Background and Aims Communication about the at-risk mental state may shape not only clinical understanding but also peer-directed social evaluations. Prior work from our group has shown that positively reframing psychosis-risk feedback reduces perceived emotional harm and clinician stigma. The present study examined whether positive reframing influences adolescents’ peer-directed social stigma and desire for social distance toward an at-risk youth, and whether these effects are moderated by adolescents’ own distressing prodromal experiences, sex, and cultural background. Methods 108 community-dwelling adolescents were randomly assigned to view either positively or negatively framed simulated clinical feedback about an at-risk youth. Participants then completed measures of social stigma and desired social distance. Prodromal experiences were assessed prior to the experimental manipulation. Results Across stigma and social distance indices, framing effects were directionally consistent with a priori hypotheses, with positive reframing associated with lower stigma-related responses. However, effects were selective in magnitude. Statistically significant or marginal effects emerged primarily for perceptions of dangerousness and willingness for limited social proximity, whereas effects on other stigma dimensions were more modest and non-significant. Framing effects varied by adolescents’ own prodromal experiences, and exploratory analyses suggested additional moderation by sex and cultural background. Conclusions Positive reframing can shape adolescents’ peer-directed social evaluations of the at-risk state in systematic but selective ways, particularly by weakening perceptions of dangerousness that drive social avoidance. These findings underscore the importance of developmentally and culturally sensitive risk communication and highlight positive framing as a context-dependent strategy with socially consequential implications beyond the clinical encounter.

Background and Aims Recent studies have shown that communicating and psycho-educating young individuals and their families about high-risk psychosis can offer benefits, like validation and access to specialized care. However, it can also negatively impact self-perception, distress, and help-seeking behavior. In a recent study [(Sol-Nottes et al., 2024)](#ref-0030), we demonstrated that clinicians view positive reframing as a way to mitigate these concerns. This study aimed to extend those findings to community dwelling adolescents with high versus low levels of distressing ‘prodromal’ experiences. An additional goal was to explore the moderating role of sex and culture. Methods The study replicated the design from Sol-Nottes et al. (2024). 108 adolescents were randomly assigned to view either negatively or positively framed simulated feedback sessions, followed by questions about the session’s impact. Prior to viewing the simulated session, all participants completed the brief version of the Prodromal Questionnaire [(Loewy et al., 2011)](#ref-0019). Results As hypothesized, positive framing significantly reduced fear and stigma. However, contrary to our secondary hypothesis, these effects were not moderated by the level of prodromal symptoms. Finally, exploratory analyses revealed a moderating effect of sex and culture, with a stronger effect of positive reframing on stigma, mobilization to seek help, and hopefulness, among male and Arab adolescents. Conclusions These findings provide further support for the potential beneficial effect of positive reframing in the context of at-risk mental states and highlight the importance of cultural factors. Together, these results lay the groundwork for clinical trials on positive framing in real-world settings.