The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American Prodrome Longitudinal Study

doi:10.1093/schbul/sbt235

. 2014 Nov;40(6):1452-61.

doi: 10.1093/schbul/sbt235. Epub 2014 Feb 18.

The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American Prodrome Longitudinal Study

Affiliations

¹ VA VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX;
² Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore - Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY;
³ Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada;
⁴ Department of Psychiatry, UCSD, San Diego, CA;
⁵ Departments of Psychology and Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA; Department of Psychiatry, Yale University, New Haven, CT;
⁶ Department of Psychiatry, Yale University, New Haven, CT;
⁷ Department of Psychiatry, University of North Carolina, Chapel Hill, NC;
⁸ Department of Psychiatry, UCSD, San Diego, CA; Center for Behavior Genomics and Institute of Genomic Medicine, UCSD, La Jolla, CA;
⁹ Departments of Psychology and Psychiatry, Emory University, Atlanta, GA;
¹⁰ Schizophrenia Spectrum Research Program, Division of Adult Translational Research, National Institute of Mental Health, Bethesda, MD;
¹¹ Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston MA; Department of Psychiatry, Harvard Medical School at Massachusetts General Hospital, Boston MA lseidman@bidmc.harvard.edu.

PMID: 24550526
PMCID: PMC4193704
DOI: 10.1093/schbul/sbt235

The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American Prodrome Longitudinal Study

Eric C Meyer et al. Schizophr Bull. 2014 Nov.

. 2014 Nov;40(6):1452-61.

doi: 10.1093/schbul/sbt235. Epub 2014 Feb 18.

Authors

Affiliations

¹ VA VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX;
² Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore - Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY;
³ Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada;
⁴ Department of Psychiatry, UCSD, San Diego, CA;
⁵ Departments of Psychology and Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA; Department of Psychiatry, Yale University, New Haven, CT;
⁶ Department of Psychiatry, Yale University, New Haven, CT;
⁷ Department of Psychiatry, University of North Carolina, Chapel Hill, NC;
⁸ Department of Psychiatry, UCSD, San Diego, CA; Center for Behavior Genomics and Institute of Genomic Medicine, UCSD, La Jolla, CA;
⁹ Departments of Psychology and Psychiatry, Emory University, Atlanta, GA;
¹⁰ Schizophrenia Spectrum Research Program, Division of Adult Translational Research, National Institute of Mental Health, Bethesda, MD;
¹¹ Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston MA; Department of Psychiatry, Harvard Medical School at Massachusetts General Hospital, Boston MA lseidman@bidmc.harvard.edu.

PMID: 24550526
PMCID: PMC4193704
DOI: 10.1093/schbul/sbt235

Abstract

Objectives: Impaired social, role, and neurocognitive functioning are preillness characteristics of people who later develop psychosis. In people with schizophrenia, neurocognition and negative symptoms are associated with functional impairment. We examined the relative contributions of neurocognition and symptoms to social and role functioning over time in clinically high-risk (CHR) individuals and determined if negative symptoms mediated the influence of cognition on functioning.

Methods: Social, role, and neurocognitive functioning and positive, negative, and disorganized symptoms were assessed in 167 individuals at CHR for psychosis in the North American Prodrome Longitudinal Study Phase 1 (NAPLS-1), of whom 96 were reassessed at 12 months.

Results: Regression analyses indicated that negative symptoms accounted for unique variance in social and role functioning at baseline and follow-up. Composite neurocognition accounted for unique, but modest, variance in social and role functioning at baseline and in role functioning at follow-up. Negative symptoms mediated the relationship between composite neurocognition and social and role functioning across time points. In exploratory analyses, individual tests (IQ estimate, Digit Symbol/Coding, verbal memory) selectively accounted for social and role functioning at baseline and follow-up after accounting for symptoms. When negative symptom items with content overlapping with social and role functioning measures were removed, the relationship between neurocognition and social and role functioning was strengthened.

Conclusion: The modest overlap among neurocognition, negative symptoms, and social and role functioning indicates that these domains make substantially separate contributions to CHR individuals.

Keywords: negative symptoms; neurocognition; prodrome; social and role functioning.

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References

1. Nelson B, Yuen HP, Wood SJ, et al. Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiatry. 2013;70:793–802 - PubMed
1. Ruhrmann S, Schultze-Lutter F, Salokangas RK, et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry. 2010;67:241–251 - PubMed
1. Cannon TD, Cadenhead K, Cornblatt B, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65:28–37 - PMC - PubMed
1. Cornblatt BA, Lencz T, Smith CW, Correll CU, Auther AM, Nakayama E. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull. 2003;29:633–651 - PubMed
1. Cornblatt BA, Carrión RE, Addington J, et al. Risk factors for psychosis: impaired social and role functioning. Schizophr Bull. 2012;38:1247–1257 - PMC - PubMed

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[1] Nelson B, Yuen HP, Wood SJ, et al. Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiatry. 2013;70:793–802 - PubMed

[2] Nelson B, Yuen HP, Wood SJ, et al. Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiatry. 2013;70:793–802 - PubMed

[3] Ruhrmann S, Schultze-Lutter F, Salokangas RK, et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry. 2010;67:241–251 - PubMed

[4] Ruhrmann S, Schultze-Lutter F, Salokangas RK, et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry. 2010;67:241–251 - PubMed

[5] Cannon TD, Cadenhead K, Cornblatt B, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65:28–37 - PMC - PubMed

[6] Cannon TD, Cadenhead K, Cornblatt B, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65:28–37 - PMC - PubMed

[7] Cornblatt BA, Lencz T, Smith CW, Correll CU, Auther AM, Nakayama E. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull. 2003;29:633–651 - PubMed

[8] Cornblatt BA, Lencz T, Smith CW, Correll CU, Auther AM, Nakayama E. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull. 2003;29:633–651 - PubMed

[9] Cornblatt BA, Carrión RE, Addington J, et al. Risk factors for psychosis: impaired social and role functioning. Schizophr Bull. 2012;38:1247–1257 - PMC - PubMed

[10] Cornblatt BA, Carrión RE, Addington J, et al. Risk factors for psychosis: impaired social and role functioning. Schizophr Bull. 2012;38:1247–1257 - PMC - PubMed

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The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American Prodrome Longitudinal Study

Affiliations

The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American Prodrome Longitudinal Study

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