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Social functioning in individuals at clinical high risk for psychosis
Open accessAbstract
Poor social functioning is a hallmark of schizophrenia. The purpose of this study was to examine social functioning in individuals at clinical high risk for psychosis. Social functioning was assessed in a sample of 86 clinical high risk (CHR) individuals and compared to that of 50 first-episode of psychosis (FE) subjects, 53 multi-episode schizophrenia subjects (ME) and 55 non-psychiatric controls (NPC). Subjects were assessed on the Social Functioning Scale (SFS), the Role Functioning subscale of the Quality of Life Scale (QLS-role), and the premorbid functioning scale. On the SFS, the CHR group did not differ significantly from the FE and ME groups and all were impaired relative to the NPCs. On QLS-role, the CHR group performed significantly better than the ME patients and significantly worse than NPCs. CHR subjects did not differ from patients in terms of premorbid functioning. This study demonstrates that even at the pre-psychotic phase of the illness, these young people are demonstrating significant deficits in social functioning, supporting that social deficits are present long before the onset of psychotic symptoms.
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“A significant decline in social functioning has been found across all stages of psychosis, from clinical high risk (CHR), and first episode of psychosis (FEP) to chronic schizophrenia (SZ) (Abel and Minor 2021; Addington et al. 2008; Raghavan et al. 2017)”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Addington et al. 2008
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“A decline in social functioning is a hallmark of psychosis and often emerges before illness onset and typically develops into long‐standing difficulties (Addington et al. 2008; Carrión et al. 2013; Robinson et al. 2004).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Addington et al. 2008
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The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review
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BackgroundInfluentialRisk Factors for Psychosis: Impaired Social and Role Functioning
Cornblatt, B. A., Carrión, R. E., Addington, J., Seidman, L. J., Walker, E. F., Cannon, T. D., Cadenhead, K. S., McGlashan, T. H., Perkins, D. O., Tsuang, M. T., et al. (2011) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr136 · Cited by 265
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“Broadly speaking the high risk state is characterized by the presence of subtresholded psychotic symptoms, cognitive and neurobiological deficits [28,37,31,16] and significant limitations in psychosocial functioning [1].”
BackgroundVelthorst, E., Nieman, D. H., Becker, H. E., van de Fliert, R., Dingemans, P. M. A. J., Klaassen, R. M. C., de Haan, L., van Amelsvoort, T., & LINSZEN, D. H. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.02.002 · Cited by 208
“Our study finds striking similar results as the study of Cannon et al. (2008). As well as the Cannon et al. study, our results show that the UHR subjects who later make the transition to psychosis have increased social anhedonia and withdrawal as assessed with the SIPS compared to the UHR subjects that do not make the…”
BackgroundResultInfluentialPrediction and Prevention of Psychosis in Youth at Clinical High Risk
Addington, J., & Heinssen, R. (2012) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032511-143146 · Cited by 189
“High levels of negative symptoms, significant impairments in academic performance and occupational functioning, and difficulties with interpersonal relationships are often observed (Addington et al. 2008b, Ballon et al. 2007, Lencz et al. 2004, Yung et al. 2008).”
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Amminger, G. P., Schäfer, M. R., Papageorgiou, K., Klier, C. M., Schlögelhofer, M., Mossaheb, N., Werneck‐Rohrer, S., Nelson, B., & McGorry, P. D. (2011) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr015 · Cited by 192
Carrión, R. E., Goldberg, T. E., McLaughlin, D., Auther, A. M., Correll, C. U., & Cornblatt, B. A. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10081209 · Cited by 184
“In addition, two prospective studies of patients at clinical high risk for psychosis (16, 17) indicated that, relative to healthy comparison subjects, patients at high risk have significant impairments in maintaining social/interpersonal relationships and managing academic and work tasks, comparable to individuals wit…”
BackgroundCorcoran, C. M., Kimhy, D., Parrilla-Escobar, M. A., Cressman, V. L., Stanford, A. D., Thompson, J. L., Ben‐David, S., Crumbley, A. H., Schobel, S., Moore, H. M., et al. (2010) · Psychological Medicine · doi:10.1017/s0033291710000802 · Cited by 156
“2007) or evenmultiple episodes (Addington et al. 2008a) of psychosis.”
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Patel, P. K., Leathem, L. D., Currin, D. L., & Karlsgodt, K. H. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.06.028 · Cited by 152
“More broadly, role functioning in CHR youth appears to be predicted by WM abnormalities (66), and to in turn predict severity of psychosis symptomatology (108).”
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Oxidative Stress and the Pathophysiology and Symptom Profile of Schizophrenia Spectrum Disorders
Murray, A., Rogers, J. C., Katshu, M. Z. U. H., Liddle, P. F., & Upthegrove, R. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.703452 · Cited by 152
“Schizophrenia has an age of onset of between 18 and 25 years in men and 25–35 years in women (5), with a prodromal phase that can be detected up to 30 months before onset (6).”
BackgroundAltered resting-state connectivity in subjects at ultra-high risk for psychosis: an fMRI study
Shim, G., Oh, J. S., Jung, W. H., Jang, J. H., Choi, C., Kim, E., Park, H.-Y., Choi, J., Jung, M. H., & Kwon, J. S. (2010) · Behavioral and Brain Functions · doi:10.1186/1744-9081-6-58 · Cited by 143
“These deficits include impaired social functioning and related problems with social skills [38-40], which are significant predictors of psychosis [41].”
BackgroundThe case for including Attenuated Psychotic Symptoms Syndrome in DSM-5 as a psychosis risk syndrome
Woods, S. W., Walsh, B. C., Saksa, J. R., & McGlashan, T. H. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.08.012 · Cited by 130
“Recent studies using more specific measures confirm current impairments of social and/or role functioning (Addington et al., 2008; Ballon et al., 2007; Shim et al., 2008).”
BackgroundSelf-citationGender Differences in Individuals at High‐Risk of Psychosis: A Comprehensive Literature Review
Barajas, A., Ochoa, S., Obiols, J. E., & Lalucat-Jo, L. (2015) · The Scientific World Journal · doi:10.1155/2015/430735 · Cited by 122
“On the other hand, there are suggestions that deficits in social functioning are often predictors of later social functioning [66].”
BackgroundDefining and predicting functional outcome in schizophrenia and schizophrenia spectrum disorders
Schennach-Wolff, R., Jäger, M., Seemüller, F., Obermeier, M., Messer, T., Laux, G., Pfeiffer, H., Naber, D., Schmidt, L., Gäebel, W., et al. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.05.032 · Cited by 120
“Addington et al. (2008) were able to demonstrate that even at the prepsychotic phase of the illness, younger patients feature significant deficits in social functioning, indicating that social deficits are present long before the onset of psychotic symptoms.”
BackgroundFamily interventions in early psychosis: specificity and effectiveness
Onwumere, J., Bebbington, P., & Kuipers, E. (2011) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796011000187 · Cited by 120
“While remission from positive symptoms is often rapidly achieved following the first episode (Lieberman et al. 2003; Schooler et al. 2005), social dysfunction is a significant issue from the very early phases (Addington et al. 2008).”
BackgroundAlvarez-Jimenez, M., Gleeson, J. F., Bendall, S., Penn, D. L., Yung, A. R., Ryan, R. M., Eleftheriadis, D., D'Alfonso, S., Rice, S., Miles, C., et al. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.07.022 · Cited by 118
Self-citationOffspring of Parents with Schizophrenia
Hameed, M. A., & Lewis, A. J. (2016) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000076 · Cited by 109
Moreno, C., Nuevo, R., Chatterji, S., Verdes, E., Arango, C., & Ayuso‐Mateos, J. L. (2013) · World Psychiatry · doi:10.1002/wps.20070 · Cited by 108
“The negative impact of psychotic symptoms on functioning seems not to be restricted to individuals with diagnosable psychotic disorders (23,24).”
BackgroundCarrión, R. E., Auther, A. M., McLaughlin, D., Olsen, R. H., Addington, J., Bearden, C. E., Cadenhead, K. S., Cannon, T. D., Mathalon, D. H., McGlashan, T. H., et al. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby126 · Cited by 107
Self-citationUnderstanding Psychosis and Schizophrenia
Cooke, A. (2014) · Cited by 163
Social dysfunction predicts two years clinical outcome in people at ultra high risk for psychosis
Fusar‐Poli, P., Byrne, M., Valmaggia, L., Day, F., Tabraham, P., Johns, L., & McGuire, P. K. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.08.016 · Cited by 104
“A complementary approach is to investigate social functioning in subjects who are at clinical risk for psychosis and who are referred to specialized clinical services for people in the prodromal phases of psychosis (Addington et al., 2008; Lencz et al., 2004; Shim et al., 2008).”
BackgroundNieman, D. H., Ruhrmann, S., Dragt, S., Soen, F., van Tricht, M. J., Koelman, J. H. T. M., Bour, L. J., Velthorst, E., Becker, H. E., Weiser, M., et al. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbt145 · Cited by 103
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Premorbid functional development and conversion to psychosis in clinical high-risk youths
Tarbox, S. I., Addington, J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Perkins, D. O., Seidman, L. J., Tsuang, M. T., Walker, E. F., HEINSSEN, R. K., et al. (2013) · Development and Psychopathology · doi:10.1017/s0954579413000448 · Cited by 89
“Reports from the North American Prodrome Longitudinal Study (NAPLS-I) consortium that use the PAS suggest a pattern of premorbid functional deterioration through late adolescence in CHR individuals (Addington et al., 2008; Woods et al., 2009).”
Self-citationDevoe, D. J. A., Farris, M. S., Townes, P., & Addington, J. (2018) · Early Intervention in Psychiatry · doi:10.1111/eip.12689 · Cited by 88
“, 2003) that may be observed in those experiencing a first episode of psychosis or even chronic course of schizophrenia (Addington et al., 2008).”
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Progress and Future Directions in Research on the Psychosis Prodrome
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“Long-standing or worsening functional difficulties are also common.(24,25) The vast majority have had previous treatment with psychotherapy or psychotropic medications.”
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“Introduction Poor social functioning (SF) is ubiquitous among individuals at clinical high risk for psychosis (CHR; Ballon et al. 2007; Addington et al. 2008; Ben-David et al. 2014) and has been found to be a predictor of development of psychotic symptoms (Cannon et al. 2008; Jang et al. 2011;…”
BackgroundModels of Neurodevelopmental Abnormalities in Schizophrenia
Powell, S. B. (2010) · Current topics in behavioral neurosciences · doi:10.1007/7854_2010_57 · Cited by 87
“3.5 Postweaning Social Isolation Social withdrawal and isolation are common features of schizophrenia that have received recent attention because of the role social factors play in the risk for schizophrenia and conversion to psychosis in prodromal patients (Addington et al. 2008).”
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“, cognition, social functioning, and educational/vocational functioning) typically worsen or remain stable over the early natural course of psychotic disorders [97–100].”
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Isolation rearing effects on probabilistic learning and cognitive flexibility in rats
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“Introduction Impaired social functioning is a diagnostic feature of schizophrenia and is present early in the course of illness (Addington et al., 2008).”
BackgroundOut of touch with reality? Social perception in first-episode schizophrenia
Ebisch, S. J. H., Salone, A., Ferri, F., De Berardis, D., Romani, G. L., Ferro, F. M., & Gallese, V. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nss012 · Cited by 77
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Self-citationNonverbal Behavior During Face-to-face Social Interaction in Schizophrenia
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“Social deficits present before the onset of positive symptoms, such as hallucinations and delusions (Addington et al., 2008), remain stable over time and predict poorer patient prognosis (Monte et al., 2008).”
BackgroundAssociation testing of copy number variants in schizophrenia and autism spectrum disorders
Crespi, B. J., & Crofts, H. (2012) · Journal of Neurodevelopmental Disorders · doi:10.1186/1866-1955-4-15 · Cited by 69
“language deficits [75-78].”
O’Brien, M. P., Miklowitz, D. J., Candan, K., Marshall, C., Domingues, I., Walsh, B. C., Zinberg, J. L., Silva, S. D. D., Woodberry, K. A., & Cannon, T. D. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0034667 · Cited by 66
“…impairments in interpersonal communication that are not significantly different from patients with first episode and multiple episodes of psychosis (Addington et al., 2008), and family burden is comparable in families of clinical high-risk and recent-onset psychosis patients (Wong et al., 2008).”
Statucka, M., & Walder, D. J. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2012.12.005 · Cited by 66
“Research with CHR (Addington et al., 2008b; Shim et al., 2008) and psychometrically at-risk (Henry et al., 2008; Heber et al., 2011) individuals may help elucidate the nature of social functioning deficits in SSDs. Successful social interactions rely on ability to read others’ emotions (Riggio,…”
BackgroundInfluentialPeng, M., Xing, J., Tang, X., Wu, Q., Wei, D., & Ran, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031862 · Cited by 68
“According to the DSM, functional impairment is one of the clinical features and markers of schizophrenia [26,27].”
BackgroundChildhood adversity and social functioning in psychosis: Exploring clinical and cognitive mediators
Palmier‐Claus, J. E., Berry, K., Darrell-Berry, H., Emsley, R., Parker, S., Drake, R., & Bucci, S. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.02.004 · Cited by 63
“ferent stages of psychotic disorder (Addington et al., 2008), where”
Genetic underpinnings of sociability in the general population
Bralten, J., Mota, N. R., Klemann, C. J. H. M., Witte, W. D., Laing, E., Collier, D. A., de Kluiver, H., Bauduin, S., Arango, C., Ayuso‐Mateos, J. L., et al. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-01044-z · Cited by 63
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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 et al., 2008; Thompson et al., 2011;…”
BackgroundSelf-citationSocial Functioning Deficits in Young People at Risk for Schizophrenia
Shim, G., Kang, D.-H., Chung, Y. S., Yoo, S. Y., Shin, N. Y., & Kwon, J. S. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802203459 · Cited by 60
“Recent studies have reported that high-risk individuals exhibit social skill deficits and impairment of social functioning [14 16], and have identified poor functioning as a potential risk factor for psychosis [17].”
BackgroundBhojraj, T. S., Sweeney, J. A., Prasad, K. M. R., Eack, S. M., Francis, A., Miewald, J. M., Montrose, D. M., & Keshavan, M. S. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.04.257 · Cited by 57
“, 2007), affect perception deficits (Addington et al., 2008), theory-of-mind deficits (Chung et al.”
BackgroundGayer-Anderson, C. E., Fisher, H. L., Fearon, P., Hutchinson, G. A., Morgan, K. D., Dazzan, P., Boydell, J. E., Doody, G. A., Jones, P. B., Murray, R. M., et al. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1058-6 · Cited by 57
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“These outcomes include varying levels of attenuated positive [18] and negative [19] symptoms, depressive symptoms [20], impairments in functioning [21] and quality of life [22], and overall remission [23].”
BackgroundLongitudinal validation of psychosis risk screening tools
Kline, E. R., Thompson, E., Demro, C., Bussell, K., Reeves, G. M., & Schiffman, J. E. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.04.026 · Cited by 54
“Research within CHR populations suggests that these patients experience considerable distress as well as impairments in social and occupational functioningwell before the onset of full-threshold psychotic symptoms (Addington et al., 2008; Ruhrmann et al., 2008; Velthorst et al., 2010; Cornblatt et al., 2011; Thompson…”
BackgroundAlameda, L., Golay, P., Baumann, P., Progin, P., Mebdouhi, N., Elowe, J., Ferrari, C., Kim, Q., & Conus, P. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw163 · Cited by 53
“36 Age at the time of first exposure was categorized as follows (1) early trauma refers to exposure between birth and age 12, according to conventions applied elsewhere,37–39 (2) late trauma refers to exposure between ages 12 and 16.”
Healey, K. M., Penn, D. L., Perkins, D. O., Woods, S. W., Keefe, R. S. E., & Addington, J. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx080 · Cited by 51
Self-citationDevoe, D. J. A., Braun, A., Seredynski, T., & Addington, J. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000273 · Cited by 49
“, level of functioning at school or work).(16)”
BackgroundSelf-citationGrealish, A., Tai, S., Hunter, A., Emsley, R., Murrells, T., & Morrison, A. P. (2016) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12111 · Cited by 60
Alterations in facial expressivity in youth at clinical high-risk for psychosis.
Gupta, T., Haase, C. M., Strauss, G. P., Cohen, A. S., & Mittal, V. A. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000413 · Cited by 44
Phensy, A. J., Duzdabanian, H. E., Brewer, S. M., Panjabi, A., Driskill, C. M., Berz, A., Peng, G., & Kroener, S. (2017) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2017.00106 · Cited by 45
“…impaired social function and isolation have been shown to precede the onset of psychotic symptoms of schizophrenia (Häfner et al., 1999; Møller and Husby, 2000; Addington et al., 2008) and they are a common risk factor for the development of psychosis in high-risk patients (Cannon et al., 2008).”
BackgroundMittal, V. A., Jalbrzikowski, M., Daley, M. L., Román, C. A. F., Bearden, C. E., & Cannon, T. D. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2011.05.007 · Cited by 45
Jang, J. H., Shin, N. Y., Shim, G., Park, H. Y., Kim, E., Jang, G.-E., Kwon, J. S., Hur, J., An, S. K., & Kwon, J. S. (2011) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2011.595684 · Cited by 43
Chudleigh, C., Naismith, S. L., Blaszczynski, A., Hermens, D. F., Hodge, M. A. R., & Hickie, I. B. (2011) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2011.00280.x · Cited by 42
“It appears that such disconnections between the self and their peers may occur prior to the onset of full-threshold psychosis, leading to continued (or even exacerbated) social withdrawal and disability throughout the illness.(14) In terms of contributors to social functioning, the current findings suggest that self-r…”
MethodResultLee, S. J., Kim, K. R., Lee, S. Y., & An, S. K. (2017) · Psychiatry Investigation · doi:10.4306/pi.2017.14.2.186 · Cited by 42
Sensorimotor gating deficits in “two-hit” models of schizophrenia risk factors
Khan, A., & Powell, S. B. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.10.009 · Cited by 47
Burke, A. S., Shapero, B. G., Pelletier‐Baldelli, A., Deng, W., Nyer, M., Leathem, L. D., Briggs, L. B. N., Landa, C. E., Cather, C., & Holt, D. J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.01030 · Cited by 48
Cowan, H. R., McAdams, D. P., & Mittal, V. A. (2018) · Development and Psychopathology · doi:10.1017/s0954579417001912 · Cited by 42
Lee, S., Kim, K. R., Lee, S. Y., & An, S. K. (2017) · Psychiatry Investigation · doi:10.4306/pi.2017.14.5.539 · Cited by 46
Poor functioning ability is associated with high risk of developing psychosis in adolescents
Granö, N., Karjalainen, M., Suominen, K. H., & Roine, M. (2010) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2010.483743 · Cited by 39
“(6) found with young adults (mean age 19.”
BackgroundCressman, V. L., Schobel, S., Steinfeld, S., Ben‐David, S., Thompson, J. L., Small, S. A., Moore, H. M., & Corcoran, C. M. (2015) · Schizophrenia · doi:10.1038/npjschz.2015.20 · Cited by 39
Childhood maltreatment and social functioning in adults with sub-clinical psychosis
Boyda, D., & McFeeters, D. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.01.023 · Cited by 41
“Indeed impairments in social functioning are a common feature in individuals at ultra-high risk (UHR) for psychotic disorder (Addington et al., 2008).”
BackgroundAyesa‐Arriola, R., Rodríguez-Sánchez, J. M., Morelli, C., Pelayo‐Terán, J. M., Pérez‐Iglesias, R., Mata, I. F., Martínez‐García, O., Pardo‐García, G., Vázquez‐Barquero, J. L., & Crespo‐Facorro, B. (2011) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2010.00249.x · Cited by 38
“Individuals with schizophrenia frequently recognize they do have deficits in social and work functioning long before the onset of psychotic symptoms.(63) However, they do not believe that these social function impairments are biased by their mental illness.”
BackgroundPowell, S. B., & Swerdlow, N. R. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad098 · Cited by 43
Mamah, D. T., Owoso, A., Sheffield, J. M., & Bayer, C. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.07.004 · Cited by 40
“Psychiatric conditions, including high risk states, can also lead to stressful experiences, for example comorbid health problems, job problems or loss, interpersonal difficulties, financial losses, problemswith schoolwork, or substance use,which can further worsen outcomes [79,80].”
BackgroundRiches, S., Pisani, S., Bird, L., Rus‐Calafell, M., Garety, P. A., & Valmaggia, L. (2021) · International Review of Psychiatry · doi:10.1080/09540261.2021.1918648 · Cited by 41
Yasuyama, T., Ohi, K., Shimada, T., Uehara, T., & Kawasaki, Y. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2016.12.053 · Cited by 36
“For example, a high rate of social withdrawal may be a common social dysfunction among patients with these major psychiatric disorders (Addington et al., 2008; Crook et al., 1981; Kaya et al., 2007).”
InfluentialImproving access to specialized care for first-episode psychosis: an ecological model
Moe, A. M., Rubinstein, E. B., Gallagher, C., Weiss, D. M., Stewart, A. M., & Breitborde, N. J. K. (2018) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s131833 · Cited by 47
“Psychotic disorders are marked by impairments in social functioning that are present even before the full onset of positive symptoms 37 and contribute to a deterioration of relationships early in the illness.”
Salokangas, R. K. R., Heinimaa, M., From, T., Löyttyniemi, E., Ilonen, T., Luutonen, S. H., Hietala, J. A., Svirskis, T., von Reventlow, H. G., Juckel, G., et al. (2013) · European Psychiatry · doi:10.1016/j.eurpsy.2013.10.003 · Cited by 33
“In terms of premorbid functioning, CHR subjects did not differ from patients with first-episode psychosis or multi-episode schizophrenia [3].”
ResultTaylor, M. A., Shorter, E., Vaidya, N. A., & Fink, M. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01589.x · Cited by 33
“About half the persons diagnosed with schizophrenia exhibit these childhood behaviours (88, 89).”
BackgroundPatterns of premorbid functioning in individuals at clinical high risk of psychosis
Lyngberg, K., Buchy, L., Liu, L., Perkins, D. O., Woods, S. W., & Addington, J. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.11.004 · Cited by 33
“CHR individuals show poorer premorbid functioning compared to healthy controls (Tikka et al., 2013; Morcillo et al., 2014; Tarbox et al., 2013) and similar premorbid functioning to patients with psychosis (Addington et al., 2008).”
BackgroundSelf-citationVines, L., Bridgwater, M., Bachman, P., Hayes, R., Catalano, S., & Jalbrzikowski, M. (2022) · Early Intervention in Psychiatry · doi:10.1111/eip.13212 · Cited by 30
Conceptualisation of recovery from psychosis: a service-user perspective
Wood, L., Price, J., Morrison, A. P., & Haddock, G. (2010) · The Psychiatrist · doi:10.1192/pb.bp.109.027409 · Cited by 31
“4,13 Further support for symptom change as an important indicator of recovery is illustrated by the number of psychometrically reliable symptom outcome measures that have been developed.”
Collip, D., Wigman, J. T. W., Lin, A. P., Nelson, B., Oorschot, M., Vollebergh, W., Ryan, J., Baksheev, G., Wichers, M., van Os, J., et al. (2011) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr115 · Cited by 32
Treating young individuals at clinical high risk for psychosis
Marshall, C., Addington, J., Epstein, I., Liu, L., Deighton, S., & Zipursky, R. B. (2011) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2011.00299.x · Cited by 30
“Likewise, ratings on social functioning are typically lower than normally seen in non-psychiatric individuals of similar age.(7) Substance misuse measures were virtually unchanged from the low level of use experienced on entering the study.”
BackgroundSelf-citationBright, M., Parker, S., French, P., Fowler, D. G., Gumley, A. I., Morrison, A. P., Birchwood, M. J., Jones, P. B., Stewart, S., & Adrian Wells, A. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.037 · Cited by 29
“…with peers and family members, engagement in leisure and sports activities, level of independence and interpersonal and communication abilities (Addington et al., 2008, 2013; Ballon et al., 2007; Cornblatt et al., 2007; Hodgekins et al., 2015; O'Brien et al., 2006; Palmier-Claus et al., 2016;…”
BackgroundElucidating negative symptoms in the daily life of individuals in the early stages of psychosis
Hermans, K. S. F. M., Myin‐Germeys, I., Gayer-Anderson, C. E., Kempton, M. J., Valmaggia, L., McGuire, P. K., Murray, R. M., Garety, P. A., Wykes, T., Morgan, C., et al. (2020) · Psychological Medicine · doi:10.1017/s0033291720001154 · Cited by 29
Intervention in the at-risk state to prevent transition to psychosis
Ruhrmann, S., Schultze‐Lutter, F., & Klosterkötter, J. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328324b687 · Cited by 29
Rekhi, G., Rapisarda, A., & Lee, J. (2017) · Early Intervention in Psychiatry · doi:10.1111/eip.12451 · Cited by 27
Haining, K., Matrunola, C., Mitchell, L., Gajwani, R., Gross, J., Gumley, A., Lawrie, S., Schwannauer, M., Schultze-Lutter, F., & Uhlhaas, P. (2019) · Psychological Medicine · doi:10.1017/s0033291718003975 · Cited by 22
“Emotion recognition deficits have been reported in some CHR studies (Addington et al., 2008a, 2008b; van Rijn et al., 2011; Amminger et al., 2012) while others have found emotion recognition to be intact (Pinkham et al., 2007; Seiferth et al., 2008; Gee et al., 2012).”
Peng, M., Chen, H., Tin, Z., Yao, Y.-Y., Li, Z.-H., Long, L., Duan, Q.-Q., Lin, F.-R., Zen, Y., Chen, J., et al. (2019) · International Journal of Social Psychiatry · doi:10.1177/0020764019866224 · Cited by 27
Bejerholm, U. (2009) · Scandinavian Journal of Occupational Therapy · doi:10.3109/11038120903254323 · Cited by 26
“It is, for example, commonly stated that people with schizophrenia have poor social functioning, in terms of participation in society, maintaining engagement in daily occupations, and communicating with others [18].”
BackgroundReciprocal social behavior in youths with psychotic illness and those at clinical high risk
Jalbrzikowski, M., Krasileva, K. E., Marvin, S. E., Zinberg, J. L., Andaya, A., Bachman, P., Cannon, T. D., & Bearden, C. E. (2013) · Development and Psychopathology · doi:10.1017/s095457941300045x · Cited by 26
“…which is characterized by a lack of involvement in social activities, difficulty communicating with others, and a reduced number of social supports (Bengtsson-Tops & Hansson, 2001; Couture, Penn, & Roberts, 2006), has been identified prior to illness onset, both prospectively and retrospectively…”
BackgroundFamily functioning moderates the impact of psychosis-risk symptoms on social and role functioning
Thompson, E., Rouhakhtar, P. R., Pitts, S. C., Demro, C., Millman, Z. B., Bussell, K., DeVylder, J., Kline, E. R., Reeves, G. M., & Schiffman, J. E. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.08.035 · Cited by 25
“Individuals at clinical high-risk (CHR) for psychosis often experience significant emotional distress and marked deficits in multiple areas of functioning, including social integration and role fulfillment (Addington et al., 2008; Cornblatt et al., 2012; Fusar-Poli et al., 2015; Olvet, 2015).”
BackgroundTarbox, S. I., Addington, J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Perkins, D. O., Seidman, L. J., Tsuang, M. T., Walker, E. F., HEINSSEN, R. K., et al. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.10.006 · Cited by 25
“A pattern of early functional deterioration among CHR individuals is also consistent with results from phase one of the North American Prodrome Longitudinal Study (NAPLS-1) (Addington et al., 2008; Woods et al., 2009), including recent evidence that poor social adjustment in adolescence predicts transition to psychosi…”
InfluentialSelf-citationRiehle, M., & Lincoln, T. M. (2017) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2017.01.003 · Cited by 26
Emotion recognition and social/role dysfunction in non-clinical psychosis
Pelletier‐Baldelli, A., Dean, D. J., Lunsford‐Avery, J. R., Smith, A. K., Orr, J. M., Gupta, T., Millman, Z. B., & Mittal, V. A. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.10.039 · Cited by 24
Predicting the risk of psychosis onset: advances and prospects
Strobl, E. V., Eack, S. M., Swaminathan, V., & Visweswaran, S. (2012) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2012.00383.x · Cited by 22
Genetic risk for schizophrenia and autism, social impairment and developmental pathways to psychosis
Velthorst, E., Froudist‐Walsh, S., Stahl, E. A., Ruderfer, D. M., Ivanov, I., Buxbaum, J. D., Børglum, A. D., Grove, J., Mattheisen, M., Werge, T. M., et al. (2018) · Translational Psychiatry · doi:10.1038/s41398-018-0229-0 · Cited by 28
Metadata
- Authors
- Addington, J., Penn, D., Woods, S. W., Addington, D., & Perkins, D. O.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of North Carolina at Chapel Hill (US)
- Yale University (US)
- University of Calgary (CA)
- Corresponding author
- Addington, Jean
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 99
- Issue
- 1-3
- Pages
- 119-124
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC2292799
- OpenAlex
- W2060028231
- Cited by
- 265
- References
- 25
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 11 · 2023: 11 · 2022: 9 · 2021: 20 · 2020: 18 · 2019: 20 · 2018: 15 · 2017: 20 · 2016: 16 · 2015: 16 · 2014: 11 · 2013: 18 · 2012: 14
- FWCI
- 5.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- UNC Libraries
- Funders
- Canadian Institutes of Health Research
- National Institute of Mental Health (U01MH066134, U01MH06634, U01MH066160, U01MH066069, U10MH066160, U01MH06634-02)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- social functioning, clinical high risk for psychosis
- MeSH terms
- Adolescent, Adult, Age Factors, Child, Chronic Disease, Employment, Female, Humans, Male, Psychotic Disorders, Quality of Life, Risk Factors, Role, Schizophrenia, Schizophrenic Psychology, Schizotypal Personality Disorder, Social Adjustment, Social Environment, Genetic Predisposition to Disease
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