title: Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study.
abstract: Evidence of social and behavioral problems preceding the onset of schizophrenia-spectrum psychoses is consistent with a neurodevelopmental model of these disorders. Here we predict that individuals with a first episode of schizophrenia-spectrum psychoses will evidence one of three patterns of premorbid adjustment: an early deficit, a deteriorating pattern, or adequate or good social adjustment. Participants were 164 (38% female; 31% black) individuals ages 15-50 with a first episode of schizophrenia-spectrum psychoses. Premorbid adjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. We compared the fit of a series of growth mixture models to examine premorbid adjustment trajectories, and found the following 3-class model provided the best fit with: a "stable-poor" adjustment class (54%), a "stable-good" adjustment class (39%), and a "deteriorating" adjustment class (7%). Relative to the "stable-good" class, the "stable-poor" class experienced worse negative symptoms at 1-year follow-up, particularly in the social amotivation domain. This represents the first known growth mixture modeling study to examine premorbid functioning patterns in first-episode schizophrenia-spectrum psychoses. Given that the stable-poor adjustment pattern was most prevalent, detection of social and academic maladjustment as early as childhood may help identify people at increased risk for schizophrenia-spectrum psychoses, potentially increasing feasibility of early interventions.
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O׳Hara Street, Pittsburgh, PA 15213, United States; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, University Drive C., Pittsburgh, PA 15240, United States. Electronic address: hortonle2@upmc.edu.
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Horton
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06159, United States. Electronic address: sarah.tarbox@yale.edu.
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Tarbox
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O׳Hara Street, Pittsburgh, PA 15213, United States; Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, United States. Electronic address: thomas.olino@temple.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Olino
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O׳Hara Street, Pittsburgh, PA 15213, United States; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, University Drive C., Pittsburgh, PA 15240, United States. Electronic address: haasgl@upmc.edu.
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Haas
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012917:Social Adjustment
keywords: First-episode schizophrenia (FEP); Premorbid adjustment; Psychosis; Schizophrenia-spectrum; Social amotivation
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