Premorbid adjustment problems, negative symptoms, and cognitive impairment in a large international sample at clinical high risk for psychosis: Findings from the Accelerating Medicines Partnership—Schizophrenia
Bibliographic record
Abstract
BACKGROUND AND HYPOTHESES: Functional impairment often precedes attenuated psychotic symptoms (APS) in youth at clinical high risk (CHR) for psychosis. This impairment has been linked to baseline symptoms and cognition, but the roles of developmental stage of APS onset and comorbid depression/anxiety are not well understood. Accelerating Medicines Partnership-Schizophrenia's diverse international sample and broad symptom assessment facilitate a detailed analysis of premorbid functioning. STUDY DESIGN: Premorbid adjustment and baseline symptoms and cognition were examined in 1056 individuals at CHR (n = 482 early-symptom, n = 574 late-symptom [first CHR-level APS in childhood/early adolescence vs. late adolescence/adulthood]). In the late-symptom group, growth curve models tested adjustment trends from childhood through late adolescence. Incremental relationships between adjustment, symptoms, and cognition were tested controlling for depression/anxiety. STUDY RESULTS: Premorbid social maladjustment correlated with baseline negative symptoms (r ≥ .25, P < .001). Premorbid academic maladjustment correlated with baseline negative symptoms (r ≥ .17, P ≤ .007) and cognitive impairment (r ≥ .27, P ≤ .001). Effects did not differ between early- and late-symptom subgroups (Δr ≤ .12, z ≤ 2.00, P > .05). Social adjustment deteriorated over time in participants with more baseline negative symptoms (γ = 0.14, P < .001) or cognitive impairment (γ ≥ -0.01, P < .004), even when controlling for depression/anxiety. APS were generally unrelated to premorbid functioning. Effects were consistent in the subsample residing outside North America (n = 579). CONCLUSIONS: Relationships between premorbid adjustment, negative symptoms, and cognition were independent of depression/anxiety and developmental stage of CHR symptom onset. Baseline negative symptoms and cognitive impairment follow insidious and worsening functional problems originating in early clinical stages, prior to onset of APS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".