The proposed research will investigate both positive and negative aspects of the adjustment of rural young adults identified as at-risk for psychosis. The incidence of breakdown, even within risk groups, is relatively low. This fact is sometimes referred to as the problem of """"""""false positives"""""""" in risk research. The individuals who do not break down may be subclinically impaired, non-symptomatic, or they may """"""""prosper"""""""" despite risk factors. This points to the need for outcome measures applicable to all subjects in a high-risk group, measures that are sensitive and cover a broad range of adaptations, and can detect adaptive skills as well as impaired functioning. The proposed study will employ sensitive and broad-band adjustment measures with two psychometrically defined groups of hypothetically psychosis-prone subjects. Subjects who reported elevated levels of unusual experiences and beliefs, impulsive behaviors, or pleasure deficits in screenings when they were college students two- to six-years previously (n=200) will be studied as well as a control group of 100 students who reported low levels of these experiences. The study will 1) provide an extensive follow-up of psychosis-prone subjects, 2) develop instrumentation for measuring outcome across multiple domains and covering a wide range of adjustment, including personal resourcefulness: skills, competencies, and creative problem solving; 3) distinguish between resourcefulness and deficits in groups at risk for predominantly positive-symptom and predominantly negative-symptom psychopathology; and 4) evaluate two cognitive vulnerability measures (Reaction Time crossover and Bizarre-Idiosyncratic thinking) as sensitive indices of psychopathology and tools for identifying subjects at risk for predominantly negative or positive psychotic symptoms. At follow-up, subjects who had high scores on measures of Perceptual Aberration and Magical Ideation are hypothesized to have higher mean levels of creativity and everyday competencies, as well as more positive symptoms. Subjects high on Physical Anhedonia are not expected to have these positive signs of adjustment; they are also expected to show specific negative- symptom deviance. This research will supply a broad-band picture of how diathesis is expressed, and will delineate factors of resourcefulness that may have positive influences on prognosis. These protective variables may prove useful for early intervention and treatment of mental disorders.
|Schuldberg, D (1993) Personal resourcefulness: positive aspects of functioning in high-risk research. Psychiatry 56:137-52|
|Schuldberg, D (1992) Ego-strength revised: a comparison of the MMPI-2 and MMPI-1 versions of the Barron Ego-strength scale. J Clin Psychol 48:500-5|