Negative Symptoms in Youth at Risk of Psychosis

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dc.contributor.advisorAddington, Jean
dc.contributor.authorDevoe, Daniel John Alexander
dc.contributor.committeememberDimitropoulos, Gina
dc.contributor.committeememberGranholm, Eric L.
dc.contributor.committeememberPatten, Scott B.
dc.date2020-11
dc.date.accessioned2020-07-06T14:14:04Z
dc.date.available2020-07-06T14:14:04Z
dc.date.issued2020-07-02
dc.description.abstractYouth 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.en_US
dc.identifier.citationDevoe, 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.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/37975
dc.identifier.urihttp://hdl.handle.net/1880/112253
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectpsychosisen_US
dc.subjectnegative symptomsen_US
dc.subject.classificationBiophysics--Medicalen_US
dc.titleNegative Symptoms in Youth at Risk of Psychosisen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplineMedicine – Medical Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrueen_US
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