The role of cognitive functioning in the outcome of those at clinical high risk for developing psychosis

Addington, Jean; Barbato, Mariapaola

doi:10.1017/s204579601200042x

Cited by 52 publications

(37 citation statements)

References 48 publications

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“…A sixth possible limitation is that the use of a statistical correction such as the Bonferroni method was not applied for multiple comparisons. A seventh limitation is that despite there being inconclusive evidence for this in the literature (Addington and Barbato, 2012) it is possible that prodromal symptoms may have affected performance on IQ. Finally, only 72% of family member diagnoses of psychosis could be confirmed in the current study via SCID interview or formal records.…”

Section: Discussionmentioning

confidence: 99%

Predictors of a clinical high risk status among individuals with a family history of psychosis

Stowkowy

Addington

2013

Schizophrenia Research

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Background Risk for psychosis can be assessed on the basis of genetic risk, referred to in the literature as family high risk (FHR) or through the presence of clinical high risk symptoms (CHR). Recent studies have also shown that certain risk factors (i.e. trauma, cannabis, migration) may play a role in the development of psychosis, possibly in combination with one another and in particular in combination with a family history of psychosis. It is unknown which risk factors may play a role in the prediction of CHR status among individuals whom are already genetically vulnerable. This study compared FHR individuals who also met CHR criteria to FHR individuals who did not on various risk factors, psychopathology and functioning. Method Participants were 25 who met FHR and CHR criteria (FHR + CHR) as determined by Structured Interview for Prodromal Syndromes, 25 who met only FHR criteria (FHR-non-CHR), and 25 healthy controls. A binary logistic regression was performed to determine the best predictors of belonging to the FHR + CHR group. Results FHR + CHR and FHR-non CHR were significantly different on measures of age first tried cannabis (F = 3.65, p < 0.05) and IQ (F = 3.32, p < 0.05). FHR groups also differed on self-reported anxiety (F = 11.79, p < 0.001) and current scores of social (F = 19.74, p < 0.0001) and role (F = 17.71, p < 0.0001) functioning. The most significant predictor of belonging to the FHR + CHR group was an earlier age of cannabis use (OR = 0.44, p = 0.05). Conclusion These preliminary results are promising in determining potential risk factors for the development of psychosis in those who are at risk for psychosis on the basis of a family history.

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Section: Discussionmentioning

confidence: 99%

Predictors of a clinical high risk status among individuals with a family history of psychosis

Stowkowy

Addington

2013

Schizophrenia Research

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“…It has been consistently reported that similar or less severe deficits in neurocognition, social cognition and functional outcome are observed in CHR individuals when compared to individuals at either their first episode or those who have a more chronic course of illness (Addington and Barbato, 2012; Thompson et al, 2011; Addington et al, 2008; Fusar-Poli et al, 2012b; Green et al, 2012). Although deficits in neurocognition (Fusar-Poli et al, 2012b) may play a role in predicting transition to psychosis in individuals at CHR, only one study to date has demonstrated that a combination of neurocognitive tasks and social cognition assessed by a theory of mind task was related to conversion (Kim et al, 2011).…”

Section: Introductionmentioning

confidence: 97%

Social cognition as a mediator between neurocognition and functional outcome in individuals at clinical high risk for psychosis

Barbato

Liu

Penn

et al. 2013

Schizophrenia Research

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In schizophrenia, neurocognition, social cognition and functional outcome are all inter-related, with social cognition mediating the impact that impaired neurocognition has on functional outcome. Less clear is the nature of the relationship between neurocognition, social cognition and functional outcome in individuals at clinical high risk (CHR) for psychosis. 137 CHR participants completed a neurocognitive test battery, a battery of social cognition tasks and the Social Functioning Scale. Confirmatory factor analysis showed that all social cognition tasks were reliable and valid measures of the latent variable. The path from neurocognition to functioning was statistically significant (standardized coefficient β = 0.22, p <0.01). The path from social cognition to functioning was also statistically significant (β= 0.27, p<0.05). In the mediation model the bootstrapping estimate revealed a nonsignificant indirect effect that was the association of social cognition with neurocognition and with functional outcome (β =0.20, 95% CI =−0.07 to 0.52, p=0.11). However, social cognition was significantly associated with neurocognition (β = 0.80, p < 0.001) and the path from neurocognition to functioning was no longer significant as soon as the mediator (social cognition) was entered into the mediation model (β = 0.02, p = 0.92). All of the model fit indices were very good. Unlike what has been observed with psychotic patients, social cognition does not seem to mediate the pathway from neurocognition to functional outcome when assessed with a measure of social attainment in individuals at CHR for psychosis.

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“…In addition to attenuated psychotic symptoms, which all participants need to have to meet CHR criteria, both cognition and social functioning have continually been demonstrated to be among the most common deficits observed in those at CHR. [14][15][16][17] Enhancing the Prospective Prediction of Psychosis (PREDICT)is a 2-year longitudinal study to determine predictors of conversion in individuals at CHR of developing psychosis, conducted at the Universities of Toronto, North Carolina, and Yale. The main hypothesis of this study was that social functioning would be the best predictor of later transition to psychosis with cognition also being an important predictor.…”

Section: Introductionmentioning

confidence: 99%

The Role of Cognition and Social Functioning as Predictors in the Transition to Psychosis for Youth With Attenuated Psychotic Symptoms

Addington

Liu

Perkins

et al. 2016

Schizophrenia Bulletin

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In the literature, there have been several attempts to develop prediction models for youth who are at clinical high risk (CHR) of developing psychosis. Although there are no specific clinical or demographic variables that seem to consistently predict the later transition to psychosis in those CHR youth, in addition to attenuated psychotic symptoms, the most commonly occuring predictors tend to be poor social functioning and certain cognitive tasks. Unfortunately, there has been little attempt to replicate alogorithms. A recently published article by Cornblatt et al suggested that, for individuals with attentuated psychotic symptoms (APS), disorganized communication, suspiciousness, verbal memory, and a decline in social functioning were the best predictors of later transition to psychosis (the RAP model). The purpose of this article was to first test the prediction model of Cornblatt et al with a new sample of individuals with APS from the PREDICT study. The RAP model was not the best fit for the PREDICT data. However, using other variables from PREDICT, it was demonstrated that unusual thought content, disorganized communication, baseline social functioning, verbal fluency, and memory, processing speed and age were predictors of later transition to psychosis in the PREDICT sample. Although the predictors were different in these 2 models, both supported that disorganized communication, poor social functioning, and verbal memory, were good candidates as predictors for later conversion to psychosis.

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The role of cognitive functioning in the outcome of those at clinical high risk for developing psychosis

Cited by 52 publications

References 48 publications

Predictors of a clinical high risk status among individuals with a family history of psychosis

Predictors of a clinical high risk status among individuals with a family history of psychosis

Social cognition as a mediator between neurocognition and functional outcome in individuals at clinical high risk for psychosis

The Role of Cognition and Social Functioning as Predictors in the Transition to Psychosis for Youth With Attenuated Psychotic Symptoms

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