Differences in developmental changes in academic and social premorbid adjustment between males and females with schizophrenia

Abstract

The assessment of premorbid adjustment in schizophrenia has received considerable attention because of models suggesting that schizophrenia is a neurodevelopmental disorder characterized by abnormalities in functioning prior to onset of the disorder. Some studies suggest that premorbid adjustment is best viewed as a multidimensional construct where different areas of functioning might be differentially impacted by the illness and sex. The current study examined these matters using of Premorbid Adjustment Scale (PAS) in a sample of 421 individuals with schizophrenia. Confirmatory factory analyses conducted for three developmental periods (childhood, early adolescence, late adolescence) and for males and females separately, indicated that the PAS consists of academic and social factors that are invariant across developmental period and sex. However, differences in severity of academic and social premorbid impairment were present between males and females across developmental periods. Findings suggest important differences between males and females in the course of premorbid deterioration prior to onset of schizophrenia.

Figure 1. Best Fitting Models at Each of the Three Developmental Levels

Note. In confirmatory factor analyses, rectangles represent measured variables (in this case, the PAS items), while circles represent latent constructs. This model includes two types of latent constructs: the factors (Academic Adjustment, Social Adjustment) and the random error components (E).

Figure 2

Changes in Social and Academic Adjustment across Developmental Levels for Males and Females