in a final version with 22 items categorized into three distinct dimensions. The research also reported comprehensive results regarding the scale’s reliability and validity.
Keywords
Childhood Early Psychotic Symptoms; Disorganization Symptoms; Mistrust/Paranoia Symptoms; Perceptual Aberrations/Hallucinations Symptoms; Symptom Screening
Authors
Babinet, Marie-Noëlle; Demily, Caroline; Michael, George A.
Purpose
The EPSy scale is designed to assess the prodromes of psychotic symptoms in children who are between 4 and 13 years of age.
Construct
The primary construct measured by this instrument is Early Psychotic Symptoms.
Validity
The scale demonstrates satisfactory convergent validity. This was established through significant correlations observed between both versions of the scale (current-age and 2-years-old), each of its individual factors, and several external measures. These measures included the Melbourne Assessment Schizotypy in Kids (MASK; Jones et al., 2015), assessments of aggression behavior, the Conners Parent Rating Scale-48 items (CPRS; Catale et al., 2014; Conners, 1969; Dugas et al., 1987), and the DSM-V criteria. All correlation coefficients were found to be greater than 0.127 with p-values less than .05.
Further evidence of validity comes from regression analysis, which indicated that the total score on the 2-years-old version significantly predicted the total score on the current-age version of the scale (F(2237) = 197.4, p < .001, R2 = 0.63; β = 0.79; SEM = 0.03; t(239) = 19.9, p < .001), with age showing no effect. The analysis also revealed that the mistrust/paranoia factor on the 2-years-old scale was a significant predictor of the mistrust/paranoia factor on the current-age scale (F (2237) = 152.4, p < .001, R2 = 0.56; β = 0.67; SEM = 0.04; t(239) =17.4, p < .001).
Reliability
Internal consistency: For the retrospective version assessing behavior at 2 years old, the Cronbach’s alpha coefficient for the total EPSy score was 0.90. The alpha coefficients for its three factors ranged from 0.65 to 0.84. For the current-age version, the total score yielded a Cronbach’s alpha of 0.85, with the coefficients for the three factors ranging from 0.65 to 0.85.
Test-retest reliability: A one-year test-retest interval was used. For the 2-years-old version, the Pearson correlation coefficient for the total score was 0.99. The coefficients for the factors were 0.99 for mistrust/paranoia, 0.99 for perceptual aberrations/hallucinations, and 0.98 for disorganization (all p-values < .001). For the current-age version, the one-year test-retest Pearson correlation was 0.99 (CI95%: 0.98 to 0.99, p < .001). The coefficients for its factors were 0.97 for mistrust/paranoia, 0.99 for perceptual aberrations/hallucinations, and 0.97 for disorganization (all p-values < .001).
Factor Analysis
Exploratory and Confirmatory factor analysis: An initial principal component analysis (PCA) was performed, which identified three factors that collectively explained 37.4% of the total variance. During this process, two items (Item 6 and Item 14) failed to load significantly onto any of the factors. This was interpreted as an indication of a lack of sensitivity, and consequently, these two items were removed from the scale. This resulted in a final set of 22 items. A Confirmatory Factor Analysis (CFA) was then conducted on the 2-years-old version, with the objective of determining if the factor structure from the current-age version was predicted by the factors at age 2. The analysis suggested that the 3-factor model of the current-age version is applicable to the 2-years-old version, with the following fit indices: χ2(206) = 1171, χ2/df = 5.68, CFI = 0.66, TLI = 0.62, RMSEA = 0.14, SRMR = 0.11, AIC = 5142, GFI = 0.68, MFI = 0.13. These results are indicative of a reasonably good fit, though not a perfect one.
Instrument
Test Type: This is an Original instrument that functions as a Screener.
Format: Each of the 22 items is rated on a Likert scale that ranges from 0 to 3. The test can be administered electronically or via a paper-and-pencil format.
Language Available: The instrument is available for use in French. The source materials are available in both English and French.
Population Group: The scale is intended for use with humans, including both males and females.
Age Group: The target age group is Childhood (birth-12 yrs), specifically covering Preschool Age (2-5 yrs), School Age (6-12 yrs), and early Adolescence (13-17 yrs). The primary respondent group is children aged 4 to 13 years.
Population Details: The validation studies were conducted in France, with children between the ages of 4 and 13 serving as the respondents.
Test Methodology: The development and validation of the scale involved evaluations of Test Validity, Convergent Validity, Test Reliability, Internal Consistency, Test-Retest Reliability, Factor Analysis, Confirmatory Factor Analysis, Exploratory Factor Analysis, and Principal Component Analysis.
Keywords
Child Psychopathology; Early Childhood Development; Hallucinations; Paranoia; Mental Health Screening; Thought Disorders
Authors
Author ocrid Identifier and Affiliation
Babinet, Marie-Noëlle: http://orcid.org/0000-0001-7784-8489
CNRS & Université Lyon 1, Centre Hospitalier Le Vinatier, Centre d’excellence Autisme iMIND Centre de Rérence Maladies Rares Troubles du Comportement d’Origine Génétique (GénoPsy Lyon)Demily, Caroline:
CNRS & Université Lyon 1, Centre Hospitalier Le Vinatier, Centre d’excellence Autisme iMIND Centre de Rérence Maladies Rares Troubles du Comportement d’Origine Génétique (GénoPsy Lyon)Michael, George A.: http://orcid.org/0000-0001-9071-4303
Université de Lyon, Université Lumiére Lyon 2 Unité de Recherche Étude des Mécanismes Cognitifs
Email addresses
Babinet, Marie-Noëlle: [email protected]
Correspondence Address
Babinet, Marie-Noëlle: CNRS & Université Lyon 1, UMR 5229, Centre Hospitalier Le Vinatier, Centre d’excellence Autisme iMIND, Centre de Référence Maladies Rares Troubles du Comportement d’Origine Génétique (GénoPsy Lyon), 95 Boulevard Pinel, Bron, France, 69500, [email protected]
Permissions & Fee and Test Year
The instrument was developed in 2023. It is not a commercial product and there is no fee for its use. It may be used for Research/Teaching purposes.
reference’s
Babinet, M.-N., Demily, C., & Michael, G. A. (2023). A new scale for the screening of childhood early psychotic symptoms. Psychiatry Research, 327, 1–12. https://doi.org/10.1016/j.psychres.2023.115418
Items of the Early Psychotic Symptoms Screening Scale (EPSy)
This is a 22-item measure. The complete list of test items is available in the source publication, specifically in Table 3 on pages 6-7 of the referenced article.
The items are grouped into three factors or subscales:
Mistrust/Paranoia symptoms
Perceptual aberrations/Hallucinations symptoms
Disorganization symptoms
Mistrust/paranoia symptoms
| French version | English version |
| A l’impression que les gens autour de lui ont l’intention de lui faire du mal | Feels like people around him intend to hurt him |
| Est méfiant envers les autres ou face à des situations | Is suspicious of others or of situations |
| A l’impression que les autres se moquent de lui | Thinks that other people are laughing at him |
| A une tendance é l’isolement que ce soit dans la cour de récréation ou bien en dehors de l’école | Has a tendency to be isolated whether in the playground or outside of school |
| Se comporte de façon inadaptée face aux émotions des autres faisant penser qu’il ne les comprend pas | Reacts inappropriately to other people’s emotions, making them think he does not understand them |
| A des difficultés pour gérer ses propres émotions | Has difficulty dealing with his own emotions |
| A tendance à ne pas regarder les gens dans les yeux, à fuir le regard des autres | Tends not to look people in the eye, to avoid the gaze of others |
| Se comporte de façon inadaptée lorsqu’un regard est dirigée vers lui comme s’il l’interprétait mal | Behaves inappropriately when people look at him, as if he is misinterpreting them |
| His speech contains unusual intonations (e.g. monotonous voice, lack of rhythm in his speech, does not change the volume of his voice depending on the place or the situation) | Has difficulty understanding humor, irony or innuendo |
| Est anxieux, stressé | Is anxious, stressed |
| Semble effrayé ou paniqué dans des situations anodines | Appears scared or panicked by trivial situations |
| Se montre méfiant de manière inexpliquée ou inhabituelle é l’égard d’événements ou de personnes | Is inexplicably or unusually suspicious of events or people |
Perceptual aberrations/Hallucinations symptoms
| French version | English version |
| A des idées, des croyances qui semblent inhabituelles ou bizarres | Has ideas, beliefs that seem unusual or weird |
| A déjà parlé de choses qu’il voit ou entend dans la nuit | Has spoken about things he sees or hears at night |
| Semble voir ou entendre des choses que les autres ne voient pas | Seems to see or hear things that others cannot see |
| Parle de sons, de visions, d’odeurs ou de sensations exacerbés, altérés ou bizarres | Talks about intensified, impaired or bizarre sounds, sights, smells or sensations |
Disorganization symptoms
| French version | English version |
| Ne distingue pas les histoires qu’il raconte et la réalité | Does not distinguish between the stories he tells and reality |
| A un discours confus qui empêche son interlocuteur de suivre le fil conducteur et de comprendre le récit | Has confused speech that prevents the person he is talking to from following what he is talking about and understanding him |
| Sa voix présente des intonations inhabituelles (ex. voix monotone, absence de rythme dans son discours, ne modifie pas le volume de sa voix en fonction de l’endroit ou de la situation) | His speech contains unusual intonations (e.g. monotonous voice, lack of rhythm in his speech, does not change the volume of his voice depending on the place or the situation) |
| Est désorganisé dans son comportement | Is disorganized in his behavior |
| Coupe la parole, suit son idée, fait des digressions donnant l’impression qu’il ne s’intéresse pas à son interlocuteur | Interrupts others when they are talking, pursues his own thoughts, digresses, giving the impression that he is not interested in the person he is talking to |
Note . Each item is rated on a Likert scale (0: This behavior is absent; 1: This behavior is present and it is not at all a problem; 2: This behavior is present and it is a minor problem; 3: This behavior is present and it is a major problem). Two items (Items 6 and 14) did not load on either factor and were therefore dropped.
Cite this article
Mohammed looti (2026). Early Psychotic Symptoms Screening Scale (EPSy). PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/early-psychotic-symptoms-screening-scale-epsy/
Mohammed looti. "Early Psychotic Symptoms Screening Scale (EPSy)." PSYCHOLOGICAL SCALES, 6 Apr. 2026, https://scales.arabpsychology.com/s/early-psychotic-symptoms-screening-scale-epsy/.
Mohammed looti. "Early Psychotic Symptoms Screening Scale (EPSy)." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/early-psychotic-symptoms-screening-scale-epsy/.
Mohammed looti (2026) 'Early Psychotic Symptoms Screening Scale (EPSy)', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/early-psychotic-symptoms-screening-scale-epsy/.
[1] Mohammed looti, "Early Psychotic Symptoms Screening Scale (EPSy)," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, April, 2026.
Mohammed looti. Early Psychotic Symptoms Screening Scale (EPSy). PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.