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

Abstract

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

Social Cognition, Negative Symptoms and Psychosocial Functioning in Schizophrenia

“…A recent investigation (the North American Prodrome Longitudinal Study) on clinically high-risk (CHR) patients for psychosis reported that negative symptoms mediated the relationship between composite neurocognition and social and role functioning; such findings replicate what a previous meta-analysis of schizophrenia studies had reported [118,119]. Nonetheless, the modest overlap among neurocognition, negative symptoms, and social functioning suggests that these domains make substantially separate contributions to the outcome in CHR patients [118].…”

“…Nonetheless, the modest overlap among neurocognition, negative symptoms, and social functioning suggests that these domains make substantially separate contributions to the outcome in CHR patients [118]. …”

“…Accordingly, in the early stages of the disease, at the first-ep-isode [89] and during the proceeding years [98,99], the presence of this symptom cluster is one of the greatest barriers to the achievement of functional recovery. Moreover, before full blown psychosis occurs, during the so-called high-risk (HR) or prodromal state, negative symptoms and impaired social cognition have been associated with marked impairment in psychosocial function [100,101] which appears to be a core feature of the HR state and tends to be resistant to all types of treatment [102]. The presence of negative symptoms of "avolition" and "poor emotional expression" in the prodrome is in agreement with the notion of their primary nature and suggests that negative symptoms and their neural substrates may even be a driver (like impaired social cognition) of transition to psychosis [85].…”

Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis

“…30 In other studies of CHRs, diminished verbal memory performance is related to concurrent social functioning, and also predicts later role functioning and transition to full psychosis. 2,31 Therefore, a treatment that directly improves this domain and/or that may pre-empt decline in verbal memory systems is of particular long-term clinical importance for CHR individuals.…”

Beyond “Cold” Cognition: Exploring Cognitive Control of Emotion as a Risk Factor for Psychosis

“…To date, high-risk research has predominantly focused on cognitive deficits and associated psychosocial impairments. Cognitive deficits across multiple domains are consistently observed in high-risk populations [8], are associated with structural and functional abnormalities in frontal and temporal regions [9], and predict symptom severity, social functioning, and transition to psychosis [8,[10][11][12]. These cognitive deficits are considered to reflect a domain-general impairment in cognitive control-the inhibitory and facilitatory functions necessary to maintain taskrelevant processing and goal-oriented behavior-which may represent a risk marker for future clinical and psychosocial deterioration.…”