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Perceptual-Motor and Memory Performance of High-Risk Children

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Perceptual-Motor and Memory Performance of High-Risk Children

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Abstract

Subjects were examined with a battery of protocols based on principles of experimental psychology and designed to measure motor control, perceptual-motor coordination, attention, learning, and memory. Differences between index and control subjects were found on the mirror-drawing protocol, reflecting visual-motor coordination, and the distractibility protocol, in which subjects divided their attention between verbal and visual stimuli. There were no differences in subjects due to conditions of rearing, and no interactions. Differences between index and control children were subtle, and tended not to appear on simpler tasks. The stage of processing leading to poor performance by the index children awaits further study for elucidation.

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... Motor impairment of coordination and balance may become more striking in children with high schizophrenia risk (166)(167)(168). Additionally, high risk children may display learning difficulties in attention, concentration, memory, and thought as well as behavioral and mood dysfunctions such as increased aggression, problematic interpersonal relations, social isolation, low self-esteem, offending behaviors, poor affective control, and depression (152,153,162,(169)(170)(171)(172)(173)(174)(175)(176). ...
... As with early childhood, broad impairments in neuromotor development, cognitive function, and behavior often mark individuals at risk for schizophrenia (reviewed in 154). As the adolescent matures, poor coordination, balance, and perceptualmotor and visual-motor functioning may become more apparent in a subgroup of cases (152,168,173). Cognitively, lower intelligence and especially a decrease in intellectual function mark schizophrenia risk (151,153,169,244). ...
... Cognitively, lower intelligence and especially a decrease in intellectual function mark schizophrenia risk (151,153,169,244). There is impairment of individual domains including arithmetic and spelling, formal thought disorders, attention difficulties, increased distractibility, poor executive functioning, and general learning and memory difficulties (152,153,169,173,245). Behaviorally, aggression, withdrawal, and generally poor social competence and peer relations are also concerning, with psychiatric symptoms including affective flattening and anxiety often present (149,151,174,175,246,247). ...
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Early life adversity and prenatal stress are consistently associated with an increased risk for schizophrenia, although the exact pathogenic mechanisms linking the exposures with the disease remain elusive. Our previous view of the HPA stress axis as an elegant but simple negative feedback loop, orchestrating adaptation to stressors among the hypothalamus, pituitary and adrenal glands, needs to be updated. Research in the last two decades shows that important bidirectional signaling between the HPA axis and intestinal mucosa modulates brain function and neurochemistry, including effects on glucocorticoid hormones and brain-derived neurotrophic factor (BDNF). The intestinal microbiome in earliest life, which is seeded by the vaginal microbiome during delivery, programs the development of the HPA axis in a critical developmental window, determining stress sensitivity and HPA function as well as immune system development. The crosstalk between the HPA and the Microbiome Gut Brain Axis (MGBA) is particularly high in the hippocampus, the most consistently disrupted neural region in persons with schizophrenia. Animal models suggest that the MGBA remains influential on behavior and physiology across developmental stages, including the perinatal window, early childhood, adolescence and young adulthood. Understanding the role of the microbiome on critical risk related stressors may enhance or transform of understanding of the origins of schizophrenia and offer new approaches to increase resilience against stress effects for preventing and treating schizophrenia.
... Attentional dysfunction (NYHR, SB, MHR) (Erlenmeyer-Kimling and Cornblatt, 1992;Erlenmeyer-Kimling et al., 2000;Weintraub, 1987;Garmezy and Devine, 1984), . Poor concentration (IHR) (Sohlberg, 1985;Lifshitz et al., 1985) . Some evidence of formal thought disorder (SB, NYHR) (Weintraub, 1987;Bolinskey et al., 2001) . ...
... The New York HR Study assessed the occurrence of thought disorder among HR children retrospectively from videotaped interviews conducted at age 9, and found that positive thought disorder could be observed already at that age and was predictive of adulthood schizophrenia-spectrum disorders (Ott et al., 2001). Other abnormalities in cognitive functioning among HR children include poor concentration (Sohlberg, 1985;Lifshitz et al., 1985), decreased ability to ignore irrelevant input (Weintraub, 1987), poor performance on mathematics and spelling (Ayalon and Merom, 1985), poor executive function, poor mental coding/encoding and learning, and poor memory . (Sohlberg, 1985;Lifshitz et al., 1985;Marcus et al., 1985) . ...
... Other abnormalities in cognitive functioning among HR children include poor concentration (Sohlberg, 1985;Lifshitz et al., 1985), decreased ability to ignore irrelevant input (Weintraub, 1987), poor performance on mathematics and spelling (Ayalon and Merom, 1985), poor executive function, poor mental coding/encoding and learning, and poor memory . (Sohlberg, 1985;Lifshitz et al., 1985;Marcus et al., 1985) . Poorer neurobehavioral functioning (JIDS) (Hans et al., 1999) . ...
Article
According to cohort studies, individuals who develop schizophrenia in adulthood show developmental abnormalities in childhood. These include delays in attainment of speech and motor milestones, problems in social adjustment, and poorer academic and cognitive performance. Another method of investigating developmental abnormalities associated with schizophrenia is the high-risk (HR) method, which follows up longitudinally the development of children at high risk for schizophrenia. Most HR studies have investigated children who have a parent with schizophrenia. This review summarizes findings concerning childhood and adolescent development from 16 HR studies and compares them with findings from cohort, conscript, and family studies. We specifically addressed two questions: (1) Does the development of HR children differ from that of control children? (2) Which developmental factors, if any, predict the development of schizophrenia-spectrum disorders in adulthood? While the answer to the first question is affirmative, there may be other mechanisms involved in addition to having a parent with schizophrenia. Factors which appear to predict schizophrenia include problems in motor and neurological development, deficits in attention and verbal short-term memory, poor social competence, positive formal thought disorder-like symptoms, higher scores on psychosis-related scales in the MMPI, and severe instability of early rearing environment.
... The examination at age 26 consisted of a portion of the Wechsler Adult Intelligence Scale (WAIS; Wechsler 1955). The earlier assessments were considerably more detailed and provided, in addition to WAIS scores, measures of personality, problem-solving skills, academic achievement, perceptual-motor skills, and memory (Lifshitz et al. 1985;Sohlberg 1985;Sohlberg and Yaniv 1985). At each assessment stage, the index Reprint requests should be sent to Dr. A.F. Mirsky,NIH/NIMH,Bldg. 10,9000 Rockville Pike, Bethesda, MD 20892. ...
... In a previous publication, one of us reported a variety of cognitive test scores obtained by the subjects at their first assessment (at an average age of 11) in relation to their DSM-UI-R diagnoses as adults (at an average age of 26) (Mirsky 1988). That analysis suggested that subjects' scores on tasks requiring focused attention, such as digit cancellation under conditions of distraction (Lifshitz et al. 1985), would have predicted their diagnoses at age 26; the subjects who were to develop schizophrenia spectrum disorders performed significantly more poorly than the other subjects. The latter were grouped into three categories: those with affective disorders, those with other disorders, and those with no diagnoses. ...
... The test procedure, described fully by Lifshitz et al. (1985), required the subject to cross out 2 target digits (e.g., 3 and 7) on a sheet of paper that contained 150 digits including 16 of each target. The subject crossed out different target digits on each of three sheets and then repeated these tasks while listening to auditory distraction tapes. ...
Article
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We assessed attention in 63 of the 98 traceable living subjects of the original 100 in the National Institute of Mental Health (NIMH) joint study of schizophrenia by the United states and Israel, known as the Israeli High-Risk Study cohort; their mean age was 32 years. These data were supplemented, for comparative purposes, with those obtained on 31 normal control and 17 schizophrenia subjects studied at NIMH. The results suggest that attention skills of the adult children of a parent with schizophrenia fall between those of schizophrenia patients and controls, and that measures of sustained attention and the ability to focus and execute provide the best discrimination among groups. Post hoc analyses revealed that poor scores on simple tests of attention obtained in childhood were associated with the development of disorders in adulthood. Low scores on a digit cancellation test at age 11, but not at age 17, predicted which of the children at genetic risk would develop schizophrenia spectrum disorders diagnosed at ages 26 and 32.
... One neuropsychological function that differentiates child relatives is motor ability. Impaired motor ability presents in children as soft neurological signs such as disturbed gait, poor balance, uncoordination, motor impersistence and impaired mirror drawing (Lifshitz et al. 1985; Asarnow and Goldstein 1986 ). In contrast, motor functioning has been less consistently impaired among adult relatives of schizophrenia patients (Kinney et al. 1986; Cannon et al. 1994; Faraone et al. 19956; Kinney et al. 1991; Rosen etal. ...
... In most (Mednick and Schulsinger 1968; Sohlberg 1985; Landau et al. 1989) but not all (Worland and Hesselbrock 1980) studies, children of schizophrenia patients showed poor short-term memory as measured by oral arithmetic scores (which require short-term memory to manipulate mathematical concepts). They are not consistently impaired when asked to recall a string of digits (Mednick and Schulsinger 1968; Worland and Hesselbrock 1980; Cornblatt and Erlenmeyer-Kimling 1985; Lifshitz et al. 1985), but they do show deficits if distracted during digit recall (Harvey et al. 1981; Winters et al. 1981; Cornblatt and Erlenmeyer-Kimling 1985; Spring 1985). Short-term digit recall has not been impaired in studies of adult relatives (Roxborough et al. 1993; Faraone et al. 19956), probably because of the lack of a distraction component in those studies. ...
Article
We sought to show that (1) schizotaxia (Meehl's term for the predisposition to schizophrenia) is a clinically consequential condition, and (2) distinguishing it from schizotypal personality disorder may be useful from both clinical and scientific perspectives. We review the features of schizotaxia that may be relevant in clinical settings and discuss their implications for the diagnosis, psychosocial functioning, family intervention and treatment of people in schizophrenia families. Our review indicates that prior work finds some of the nonpsychotic and nonschizotypal relatives of schizophrenia patients to have a psychiatric syndrome characterized by negative symptoms, neuropsychological impairment, and psychosocial dysfunction. Following Meehl, we call this constellation of clinical and neurobiological features schizotaxia. The studies we review suggest it may be worthwhile to consider schizotaxia as a separate diagnostic class. Doing so would alert clinicians to a neurobehavioral syndrome not adequately covered by current diagnostic criteria and would motivate researchers to develop diagnostic and therapeutic approaches aimed at helping schizotaxic individuals and, perhaps, preventing the onset of schizophrenia.
... Early studies by Fish and colleagues of individuals with childhoodonset schizophrenia (Fish, 1977) led to the development of the theory of pandysmaturation, a neurointegrative disorder that includes problems with motor and visual motor development. Perceptual-motor functioning was assessed in the Israeli HR Study, in which FHR subjects performed worse than controls on a mirror drawing task, but not on an individual rhythm task (Lifshitz, et al., 1985). The Swedish HR study did not find a significant difference between offspring of mothers with schizophrenia and normal risk offspring in the finger-tapping test (Schubert, et al., 2005). ...
... Israeli High Risk Cohort Study (Lifshitz, 1985, Sohlberg 1985, Mirsky 1995 Assessed ...
Article
Introduction: Neurocognitive dysfunction is a central feature of schizophrenia and is observed during all phases of the illness. Because schizophrenia is known to run in families, studying neurocognitive function in first-degree, nonpsychotic relatives has been a widely utilised strategy for almost 50 years for understanding presumed "genetic risk". Studying nonpsychotic relatives ("familial high-risk", or FHR) allows for identification of cognitive vulnerability markers independent of confounds associated with psychosis. Methods: Prior meta-analyses have elucidated the level and pattern of cognitive deficits in the premorbid, prodromal, and postonset periods of psychosis, and in relatives regardless of age. However, no prior quantitative analyses have specifically focused on studies of young first-degree relatives of individuals with schizophrenia who have not passed through the peak age illness risk (<age 30). The English language literature of neuropsychological studies of first-degree relatives for schizophrenia was identified up to 15 May 2011. Results: From 33 studies, 28 studies met our criteria for quantitative review, utilising >70 individual tests and 250 variables. Conclusions: In general, young FHR individuals demonstrated deficits with a moderate level of severity compared with healthy controls. The largest average effect sizes (ESs), based on tests given in at least three independent studies, were on estimates of Full Scale IQ (d= -0.777), followed by Vocabulary (d= -0.749) and single word reading tests (d= -0.698) (often used as estimates of IQ). Measures of declarative memory, sustained attention, working memory and others had more modest ESs. Deficits were milder than in established schizophrenia, but often as severe as in clinical high-risk or putatively prodromal participants and in older relatives examined in prior meta-analyses. Additionally, while assessed from a more limited literature, youth at FHR for schizophrenia tended to show worse neurocognitive functioning than those at FHR for affective psychosis. This suggests that genetic risk for schizophrenia as reflected in a positive FHR carries an especially heavy impact on cognitive ability.
... The Digit Cancellation task was modelled after the distractibility test described by Lifshitz, Kugelmass, and Karov (1985). Two conditions were included in the present study. ...
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We administered a comprehensive attentional battery to an epidemiologically defined sample of 435 first-and second-grade children to assess the influence of gender and verbal intelligence on attention. The battery included three versions of the continuous performance test (CPT), two digit cancellation tasks, three subtests from the WISC-R, and the Wisconsin Card Sorting Test. The results indicated that both gender and intelligence had an impact on attentional performance. Girls performed better than boys; they made fewer errors on the CPT and obtained higher scores on the digit cancellation task and the Coding subtest of the WISC-R. Children with higher verbal intelligence also performed better on the attentional tests, but this advantage was not observed across measures or levels of performance. For example, children with limited verbal skills performed significantly worse than their peers only in measures with high processing demands (the degraded CPT and the distraction version of the digit cancellation task).
... 38,59,60 The battery included neurologic tasks scored on 4-point clinical scales (indicating no, mild, moderate, or severe impairment) 61-63 and averaged across multiple presentations of items as well as standard administered neuropsychological tests and procedures. [58][59][60][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] For analyses in this article, 20 summary variables were selected from these instruments ( Table 2). ...
Article
Full-text available
The Jerusalem Infant Development Study is a prospective investigation comparing offspring of schizophrenic parents with offspring of parents who have no mental disorder or have nonschizophrenic mental disorders. During infancy and school age, a subgroup of offspring of schizophrenic parents showed global neurobehavioral deficits that were hypothesized to be indicators of vulnerability to schizophrenia. The purposes of the present investigation were to determine if neurobehavioral deficits were present in the offspring of schizophrenics at adolescence, to examine their stability over time, and to explore their relation to concurrent mental adjustment. Sixty-five Israeli adolescents were assessed on a battery of neurologic and neuropsychological assessments. They were also administered psychiatric interviews from which best-estimate DSM-III-R diagnoses and scores of global adjustment were derived. Adolescents with poor neurobehavioral functioning were identified from composites of motor and cognitive-attentional variables. A disproportionate number of offspring of schizophrenic parents (42%; 10/24), and especially male offspring of schizophrenic parents (73%; 8/11), showed poor neurobehavioral functioning relative to offspring of nonschizophrenic parents (22%; 9/41). Adolescent offspring of schizophrenics with poor neurobehavioral functioning had been poorly functioning at earlier ages and had poor psychiatric adjustment at adolescence. All 4 offspring of schizophrenics receiving schizophrenia spectrum diagnoses by adolescence showed a pattern of poor neurobehavioral functioning across developmental periods. Results are consistent with the hypothesis that individuals at genetic risk for schizophrenia may display lifelong neurobehavioral signs that are indicators of vulnerability to schizophrenia and that are associated with psychiatric adjustment generally and schizophrenic spectrum disorder specifically.
... 3. Index cases at age 11 showed a trend toward slower EDA recovery (i.e., in the direction of hypoarousal) versus controls (Kugelmass et al. 1985). However, subjects who would later be diagnosed in the schizophrenia spectrum had an unexpected hyperresponsive skin conductance orienting response to the dishabituation tone in a habituation series (Kugelmass et al. 1995, this issue). ...
Article
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We report a 25-year followup of a group of 50 children at genetic risk for schizophrenia (by virtue of having a parent with the disorder) and 50 matched controls. The children who eventually developed schizophrenia spectrum disorders, including schizophrenia, were identifiable by cognitive-psychophysiological, neurointegrative, and social/personality traits in the preteenage period. The children at risk were also more likely to develop other Axis I disorders, chiefly affective. Moreover, the risk of Axis I disorders was significantly greater among children raised in the group atmosphere of a kibbutz than among those raised in their own nuclear families in cities and towns in Israel. The study is a unique contribution to knowledge of factors underlying the development of psychopathology.
... Low childhood intelligence quotient (IQ) and other measures of general intellectual ability (such as IQ decline) were also predictors of psychosis (Kremen et al. 1998) and schizophrenia, in high-risk and followup studies (Lane and Albee 1964;Rieder et al. 1977;Aylward et al. 1984;Jones et al. 1994;Crow et al. 1995;Russell et al. 1997). Neuromotor deficits and soft neurologic signs have been found consistently in children at high risk for schizophrenia (Orvaschel et al. 1979;Lifshitz et al. 1985;Marcus et al. 1987;Auerbach et al. 1993). However, these childhood neuropsychological abnormalities have yet to be linked to PPCs because existing studies typically have not evaluated both types of precursors to schizophrenia. ...
Article
Full-text available
Previous literature shows that children who later develop schizophrenia have elevated rates of prenatal and perinatal complications (PPCs) and neuropsychological deficits in childhood. However, little is known about the relationship of these risk factors to each other. We evaluated the relationship between PPCs and neuropsychological functioning at age 7 in a large epidemiological study of pregnancy, birth, and development: the National Collaborative Perinatal Project (NCPP). Thirteen standardized measures of cognitive abilities were acquired on 11,889 children at approximately age 7. Principal components analysis was used to create three neuropsychological measures: academic achievement skills, verbal-conceptual abilities, and perceptual-motor abilities. We measured the relationship between these factors and three measures of PPCs: low birth weight (LBW), probable hypoxicischemic complications, and chronic hypoxia. All three measures of PPCs were significantly associated with lower neuropsychological performance, after controlling for various confounders. LBW had the strongest association with neuropsychological performance, followed by an index of presumed hypoxic insults. The effect sizes between PPCs and cognitive factors at age 7 were consistently largest with perceptual-motor abilities, followed by academic achievement skills and verbal-conceptual abilities. Future studies will evaluate the effects of specific PPCs and genetic risk factors for psychosis on cognitive functioning in childhood.
... Deficits have been reported in concept formation, object sorting, and general intelligence, subsequently referred to as IQ (Mednick and Schulsinger 1968;Rieder et al. 1977;Nuechterlein 1983;Erlenmeyer-Kimling and Cornblatt 1992). Neuromotor deficits (Orvaschel et al. 1979;Lifshitz et al. 1985;Asarnow and Goldstein 1986;Marcus et al. 1987), soft neurological signs (Auerbach et al. 1993;Buka et al. 1998), and attentional deficits (Rieder and Nichols 1979;Cornblatt et al. 1989;Erlenmeyer-Kimling and Cornblatt 1992) have been found consistently in offspring at high risk for schizophrenia, all of which may have a negative impact on IQ performance. High-risk (Rieder et al. 1977;Mednick et al. 1978;Cornblatt et al. 1989), birth cohort (Jones et al. 1994;Rantakallio et al. 1997), and other case-control studies of schizophrenia (Aylward et al. 1984;O'Callaghan et al. 1992) have also shown that boys are more likely to experience premorbid IQ deficits than girls, suggesting that the male fetus may be particularly vulnerable. ...
Article
Full-text available
Risk factors for schizophrenia, such as genetic vulnerability and obstetric complications, have been associated with cognitive deficits in schizophrenia. We tested the association of these risk factors with general intellectual ability in offspring at high risk for psychoses and normal control subjects. Offspring of 182 parents with DSM-IV schizophrenia or affective psychoses were recruited and diagnosed from the Boston and Providence cohorts of the National Collaborative Perinatal Project (NCPP). Control subjects from the NCPP were selected to be comparable with affected parents based on the parent's age, ethnicity, study site, number of offspring enrolled in the NCPP, and pay ment status, and on the offspring's age, sex, and history of obstetric complications. Based on data prospectively acquired from pregnancy and events of gestation, labor, delivery, and the neonatal period, we derived a measure of probable hypoxic-ischemic insult. We also report on standardized measures of general intelligence (intelligence quotient [IOQ]) collected at age 7. General linear mixed models were used to test for the simultaneous effects of genetic vulnerability, defined as parental diagnosis, and probable hypoxic insult on age 7 IQ. Specificity of the effects for schizophrenia compared with affective psychoses and sex effects were also tested. Low IQ at age 7 was significantly associated with genetic vulnerability to psychoses, in particular with schizophrenia.
... Offspring of patients with schizophrenia more often have social and cognitive disadvantages than offspring of non-schizophrenic parents, including lower IQ (David et al. 1997 ; Kremen et al. 1998 ; Davidson et al. 1999), greater attention deficits (Lifshitz et al. 1985 ; Sohlberg, 1985 ; Erlenmeyer-Kimling & Cornblatt, 1992 ), higher incidence of speech impairment (DeLisi et al. 1991 ; Jones et al. 1994), difficulties with social adjustment (Walker et al. 1993 ; Bearden et al. 2000) and higher risk of schizophrenia (McDonald & Murphy, 2003). Several studies also suggest that children with parents suffering from schizophrenia have lower school competence as rated by peers and teachers (Fisher et al. 1980), lower motivation and more behavior problems ( Janes et al. 1983), and poorer mathematical reasoning (Ayalon & Merom, 1985). ...
Article
Full-text available
Offspring of patients with schizophrenia exhibit poorer school performance compared with offspring of non-schizophrenic parents. We aimed to elucidate the mechanisms behind this association. We linked longitudinal national population registers in Sweden and compared school performance among offspring of schizophrenic parents with offspring of non-schizophrenic parents (1 439 215 individuals with final grades from compulsory school 1988-2006). To investigate the mechanisms, we studied offspring of schizophrenic patients and controls within the same extended families. We investigated genetic effects by stratifying analyses of parent-child associations according to genetic relatedness (half-cousins, full cousins and half-siblings). Environmental effects were investigated by comparing school performance of offspring of schizophrenic fathers and of schizophrenic mothers, respectively, and by stratifying the analyses according to environmental relatedness while controlling genetic relatedness (paternal and maternal half-cousins, paternal and maternal half-siblings). Offspring of parents with schizophrenia had poorer overall school performance than unrelated offspring of non-schizophrenic parents (-0.31 s.d.). Variability in genetic relatedness greatly moderated the strength of the within-family association (β=-0.23 within exposure-discordant half-cousins, β=-0.13 within exposure-discordant full cousins, β=0.04 within exposure-discordant half-siblings), while no evidence was found that the environment affected offspring school performance. Genetic factors account for poorer school performance in children of parents with schizophrenia. This supports that cognitive deficits found in individuals with schizophrenia and their relatives might be genetically inherited. Early detection of prodromal signs and impaired functioning of offspring of patients with schizophrenia could lead to earlier and better tailored interventions.
... Thus, to the extent that cognitive dysfunction during childhood reflects disturbances of brain development, our results replicate and extend those of Jones et al. (1994) and David et al. (1997) in suggesting that such neurodevelopmental compromise is more broadly characteristic of this syndrome than has previously been supposed (Lewis and Murray 1987). Consistent with the results of numerous prior studies of children at elevated genetic risk for schizophrenia (Mednick and Schulsinger 1968; Landau et al. 1972; Asamow et al. 1978; Rutschmann et al. 1980; Harvey et al. 1981; Winters et al. 1981; Worland et al. 1982; Driscoll 1984; Lifshitz et al. 1985; Sohlberg 1985; Hallett et al. 1986; Fish 1987; Goodman 1987; Sameroff et al. 1987; Weintraub 1987; Erlenmeyer-Kimling et al. 1989; Schreiber et al. 1992; Marcus et al. 1993; Bergman and Walker 1995), in this study cognitive deficits were also observed among the unaffected siblings of preschizophrenia patients at 4 and 7 years of age, regardless of whether siblings with adult psychiatric disorders were included. Given that a substantial number of the first degree relatives of schizophrenia patients carry a predisposing genotype without manifesting the disorder phenotypically (Fisher 1973; Gottesman and Bertelsen 1989), this pattern is consistent with an association between presence of a genetic diathesis to schizophrenia and expression of cognitive dysfunction during childhood. ...
Article
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While it is known that children of schizophrenia parents perform more poorly on tests of cognitive functioning than children of normal parents, less certain is the degree to which such deficits predict schizophrenia outcome, whether cognitive functioning deteriorates during childhood in preschizophrenia individuals, and whether nongenetic etiologic factors (such as obstetric complications) contribute to these deficits. In the present study, 72 patients with schizophrenia or schizoaffective disorder, 63 of their siblings not diagnosed with schizophrenia, and 7,941 controls with no diagnosis were ascertained from a birth cohort whose members had been evaluated with standardized tests of cognitive functioning at 4 and 7 years of age. Adult psychiatric morbidity was ascertained via a longitudinal treatment data base indexing regional public health service utilization, and diagnoses were made by review of all pertinent medical records according to DSM-IV criteria. Both the patients with schizophrenia and their unaffected siblings performed significantly worse than the nonpsychiatric controls (but did not differ from each other) on verbal and nonverbal cognitive tests at 4 and 7 years of age. Preschizophrenia cases and their siblings were increasingly overrepresented across decreasing quartiles of the performance distributions. There was not significant intra-individual decline, and there were no significant relationships between obstetric complications and test performance among the preschizophrenia subjects. These results suggest that during the period from age 4 to age 7 years, premorbid cognitive dysfunction in schizophrenia represents a relatively stable indicator of vulnerability deriving from primarily genetic (and&sol;or shared environmental) etiologic influences.
... Numerous studies show that offspring of parents with schizophrenia have higher risks for a variety of social, cognitive, neurological, and emotional problems [11]; social adjustment [12,13], social and cognitive disadvantages, including lower IQ [14][15][16], attention deficits [17,18], poorer school performance [19], lower motivation and more behavior problems [20] and have higher risk to develop schizophrenia [21]. ...
Article
Objective: This study examined the relationship between perceived losses and gains of psychological resources and quality of life of adult daughters of women with schizophrenia. Method: Thirty one adult daughters of mothers with schizophrenia (age range 30 to 50years) and thirty women of similar socio-demographic characteristics whose mothers were mentally healthy (the control group) participated in this study. Results: (a) Resource loss was higher and resource gains were lower among daughters of women with schizophrenia, compared to the control group; (b) despite resource gains total score of quality of life was significantly lower among daughters of mothers with schizophrenia compared to the controls; (c) daughters of mothers with schizophrenia had lower levels of family functioning, a higher level of negative emotions and a lower level of positive emotions; (d) resource gains moderated the negative relationship between resource loss and quality of life; (e) the most significant predictor of quality of life was the group (i.e. daughters of women with schizophrenia compared with controls); (f) quality of life was more strongly associated with resource loss than with resource gain. Discussion: The findings of this research underscore the importance of raising awareness of caregivers and healthcare authorities to the needs of the unique population of daughters of women diagnosed with schizophrenia for support and even treatment.
Article
In an earlier study of an epidemiological sample of 435 urban 8-year-old children, factor analytically-derived components of attention, as assessed by neuropsychological tests, were identified and were found to be significantly related to adaptive functioning. In this study we followed that cohort longitudinally and assessed developmental changes in specific aspects of attentional function into early adolescence. Significant reductions in omission errors and improvements in reaction times were found from ages 8 to 13 years on different versions of the Continuous Performance Task, a measure of sustained attention, with the effects varying by task difficulty level and subjects' gender. Significant improvements across age also were found on measures of the ability to focus attention and execute a response, shift attentional focus, and encode information in memory. In general, the most rapid changes in attention occurred between ages 8 to 10 years with more gradual changes occurring between ages 10 to 13. The results highlight the importance of developmental epidemiological approaches for assessing and predicting the normal evolution of attentional function in school-aged children.
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Siblings and offspring of persons with schizophrenia carry elevated genetic risk for the illness and manifest attentional and memory impairments. Because less is known about other neuropsychological functions and their specificity in adolescents, we conducted a genetic high-risk (HR) study of schizophrenia (HR-SCZ) and affective psychosis (HR-AFF). Participants (ages 12-25) were from the Harvard Adolescent High-Risk and Hillside Family studies, including 73 HR-SCZ, 18 HR-AFF, and 84 community controls (CCs) recruited in metropolitan Boston and New York. Groups were compared on overall neurocognitive functioning, 6 domains, and 13 test scores, controlling for age, parental education, and correlated data within families. The HR-SCZ group was significantly impaired overall, while the HR-AFF group demonstrated a trend toward overall impairment. HR-SCZ subjects showed significantly lower Verbal Ability (d = .73) and Executive Functioning/Working Memory (d = .47) than CCs. HR-AFF subjects showed reduced Verbal Ability (d = .64) compared to CCs. Excluding 12 CCs with a parental history of depression (without psychosis) led to larger differences between HR and CC groups across domains. Moreover, HR-SCZ and CC group differences in Verbal Memory (d = .39) and Visual-Spatial (d = .34) became statistically significant. There were no significant differences between HR-SCZ and HR-AFF groups. Data support a modest neuropsychological deficit in persons at genetic HR for psychosis, with a broader range of deficits in HR-SCZ. Future work should assess the relationship of neurocognition to adaptive functioning and possible onset of psychosis in HR samples. Ascertainment criteria for controls may markedly influence results and interpretation of group differences.
Article
Conceptualizations of the liability for schizophrenia help guide the development of research protocols, which, in turn, provide empirical confirmations or disconfirmations of the conceptualization's tenets. This paper focuses on a conception of liability and its relationships to genetic adolescent high-risk studies. Specifically, the derivation and nature of a proposed multidimensional syndrome of liability to schizophrenia ("schizotaxia") are outlined, followed by a representative review of features reported in previous high-risk studies that may be related to schizotaxia, and a perspective on future high-risk investigations. Overall, genetic high-risk studies generally confirm the concept of liability in the offspring of parents with schizophrenia, as expressed by deficits or abnormalities in multiple dimensions. It is concluded that high-risk studies on the liability to schizophrenia provide an important tool with which to explore the etiology and development of schizophrenia, in part by contributing to the identification and validation of specific liability syndromes.
Article
Psychological parameters of mental activity (30 in total) and their genetic determination were studied in 67 families of schizophrenia patients (67 patients, 107 parent, and 30 sibs). Abnormalities of most of the examined characteristics were found in both the patients and their healthy relatives. Parameters of attention shifting and emotionality exhibited the largest genetic component (25-75 and 17-98%, respectively) in all analyzed groups of relatives (probands-affected sibs, probands-healthy sibs, healthy parents-healthy children, affected parents-affected children). Significant impact of genetic factors was also found in parameters "steadiness of attention under conditions of continuous concentration," "mediated retention span" "productivity of arbitrary retention by reproduction data," "personal anxiety level," "reflection of unusual social groups," and "self-assessment." The relationships among the characteristics examined in the system of mental activity were established by means of cluster analysis. The results of this study can be used in medical genetic counseling for identifying persons at high risk for schizophrenia.
Chapter
In this chapter, we show that (a) schizotaxia (Meehl’s term for the predisposition to schizophrenia) is a clinically consequential condition and (b) that distinguishing it from schizotypal personality disorder (SPD) may be useful from both clinical and scientific perspectives. We review prior work indicating that some of the nonpsychotic and nonschizotypal relatives of schizophrenic patients have a psychiatric syndrome characterized by negative symptoms, neuropsychological impairment, and psychosocial dysfunction. Following Meehl, we call this constellation of clinical and neurobiologic features schizotaxia. The studies we review suggest it may be worthwhile to consider schizotaxia as a separate diagnostic class. Doing so would alert clinicians to a neurobehavioral syndrome not adequately covered by current diagnostic criteria and would motivate researchers to develop diagnostic and therapeutic approaches aimed at helping schizotaxic individuals and, perhaps, preventing the onset of schizophrenia.
Article
To investigate familial effects of neuropsychological deficits associated with seizure disorders, we studied 65 families, in which 1 member had epilepsy. The disorders included childhood absence epilepsy (CAE), juvenile myoclonic epilepsy (JME) and temporal lobe epilepsy (TLE). Age-appropriate tests were administered to assess sustained attention, encoding and verbal memory, executive and focused attention and attentional flexibility/impulsivity. CAE probands attained lower scores than other probands in visual sustained attention and the ability to focus on and execute a visual-motor task. Scores of the unaffected relatives tended to fall between those of the probands and the controls. JME relatives had lower scores than other relatives in tests of visual and auditory sustained attention and attentional flexibility, and showed greater variability in response time. Behavioral information of this type may aid in the specification and differentiation of genetic linkages in affected families.
Article
This study examined neurocognitive deficits as familial vulnerability factors to schizophrenia. Twenty-three Chinese schizophrenic patients, 21 of their non-psychotic siblings and 26 healthy volunteers, matched for age, sex and education, were assessed by using a battery of neurocognitive tests including: Wisconsin Card Sorting Test (WCST), semantic verbal fluency, logical memory, digit span, information, comprehension and similarity. The results showed that siblings had significantly less word output in the verbal fluency test as compared to controls. No significant difference was found between siblings and controls for other tests except that a trend difference was noted for the performance on the similarity test and number of categories completed on the WCST. The verbal fluency abnormality can be considered as a familial trait marker for schizophrenia. Relationships between the residual symptoms after an acute psychotic episode and the magnitude of familial risk were examined. More severe residual symptoms of probands at clinical remission could be predicted by their older age of onset and by better verbal fluency performance in their non-psychotic siblings. This tentatively suggests that patients with a milder genetic form of schizophrenic illness may have a more severe environmental contribution to cerebral insult according to the multifactorial/threshold model. The environmental cerebral insult may cause structural abnormalities leading to incomplete remission of clinical symptoms.
Article
Patients with schizophrenia and high-risk populations have elevated rates of eye movement abnormalities. However, it is not known whether these abnormalities are specific to eye movements or whether they are also found in more traditional domains of motor control. Most studies examining the motor function of patients with schizophrenia have involved patients treated with medication; abnormalities in motor function could be a result of treatment rather than the disease itself. If motor abnormalities are related to schizophrenia, they should also be found in neuroleptic-naïve patients and possibly in high-risk populations in whom eye movement abnormalities are also observed. We reviewed relevant empirical papers published in the last 35 years. Results suggest that approximately one-fifth of neuroleptic-naïve patients with schizophrenia have increased rates of parkinsonism and neurological soft signs. In high-risk populations, replicated findings include delayed motor development in preschizophrenia subjects, and poor motor skills in the offspring of patients with schizophrenia. In first-degree relatives, increased rates of neurological soft signs were reported. These findings suggest that motor abnormalities are not limited to eye movements and may constitute markers of vulnerability. The literature has several weaknesses that should be addressed in future studies.
Target features are clinical or neurobiological characteristics that are expressions of the underlying predisposition to an illness. They comprise a wide range of phenomena, from the classic signs and symptoms of psychopathology to sophisticated measures of brain structure and function. For schizophrenia, many target features have been identified. These include eye tracking dysfunction, attentional impairment, allusive thinking, neurological signs, thought disorder, characteristic auditory evoked potentials, neuropsychological impairment, structural brain abnormalities and functional brain abnormalities. In their most pathological forms, these features are present among many schizophrenic patients, yet it is their presence among their non-psychotic relatives that shows them to be target features. We discuss the theoretical background for target features, present examples and describe how the discovery of target features has implications for schizophrenia research.
Article
We obtained neuropsychological assessment data on persons from five countries whose ages range from 8 to 90 years. Participants were assessed in four languages. The results from the multivariate analyses indicate that reaction-time measures obtained in tests of sustained attention are minimally affected by country of origin and level of education. In contrast, tests assessing the ability to focus attention and solve a problem, to shift strategies, and to inhibit an automatic response tendency differ significantly by country and level of education. Most of these differences tend to disappear at about the age of 54. The data provide partial support for the hypothesis of commonality of some neuropsychological functions across cultures.
Article
Twenty-three children with autism and two control groups completed an attention battery comprising three versions of the continuous performance test (CPT), a digit cancellation task, the Wisconsin Card Sorting Test (WCST), and two novel, computerized tests of shifting attention (i.e., the Same-Different Computerized Task and the Computerized Matching Task). Children with autism could focus on a particular stimulus and sustain this focus as indicated by their performance on the digit cancellation task and the CPT. Their performance on the WCST suggested problems in some aspects of shifting attention (i.e., disengaging attention). The autism group performed as well as controls on the Same-Different Computerized Task, however, that required successive comparisons between stimuli. This implies that they could, in fact, shift their attention continuously. In addition, they did not differ from controls on the Computerized Matching Task, an analog of the WCST, suggesting that they do not have a general deficit in shifting attention.
Article
This preliminary study evaluated the adaptation of visually guided behavior to reversed vision in schizophrenia. The study included 54 patients who met DSM-III-R criteria for schizophrenia. Visuomotor reaction times (VRTs) during reversed vision were measured in six blocks of 35 consecutive trials. The VRTs of schizophrenics were compared with those of normal subjects. A good fit (R2 = 0.9981) for the adaptation process of VRTs during reversed vision was found with the equation y = 1030 + 1499/x, where x is the order of the block and y is the group mean VRT for each block. The VRTs in schizophrenics were significantly slower than those in normal subjects. However, the adaptation process to reversed vision essentially did not differ from normal. The adaptation of visually guided behavior during reversed vision may involve procedural learning; this task may thus be useful in evaluating such learning. The VRTs during reversed vision may be related to some aspects of symptoms in the patient with schizophrenia and may also be useful in predicting clinical outcome.
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1. Dohan has proposed that schizophrenia is a genetic disposition which interacts with an overload of dietary proteins such as casein and gluten or gliadin. 2. A systematic attempt is made to see if this hypothesis is possible faced with aspects of schizophrenia that must be accounted for. 3. The authors conclusion is that it is possible, but more serious work in this field is urgently needed.
Article
Molecular genetics is helping define the contribution of genetic involvement in behavioral disorders. At this time, however, a severely limiting factor for DNA linkage studies of these disorders remains the definition of the phenotype. An example of this is found in the group of studies examining linkage of schizophrenia to the 5q location. Although various broad clinical interpretations of the schizophrenia phenotype were used to test for linkage, all but one study reported findings negative for linkage of schizophrenia to the 5q area. We offer a strategy based on family studies using segregation data of behavioral subtypes. We apply this strategy using molecular genetic technology to our study of psychopathology in patients. This approach offers the possibility of a clearer definition of the phenotype and is suggested for use in both linkage and association studies of neuropsychiatric disorders.
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Objective: In this study, we aimed find out the value of the soft neurological signs in children of schizophrenic parents. Method: In the study, 8-18 year-old 43 healthy children of 30 schizophrenic parents and 8-18 year old 45 healthy children of 30 healthy parents were included. Neurologic Evaluation Scale (NES) was administered to all subjects. Results: Soft neurological sign severity (intensity) and frenquency was statistically higher in children of schizophrenic parents than the control groups' children. Conclusion: Long-term follow up studies are needed for evaluation of these results as an indicator of predicting schizophrenia.
Article
: The visuo-motor reaction times of normal subjects and schizophrenics were measured to investigate adaptation of eye-hand coordination in schizophrenics under modified vision. Reaction time was measured in 32 normal subjects and 32 schizophrenics by using a rectangular board with 24 illuminated buttons. Subjects' task was to press an illuminated button as quickly as possible under normal and modified vision. Time elapsed from when the light was switched on to when the button was pressed was measured as the visuo-motor reaction time in msec. Three conditions were set up: control in normal vision; inverted using an inverting goggle; reversed using a reversing goggle. In general the visuo-motor reaction times of schizophrenics were slower than those of nonnal subjects. But in the reversed condition, there was no significant difference between normal subjects and schizophrenics. The visuo-motor reaction times of schizophrenics in the reversed Condition showed a large dispersion with the fastest being faster than that of any normal subjects. It is suggested that there may be a group among schizophrenics whose basic paradigm of visuo-motor association is different from that of normal subjects.
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The higher prevalence of schizophrenia in children of schizophrenics than in the general population has generated an interest in pinpointing those behaviors that may precede the disorder and serve as an index of vulnerability to the disorder. Signs of neurobehavioral dysfunction in areas of neurocognitive functioning and social behavior have been found in school-age children of schizophrenic parents. This study assessed the neurobehavioral functioning, social behavior, cognitive functioning, attention and intelligence in children with a schizophrenic parent and compared the same parameters with children of mentally healthy parents. The children aged 12-15 years, were assessed with a battery of neurobehavioral tests. The children with a schizophrenic parent performed more poorly on the tests as compared to the children of mentally healthy parents. The children with a schizophrenic parent were seen to have more behavioral problems, especially withdrawn behavior and more social problems when compared to the other children in the study. Poor attention, disordered thoughts and lower intelligence were also observed to be more in the children of the schizophrenic parent.
Article
Reviews data and recent studies that support the role of prenatal and perinatal complications (PPCs) in the etiology of schizophrenia and other psychoses. Because less severe forms of PPCs are not rare (with the prevalence of certain complications exceeding 20%), it is unlikely that most forms of PPCs or that PPCs alone are sufficient causes of schizophrenia. Instead, it is hypothesized that certain forms of PPCs, in combination with a genetic predisposition to schizophrenia, may be operative. The data presented here on the interactive effects of parental schizophrenia and perinatal hypoxia on neurobehavioral function at age 7 yrs supports this hypothesis. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Summary The application of molecular genetic techniques to schizophrenia has so far failed to identify susceptibility genes. This in part may be due to heterogeneity and misclassification of gene carriers. Biological markersanatomical, physiological or biochemical variables that correlate with the main trait of interest and serve to better define that trait or its underlying genetic mechanism-offer a potential solution to these problems. In this article, we review studies that have evaluated the use of the following to identify biological markers of schizophrenia: structural neuroimaging, neuropsychological deficits, neurological signs, eye tracking, eventrelated potentials, and minor physical anomalies. Then we discuss the early reports from the Maudsley Family Study, which is investigating a number of putative biological markers in families multiply affected with schizophrenia.
Article
Psychological parameters of mental activity (30 in total) and their genetic determination were studied in 67 families of schizophrenia patients (67 patients, 107 parent, and 30 sibs). Abnormalities of most of the examined characteristics were found in both the patients and their healthy relatives. Parameters of attention shifting and emotionality revealed the largest genetic component (25–75 and 17–98%, respectively) in all analyzed groups of relatives (probands–affected sibs, probands–healthy sibs, healthy parents–healthy children, affected parents–affected children). Significant impact of genetic factors was also found in parameters stability of attention under conditions of continuous concentration, mediated retention span productivity of voluntary retention by reproduction data, personal anxiety level, reflection of unusual social groups, and self-assessment. The relationships among the characteristics examined in the system of mental activity were established by means of cluster analysis. The results of this study can be used in medical genetic counseling for identifying subjects at high risk for schizophrenia.
Chapter
Prospective longitudinal studies are a powerful means to identify the causal chains of biological and environmental factors that underlie the development of serious mental disorders. Schizophrenia is one of these disorders. Schizophrenia is a multifactorial neurodevelopmental disorder whose specific molecular genetic, epigenetic, stochastic, and environmental bases remain elusive. The chronic debilitating nature of the disorder places a heavy emotional and financial burden on the individual, family, and society. Although the lifetime prevalence of schizophrenia is 1% in the general population that has passed through the risk period, it accounts for up to 3% of total national health-care expenditures in Western countries (). The hypothetical ability to intervene in the developmental progression of the disorder at a point before breakdown is contingent upon the elucidation of early behavioral and other markers of genetic liability to the disorder and their triggers. In this chapter, we focus on research aimed at early detection of markers that may predict to the later onset of schizophrenia. Once these markers are identified, intervention can, at least in principle, be targeted to those individuals most at risk for the disorder.
Chapter
Autism is a complex pervasive developmental disorder (PDD) associated with substantial impairments in terms of social deficits, communication abnormalities, stereotypical and repetitive behaviors, and a wide range of clinical presentations (Cody, Pelphry, & Piven, 2002).
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Schizophrenia and affective psychoses are debilitating disorders that together affect 2%-3% of the adult population. Approximately 50%-70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Article
In this article, the National Institute of Mental Health (NIMH) "Israeli High Risk Study," which extended over two decades and compared the relative effects of kibbutz and city environments on the diathesis of schizophrenia, is critically examined. Comparison data on personality and cognitive functions of groups of 11- to 16-year-olds and adults are reviewed in the light of previously published material. The apparent shifts in level of adjustment of kibbutz and city subjects, as well as the allegedly greater incidence of pathology in the kibbutz index group, are questioned on methodological grounds.
Article
Since the early 1950s high-risk studies have systematically investigated the offspring of schizophrenics. The majority of high-risk children had schizophrenic mothers, to a lesser degree schizophrenic fathers and even more seldom schizophrenic siblings. Family studies revealed that disturbances from the so called "schizophrenia spectrum" - also play a role for the genetic proliferation of schizophrenic diseases. High-risk studies must be carefully planned for an extremely long future. Schizophrenic mothers are difficult "co-workers". The drop-out rate is high. Scientists investigating healthy children are confronted with criticism from the public. Last but not least after many years of follow-up one wishes to have taken into consideration scientific means that were not available at the beginning of the study. Notwithstanding these hardships high-risk studies at various centres all over the world have meanwhile been going on for several decades, the former children have become grown-ups, have reached and passed the critical age for schizophrenia outbreak and a vast amount of data have been collected and contribute to our knowledge of the disease. Already at a very young age high-risk children of schizophrenia differ in many aspects from their low-risk peers: physically, mentally, behaviourally and in the ways they are being brought up. They are underweight, show physical abnormalities, reach important developmental stages later in life, are inclined to isolate themselves, are more depressed, have worse school-careers, show more forensic problems and have an early history of psychiatric contacts. Terms like "pandevelopmental retardation" or "pandysmaturation" have become common to describe the problem. - Growing up with a schizophrenic mother has many disadvantages for these children. Schizophrenic mothers are often socially marginalised, they show less empathy, understanding and spontaneity, their educational style has been described as "poorer", the family climate is chaotic, neglect and physical abuse are not infrequent. High-risk children have a tendency to make themselves "invisible". - Among the high-risk population one does also find children that are especially gifted, talented and creative, with rich fantasies and later on successful as adults. Much is known about risk factors that eventually might lead to the outbreak of the disease, though many of them being unspecific: all irregularities, disturbances and problems during pregnancy, birth and childhood have a positive correlation with later schizophrenia, the earlier they happen and the more severe they are, the greater the risk. Traumata during the 6th gestational month seem to bear most unfortunate consequences. - Cultural, social and familial factors have also some impact on later schizophrenia. Father's age over 55 at the time the children are born is considered unfortunate, such as an early outbreak of mother's disease, cannabis-abuse of the mother and a mother's body-mass index of over 30. Families with a high level of disturbed communication (i.e. conflicts between parents and children, lack of empathy, breaches in inner familial communication, a narrowing milieu and problems with borders) seem to contribute to the outbreak of schizophrenia in the offspring. Some knowledge is available about protective factors. Major interest focussed on environmental influence, detrimental as well as protective. There is clear evidence that for persons at risk favourable circumstances do contribute to preventing the outbreak of the disease, while unfavourable conditions increase the probability of disease outbreak. Further investigations on that subject are required.
Chapter
This chapter reviews and evaluates evidence bearing on the questions of whether and how both early (i.e., pre- and perinatal) and late (i.e., adolescent) neurodevelopmental influences may be involved in the etiology and pathogenesis of Schizophrenia. It describes the various neural disturbances detected in Schizophrenia. This is followed by an analysis of studies investigating the roles of genetic and nongenetic factors in brain abnormalities. These studies provide a framework for hypothesis generation concerning the timing of onset and course of brain abnormalities in Schizophrenia. The chapter presents an analysis of the various literatures bearing more directly on the question of the timing of onset and course of brain abnormalities in Schizophrenia. It finally provides an updated version of the neurodevelopmental hypothesis of Schizophrenia, specifying a number of ways in which particular sets of early and late influences might interact in determining the timing of onset and course of the disorder.
Article
Introduction Examination of neuropsychological functioning, both in healthy populations and in individuals with brain injury, has provided important information with regard to lateralization of cognitive function, sex differences in neuropsychological performance, functional differences associated with disconnection syndromes, and cognitive capacity at various developmental stages. Studies of neuropsychological performance conducted at different maturational levels have helped identify abnormalities associated with childhood disorders, including chromosomal and genetic disorders, structural abnormalities, prematurity and low birth weight, infections, toxic damage, nutritional disorders, anoxic disorders, traumatic brain injury, focal neurological disorders, convulsive disorders, hemispherectomy and other effects of surgical manipulations (Spreen et al., 1995b). The utility of neuropsychological assessment in children and adolescents with neuropathologic conditions is not only to provide information regarding their progress in achieving normative developmental milestones but also to provide a framework for the identification of brain dysfunction and for the development of remediation strategies. Significant development of the central and peripheral nervous systems occurs throughout early life, with major alterations being observed from infancy to adolescence (for review, see Huttenlocher, 1994). These rapidly evolving systems include the sensory systems (auditory, visual, chemical senses, somesthetic), motor systems (pyramidal and extrapyramidal) and integrative higher-order systems (association areas, reticular formation and brainstem chemical pathways, language areas) (Spreen et al., 1995a). Both structural and functional changes in these systems permit the rapid improvements in cognitive abilities observed from infancy through late adolescence.
Article
Introduction A major purpose of diagnosis is to indicate the type of treatment that is required for the presenting patient. Other purposes of diagnosis identified by Kendell (1975) include predicting course and prognosis, understanding etiology and factors leading to the condition, and in the calculation of prevalence and incidence rates in epidemiological research. The latter indicates the “health” of the nation and aids in determining the allocation of mental health infrastructure and resources to specific geographic regions with the greatest unmet need. Issues of reliability and, to a lesser extent, the validity of diagnoses dominate the study of psychopathology. These issues led to the publication of DSM–III (American Psychiatric Association,1980). They are of the utmost importance; however, we have shored up reliability without impacting on validity. Indeed, validity has largely weakened over the past 20 years as treatments diffuse across diagnostic boundaries, e.g. antidepressants being prescribed for both major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) (Palmer & Benfield, 1994). Philosophical differences revolve around the role of psychopathology as the basis for reaching a diagnosis. Two approaches – one clinical and one biological – represent the major differences. The clinical approach posits clinical pictures as being of paramount importance in defining psychopathology, i.e. the observations of clinicians, the reports of patients and of others – including family members. Proponents of the clinical perspective place great emphasis on the clinician's acumen in judging the presence or absence of phenomena and in grading those phenomena.
Article
Investigations of the childhood antecedents of adult schizophrenia may clarify our understanding of the etiology of the disease, provide guidelines for meaningful classification of subtypes of schizophrenic illness, point to strategies for identifying those individuals in need for early intervention, and suggest appropriate techniques for early intervention. Among the more salient characteristics of schizophrenic illness are disturbances in interpersonal relations, especially withdrawal from normal social interaction.
Article
High-risk research on schizophrenia has been concerned chiefly with two types of issues: (1) description of background factors in the early lives of high-risk subjects; and (2) identification of biological variables that may be markers of the genetic liability to schizophrenic disorders. It is concluded that efforts to describe background factors have led to some conflicting results, have shown little evidence of specificity of the factors under study to risk for schizophrenia, and may not be generalizable to most individuals who develop schizophrenia. Results of research focusing on biological variables are summarized under the headings of attention and information processing (AIP), smooth pursuit eye movement (SPEM), neurological signs, electrodermal responding, event related potentials, and ventricular size. Of these, certain AIP and SPEM dysfunctions show substantial evidence of serving as biological markers, certain other AIP impairments are promising in this regard, electrodermal responsivity is not, and the other three categories present uncertain or conflicting results. Several methodological issues that have hampered the first generation of high-risk research are discussed.
Article
To explore different aspects of executive function (i.e. sequencing, set shifting and mental flexibility) in children who are at high risk for schizophrenia by comparing them with normal controls. The high risk (HR) group consisted of 30 children whose parents were diagnosed as schizophrenia. As the control group (CG) 30 children, whose parents did not meet any DSM IV diagnostic criteria for any psychiatric disorder, participated. They were age and sex matched with the HR group. For the evaluation of different domains of cognitive functions Wechsler intelligence scale for children-revised (WISC-R), and a group of neuropsychological tests, including Trail Making A-B Tests, Color Form Test, and Progressive Figures Test were administered. Behavioral problems were assessed using Hacettepe Adjustment Scale. The subjects in the high risk group had significantly lower scores on Trail Making A-B, Color Form, Progressive Figures Tests, as well as subtests and scores of WISC-R (Information, Comprehension, Similarities, Picture Completion, Block Design, Object Assembly and Coding subtests, Verbal, Performance and Full Scale IQ scores). There is no significant difference between the two groups in the frequency and severity of behavioral problems. Children of parents with schizophrenia displayed significantly greater number of difficulties in several areas of executive function, such as sequencing, set shifting, and mental flexibility, when compared to their controls.
Article
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Thesis--State University of New York at Stony Brook. Includes bibliographical references (p. 101-108).
Article
The research literature on psychotic disturb- ances of early childhood has rapidly expanded in the last 6 years. Since the appearance of Rimland's review of infantile autism in 1964 and the annotated bibliography on childhood schizo- phrenia done by Tilton, DeMyer, and Loew 2 years later, publications relevant to early child- hood psychoses have numbered more than 400 articles and six books, 1 making it increasingly dif- ficult to keep abreast of current research trends. Recent investigations have been characterized by renewed interest in the development of treat- ment procedures, attempts at more adequate de- scription of perceptual processes, intelligence, and language, and a search for neurobiological correlates. In this review we shall summarize some of these newer directions in research, with the hope of clarifying a number of critical issues and further stimulating the design of systematic research strategies and effective therapeutic
Article
Compared the performance of 30 chronic schizophrenics and 30 patients with personality disorders on 2 measures of overinclusion. Consistent with previous research, schizophrenic Ss showed more overinclusion than nonschizophrenic Ss on an R. W. Payne-type test, and were more overinclusive on a Payne-type test than on an L. J. Chapman-type test. Results are interpreted within the framework of W. E. Broen and L. H. Storm's theory of partial collapse of response hierarchies in schizophrenia. (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Article
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Schizophrenia may be viewed as a defect in organization resulting from varying combinations of genetic, organic, intrafamilial and social influences. A number of clinical syndromes are described and their differential diagnosis considered. The clinical picture will usually change as the child grows older. Laboratory investigations including EEG. are not helpful. At whatever age the schizophrenic child is seen, the following difficulties are most likely to be encountered: 1) Lack of firm self-identity, disturbed body image and lack of clear ego boundaries. This may be directly apparent or may be determined by the use of projective methods or drawings. These difficulties constitute the core problem and are essential to the diagnosis. 2) Dereistic feeling, thinking and behaviour. 3) The simultaneous presence of impaired and precocious psychological functioning. 4) A loss of normal interests or the appearance of unusual or regressive ones. 5) Language disturbances in content or in rhythm, intonation, pitch, stress or volume. 6) Deficient social relationships with impaired capacity to empathize and a tendency to withdrawal. Certainty about individual identity and what lies outside and inside the ego is essential for normal relationships. Awareness of the changing clinical features of childhood schizophrenia and careful examination for basic problems in identity and distinction of internal and external reality will help in arriving at a diagnosis.
Article
Assessed the short-term memory capacities of 4 chronic, schizophrenic and 4 nonschizophrenic psychiatric patients who served as controls. The information to be remembered was presented both visually and verbally and was later probed for after a variable interval by either visual or verbal cues. Schizophrenics and controls did not differ with respect to which type of cue retrieved more of the information, suggesting that the modality in which the information was stored was the same for both groups. However, schizophrenics were markedly inferior to controls regarding both the initial acquisition of information and the maintenance of it in storage. (French summary)
Article
IN THE ATTEMPT to understand why schizophrenic symptoms appear in one individual and not in another, major investigative efforts have been directed toward: (1) assessing the genetic component which controls the cellular and physiologic characteristics of the central nervous system, thereby influencing what is called temperament, nervous disposition, personality, or mind; (2) assessing the environmental experiential factors which temper the degree of development and expression of the personality; or (3) the complex interaction of endowment and environment. The study of pairs of monozygotic twins, when one twin has developed schizophrenic symptomatology and the other has not, has the unique research power of controlling for the genetic differences which occur between siblings and randomly selected individuals. Differences in environmental experience from the intra-uterine period through the onset of illness are therefore highlighted in these pairs. Characteristics of an infant at birth, the classically designated time for the "begin
Attention dysfunction in chronic schizophrenics Rodnick, E.H. The psychopathology of development: Investigating the etiology of schizophrenia
  • M H Orzack
  • C Kornetsky
Orzack, M.H., and Kornetsky, C. Attention dysfunction in chronic schizophrenics. Archives of General Psychiatry, 14:323-326, 1966. Rodnick, E.H. The psychopathology of development: Investigating the etiology of schizophrenia. American Journal of Orthopsychiatry, 38:784-798, 1968.
Sustained attention in children at risk for schizophrenia Archives of General Psychiatry Schopler, E. Visual versus tactual receptor preference in normal and schizophrenic children Short-term memory impairment in chronic schizophrenia
  • J Rutschmann
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Rutschmann, J.; Cornblatt, B.; and Erlenmeyer-Kimling, L. Sustained attention in children at risk for schizophrenia. Archives of General Psychiatry, 34:571-575, 1977. Schopler, E. Visual versus tactual receptor preference in normal and schizophrenic children. Journal of SCHIZOPHRENIA BULLETIN Abnormal Psychology, 71:108-114, 1966. Smith, E.E. Short-term memory impairment in chronic schizophrenia. Canadian Journal of Psychology, 23:114-126, 1969.
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Conceptual performance in schizophrenia Abnormal Psychology Short-term memory impairment in chronic schizophrenia Early characteristics of monozygotic twins discordant for schizophrenia
  • A A Adinolfi
  • R Barocas
  • E E Smith
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Adinolfi, A.A., and Barocas, R. Conceptual performance in schizophrenia. Journal of Clinical Psychology, 26:167-170, 1970. Abnormal Psychology, 71:108-114, 1966. Smith, E.E. Short-term memory impairment in chronic schizophrenia. Canadian Journal of Psychology, 23:114-126, 1969. Stabenau, J.R., and Pollin, W. Early characteristics of monozygotic twins discordant for schizophrenia. Archives of General Psychiatry, 17:723-734, 1967.
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