Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: A longitudinal study

Abstract

This study prospectively examined the relationship between social problem solving behavior exhibited by youths at ultra-high risk for psychosis (UHR) and with recent onset psychotic symptoms and their parents during problem solving discussions, and youths' symptoms and social functioning six months later. Twenty-seven adolescents were administered the Structured Interview for Prodromal Syndromes and the Strauss-Carpenter Social Contact Scale at baseline and follow-up assessment. Primary caregivers participated with youth in a ten minute discussion that was videotaped, transcribed, and coded for how skillful participants were in defining problems, generating solutions, and reaching resolution, as well as how constructive and/or conflictual they were during the interaction. Controlling for social functioning at baseline, adolescents' skillful problem solving and constructive communication, and parents' constructive communication, were associated with youths' enhanced social functioning six months later. Controlling for symptom severity at baseline, we found that there was a positive association between adolescents' conflictual communications at baseline and an increase in positive symptoms six months later. Taken together, findings from this study provide support for further research into the possibility that specificfamily interventions, such as problem solving and communication skills training, may improve the functional prognosis of atrisk youth, especially in terms of their social functioning.

Coping Styles in Carers of People With Recent and Long-Term Psychosis

“…This will probably benefit patients as well. Moreover, good problem-solving skills in carers have been linked to good problemsolving in patients, itself linked to improved social functioning (O'Brien et al, 2009). …”

What drives poor functioning in the at-risk mental state? A systematic review

“…Caregiver warmth at baseline interview was significantly associated with patients' improvement in functioning over 3 and 4 months (O'Brien et al, 2006. ARMS adolescents' conversational problem solving abilities, along with the degree of constructive communication displayed with their primary caregiver also positively correlated with functioning at 6-month follow-up (O'Brien et al, 2009). …”

“…Family support was predictive of better functioning (O'Brien et al, 2006(O'Brien et al, , 2007(O'Brien et al, , 2009. Caregiver warmth at baseline interview was significantly associated with patients' improvement in functioning over 3 and 4 months (O'Brien et al, 2006.…”

Youth-caregiver Agreement on Clinical High-risk Symptoms of Psychosis

“…In particular, unusual thought content, suspiciousness, social withdrawal, and substance abuse are predictive of conversion to psychosis (Cannon et al 2008). In addition, environmental factors, such as warm, supportive family environments are predictive of reduction of symptomatology in CHR youth (O'Brien et al 2006; 2009; Schlosser et al 2010). No published studies to date, however, have specifically examined cross-informant agreement on CHR symptoms in a clinically referred sample.…”