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Key PointsQuestionDo baseline and longitudinal cognitive architecture discriminate healthy controls from subgroups of young individuals at risk for psychosis?FindingsThis multiple-group design study involving 384 healthy controls and 173 individuals at ultrahigh risk for psychosis found that baseline cognitive architecture differentiated healthy controls from converters and nonremitters. Remitters were found to recover their cognitive deficits over time, but nonremitters did not.MeaningCognitive deficits appear to identify the individuals most likely to develop psychosis and appear to reflect an underlying deterioration of a person’s clinical condition over time.