Negative Symptoms in Youth at Risk of Psychosis
Date
2020-07-02
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Abstract
Youth at clinical high risk (CHR) for psychosis often demonstrate significant negative symptoms but the impact of treatment on negative symptoms remains unknown. Investigations into possible mechanisms that may contribute to the development, maintenance, and exacerbation of negative symptoms in CHR youth are needed as well. One such area that remains understudied is persistent negative symptoms (PNS) in those at CHR . In addition, functioning, neurocognition, defeatist beliefs, self-efficacy, and early maladaptive schemas have been shown to contribute to negative symptoms in schizophrenia but these associations with negative symptoms remain understudied in CHR for psychosis youth. In this manuscript based thesis we conducted a systematic review and network meta-analysis of all intervention studies examining negative symptom outcomes in youth at CHR for psychosis. Next, in a large longitudinal cohort generalized linear mixed models for repeated measures were used to examine changes over time between a PNS group vs a non-PNS group on functioning, neurocognition, and defeatist beliefs. In the third study, we conducted a systematic review and meta-analysis to summarize the relationship between negative symptoms and functioning in CHR samples. In the final study, the aim was to examine if negative symptoms were associated with defeatist beliefs, self-efficacy, and early maladaptive schemas in CHR youth. In the network meta-analysis no treatments were found to significantly reduce negative symptoms and the majority of treatment trials were not designed to target negative symptoms. In the longitudinal cohort, PNS resulted in significant and persistent functional impairment, which remained when controlling for persistent depressive symptoms. For the systematic review and meta-analysis, negative symptom total scores were significantly associated with poorer global functioning, social functioning, and role functioning. In the final study, asocial beliefs, social self-efficacy and maladaptive schemas about the self were significantly related to total negative symptom scores. With no treatments established to help negative symptoms and given their significant relationship with functional impairments, an unfortunate trajectory emerges for CHR youth with negative symptoms in that they require treatments that may alleviate their symptoms and improve their day to day lives. Thus, psychosocial interventions may wish to target asocial beliefs, social self-efficacy, and maladaptive schemas in effort to reduce negative symptoms in those at CHR for psychosis.
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Keywords
psychosis, negative symptoms
Citation
Devoe, D. J. A. (2020). Negative Symptoms in Youth at Risk of Psychosis (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.