{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:34:56Z","timestamp":1790015696376,"version":"4.0.1"},"reference-count":158,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Psychotic\u2010like experiences (PLEs) are subthreshold psychotic phenomena that occur along the psychosis continuum and are frequently accompanied by distress. However, the factors underlying distress in individuals reporting PLEs\u2014particularly within non\u2010clinical populations\u2014remain insufficiently understood. This systematic review aims to synthesise the evidence on factors directly or indirectly associated with distress in PLEs among non\u2010clinical samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic search of Medline, Web of Science, Embase, and Cochrane (January 2000\u2013March 2025) using the terms\n                      <jats:italic>psychotic\u2010like experiences<\/jats:italic>\n                      AND (\n                      <jats:italic>distress<\/jats:italic>\n                      OR\n                      <jats:italic>resilience<\/jats:italic>\n                      OR\n                      <jats:italic>burden<\/jats:italic>\n                      OR\n                      <jats:italic>coping<\/jats:italic>\n                      OR\n                      <jats:italic>adaptive behaviour<\/jats:italic>\n                      ) identified 762 studies, of which 111 met inclusion criteria and were included in a narrative synthesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Distress related to PLEs can be differentiated into direct PLE\u2010related distress and indirect psychological distress. Factors associated with distress clustered into three domains: (i) Symptomatology\u2014greater frequency, intensity, persistence and specific subtypes predict higher distress, as do comorbid depression, anxiety and suicidality. (ii) Psychological factors\u2014maladaptive metacognitive biases, poor emotion regulation and avoidant or emotion\u2010focused coping contribute to distress, whereas self\u2010compassion and problem\u2010focused coping may be protective. (iii) Environmental and contextual factors\u2014traumatic life events, discrimination, daily stressors and substance use amplify distress, often by interacting with internal vulnerabilities and emotion regulation capacities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distress in PLEs arises from the interaction between symptom features, internal psychological vulnerabilities and external environmental factors. Consistent with emotion regulation models, distress reflects disruptions in adaptive appraisal and coping processes that heighten emotional reactivity. Conceptualizing distress as a transdiagnostic vulnerability underscores its relevance for early identification and preventive interventions. Future research should harmonise definitions of distress, examine longitudinal pathways and evaluate resilience\u2010building approaches to mitigate risk and improve mental health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.70175","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:30:14Z","timestamp":1777858214000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unravelling Distress in Psychotic\u2010Like Experiences: A Systematic Review of Non\u2010Clinical Populations"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4878-1857","authenticated-orcid":false,"given":"Joachim","family":"Rockenschaub","sequence":"first","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy Medical University of Vienna  Vienna Austria"},{"name":"Comprehensive Center for Clinical 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