Premorbid social adjustment and association with attenuated psychotic symptoms in clinical high-risk and help-seeking youth
Abstract
BACKGROUND: Attenuated positive symptom syndrome (APSS), characterized by 'putatively prodromal' attenuated psychotic-like pathology, indicates increased risk for psychosis. Poor premorbid social adjustment predicts severity of APSS symptoms and predicts subsequent psychosis in APSS-diagnosed individuals, suggesting application for improving detection of 'true' prodromal youth who will transition to psychosis. However, these predictive associations have not been tested in controls and therefore may be independent of the APSS diagnosis, negating utility for improving prediction in APSS-diagnosed individuals. METHOD: Association between premorbid social maladjustment and severity of positive, negative, disorganized, and general APSS symptoms was tested in 156 individuals diagnosed with APSS and 76 help-seeking (non-APSS) controls enrolled in the Enhancing the Prospective Prediction of Psychosis (PREDICT) study using prediction analysis. RESULTS: Premorbid social maladjustment was associated with social anhedonia, reduced expression of emotion, restricted ideational richness, and deficits in occupational functioning, independent of the APSS diagnosis. Associations between social maladjustment and suspiciousness, unusual thought content, avolition, dysphoric mood, and impaired tolerance to normal stress were uniquely present in participants meeting APSS criteria. Social maladjustment was associated with odd behavior/appearance and diminished experience of emotions and self only in participants who did not meet APSS criteria. CONCLUSIONS: Predictive associations between poor premorbid social adjustment and attenuated psychotic-like pathology were identified, a subset of which were indicative of high risk for psychosis. This study offers a method for improving risk identification while ruling out low-risk individuals.
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A reciprocal relationship appears to exist between poor premorbid social adjustment and increased levels of social anhedonia in help-seeking youth at clinical high risk for psychosis.
“Moving into clinical samples, a reciprocal relationship appears to exist between poor premorbid social adjustment and increased levels of social anhedonia in help-seeking youth at clinical high risk for psychosis (46).”
From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [46]
Cites
Dementia Praecox and Paraphrenia.
(1972) · Annals of Internal Medicine · doi:10.7326/0003-4819-76-6-1058_8 · Cited by 2,906 · see citing works
Miller, T. J., McGlashan, T. H., Rosen, J. L., Cadenhead, K. S., Ventura, J., McFarlane, W. R., Perkins, D. O., Pearlson, G. D., & Woods, S. W. (2003) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a007040 · Cited by 1,800 · see citing works
Self-citationThe Psychosis High-Risk State: A Comprehensive State-of-the-Art Review
Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., Keshavan, M., Wood, S., Ruhrmann, S., Seidman, L. J., et al. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.269 · Cited by 1,483 · see citing works
Self-citationCannon, T. D., Cadenhead, K., Cornblatt, B., Woods, S. W., Addington, J., Walker, E., Seidman, L. J., Perkins, D., Tsuang, M., McGlashan, T., et al. (2008) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2007.3 · Cited by 1,269 · see citing works
Self-citationMeasurement of Premorbid Adjustment in Chronic Schizophrenia
Cannon-Spoor, H. E., Potkin, S. G., & Wyatt, R. J. (1982) · Schizophrenia Bulletin · doi:10.1093/schbul/8.3.470 · Cited by 1,197 · see citing works
Psychosis prediction: 12-month follow up of a high-risk ("prodromal") group
Yung, A. R., Phillips, L. J., Yuen, H. P., Francey, S. M., McFarlane, C. A., Hallgren, M., & McGorry, P. D. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00167-6 · Cited by 1,136 · see citing works
Miller, T. J., McGlashan, T. H., Rosen, J. L., Somjee, L., Markovich, P. J., Stein, K., & Woods, S. W. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.5.863 · Cited by 872 · see citing works
Self-citationThe Prediction of Outcome in Schizophrenia
Strauss, J. S. (1972) · Archives of General Psychiatry · doi:10.1001/archpsyc.1972.01750300011002 · Cited by 795 · see citing works
Ruhrmann, S., Schultze-Lutter, F., Salokangas, R. K. R., Heinimaa, M., Linszen, D., Dingemans, P., Birchwood, M., Patterson, P., Juckel, G., Heinz, A., et al. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.206 · Cited by 632 · see citing works
An Individualized Risk Calculator for Research in Prodromal Psychosis
Cannon, T. D., Yu, C., Addington, J., Bearden, C. E., Cadenhead, K. S., Cornblatt, B. A., Heinssen, R., Jeffries, C. D., Mathalon, D. H., McGlashan, T. H., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15070890 · Cited by 574 · see citing works
Self-citationThe Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-Up
McGlashan, T. H., Walsh, B. C., & Woods, S. W. (2010) · Cited by 571 · see citing works
Self-citationSocial anhedonia as a predictor of the development of schizophrenia-spectrum disorders
Kwapil, T. R. (1998) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.107.4.558 · Cited by 512 · see citing works
At Clinical High Risk for Psychosis: Outcome for Nonconverters
Addington, J., Cornblatt, B. A., Cadenhead, K. S., Cannon, T. D., McGlashan, T. H., Perkins, D. O., Seidman, L. J., Tsuang, M. T., Walker, E. F., Woods, S. W., et al. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10081191 · Cited by 477 · see citing works
Self-citationWoods, S. W., Addington, J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., HEINSSEN, R. K., Perkins, D. O., Seidman, L. J., Tsuang, M. T., Walker, E. F., et al. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp027 · Cited by 404 · see citing works
Self-citationRisk 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 · see citing works
Self-citationNonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia
Lencz, T. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(03)00214-7 · Cited by 237 · see citing works
Fusar‐Poli, P., Cappucciati, M., Rutigliano, G., Schultze‐Lutter, F., Bonoldi, I., Borgwardt, S., Riecher‐Rössler, A., Addington, J., Perkins, D., Woods, S. W., et al. (2015) · World Psychiatry · doi:10.1002/wps.20250 · Cited by 234 · cited 1× · see citing works
“Conversely, associations between premorbid social adjustment and APSS symptoms, observed only in the absence of theAPSS diagnosis, would suggest low risk for APSS and in turn, predict low risk for psychosis (Fusar-Poli et al. 2015).”
BackgroundSelf-citationNorth American Prodrome Longitudinal Study (NAPLS 2)
Addington, J., Liu, L., Buchy, L., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Perkins, D. O., Seidman, L. J., Tsuang, M. T., Walker, E. F., et al. (2015) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000290 · Cited by 231 · see citing works
Self-citationHandbook of social functioning in schizophrenia
Mueser, K. T., & Tarrier, N. (1998) · Cited by 229 · see citing works
Premorbid and Onset Features of First-Episode Schizophrenia
Haas, G. L., & Sweeney, J. A. (1992) · Schizophrenia Bulletin · doi:10.1093/schbul/18.3.373 · Cited by 196 · see citing works
Handbook of Social Functioning in Schizophrenia
Tohen, M. F. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.8.1286 · Cited by 186 · see citing works
Carrión, R. E., Cornblatt, B. A., Burton, C. Z., Tso, I. F., Auther, A. M., Adelsheim, S., Calkins, R., Carter, C. S., Niendam, T., Sale, T. G., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15121565 · Cited by 170 · cited 2× · see citing works
“…prediction of unusual thought content and suspiciousness is particularly noteworthy given that these twopositive symptomsare central to theAPSSdiagnosis and are key predictors of psychosis in APSS youth (Cannon et al. 2008, 2016; Addington et al. 2015; Carrion et al. 2016; Brucato et al. 2017).”
BackgroundModeling the Early Course of Schizophrenia
Hafner, H., Maurer, K., Löffler, W., der Heiden, W. A., Hambrecht, M., & Schultze‐Lutter, F. (2003) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a007008 · Cited by 167 · see citing works
Anhedonia and perceptual aberration in first-episode psychotic patients and their relatives.
Katsanis, J., Iacono, W. G., & Beiser, M. (1990) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.99.2.202 · Cited by 155 · see citing works
Miller, T. J., Zipursky, R. B., Perkins, D., Addington, J., Woods, S. W., Hawkins, K. A., Hoffman, R., Preda, A., Epstein, I., Addington, D., et al. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00440-1 · Cited by 150 · see citing works
Self-citationDevelopment of social functioning in preschizophrenia children and adolescents: A systematic review.
Tarbox, S. I., & Pogue‐Geile, M. F. (2008) · Psychological Bulletin · doi:10.1037/0033-2909.34.4.561 · Cited by 143 · see citing works
Factorial structure of the Scale of Prodromal Symptoms
Hawkins, K. A. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(03)00053-7 · Cited by 118 · see citing works
Patterns of premorbid functioning in first episode psychosis: relationship to 2‐year outcome
Addington, J., & Addington, D. E. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00511.x · Cited by 117 · see citing works
Self-citationAddington, J., Liu, L., Perkins, D. O., Carrión, R. E., Keefe, R. S. E., & Woods, S. W. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw152 · Cited by 107 · see citing works
Self-citationPremorbid adjustment as predictor of outcome in schizophrenia: results of a prospective study
Bailer, J., Bräuer, W., & Rey, E.-R. (1996) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1996.tb10662.x · Cited by 104 · see citing works
A multivariate perspective on schizotypy and familial association with schizophrenia: A review
Tarbox, S. I., & Pogue‐Geile, M. F. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.07.002 · Cited by 97 · see citing works
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 · see citing works
Self-citationKimhy, D., Gill, K. E., Brucato, G., Vakhrusheva, J., Arndt, L. Y., Gross, J. J., & Girgis, R. R. (2016) · Psychological Medicine · doi:10.1017/s0033291716000490 · Cited by 87 · see citing works
Brucato, G., Masucci, M. D., Arndt, L. Y., Ben‐David, S., Colibazzi, T., Corcoran, C. M., Crumbley, A. H., Crump, F. M., Gill, K. E., Kimhy, D., et al. (2017) · Psychological Medicine · doi:10.1017/s0033291717000319 · Cited by 78 · see citing works
Validity of the Premorbid Adjustment Scale
Brill, N., Reichenberg, A., Weiser, M., & Rabinowitz, J. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm128 · Cited by 66 · see citing works
Affect recognition in people at clinical high risk of psychosis
Addington, J., Piškulić, D., Perkins, D. O., Woods, S. W., Liu, L., & Penn, D. L. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.06.012 · Cited by 62 · see citing works
Self-citationHorton, L. E., Tarbox, S. I., Olino, T. M., & Haas, G. L. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.02.013 · Cited by 42 · see citing works
Patterns 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 · see citing works
Self-citationAlderman, T., Addington, J., Bearden, C., Cannon, T. D., Cornblatt, B., McGlashan, T., Perkins, D., Seidman, L., Tsuang, M., Walker, E., et al. (2014) · Early Intervention in Psychiatry · doi:10.1111/eip.12128 · Cited by 30 · see citing works
Self-citationFamily–genetic research and schizotypal personality
Ingraham, L. J. (1995) · Cambridge University Press eBooks · doi:10.1017/cbo9780511759031.003 · Cited by 28 · see citing works
The Prodrome and Clinical Risk for Psychotic Disorders
Goulding, S. M., Holtzman, C. W., Trotman, H. D., Ryan, A. T., MacDonald, A. N., Shapiro, D. I., Brasfield, J. L., & Walker, E. F. (2013) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.04.002 · Cited by 26 · see citing works
Multisubstance Intoxication Among Schizophrenic Inpatients: Reply to Hyde
Koczapski, A. B., Ledwidge, B., Paredes, J., et al. (1990) · Schizophrenia Bulletin · doi:10.1093/schbul/16.3.373 · Cited by 16 · see citing works
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A transdiagnostic perspective on social anhedonia
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Salazar de Pablo, G., Catalan, A., & Fusar-Poli, P. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.3561 · Cited by 103 · see citing works
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- Authors
- Tarbox-Berry, S. I., Perkins, D. O., Woods, S. W., & Addington, J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Yale University (US)
- University of Calgary (CA)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-09-06
- Volume
- 48
- Issue
- 6
- Pages
- 983-997
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2751436812
- Cited by
- 14
- References
- 42
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2021: 3 · 2020: 3 · 2019: 4
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (U01MH066134, U01MH066160, U01MH066069)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- attenuated psychotic symptoms, psychosis prediction, social maladjustment, social anhedonia, avolition, dysphoric mood, stress tolerance, PREDICT study
- MeSH terms
- Help-Seeking Behavior, Adolescent, Adult, Female, Humans, Male, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders, Social Adjustment, Risk Assessment, Young Adult, Prodromal Symptoms
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