Allen D N, Kelley M E, Miyatake R K, Gurklis J A, van Kammen D P
Psychology Department, University of Nevada, Las Vegas 89514-5030, USA.
Schizophr Bull. 2001;27(1):39-46. doi: 10.1093/oxfordjournals.schbul.a006858.
Because schizophrenia is considered to be a neurodevelopmental disorder, premorbid adjustment is of particular interest. Premorbid adjustment is probably not a unitary construct but rather is expressed across a number of developmental domains. The current investigation examined the validity of a two-factor model that differentiated premorbid adjustment across social and academic domains and evaluated relationships between these premorbid adjustment domains and other variables of interest. Participants with schizophrenia (n = 141) underwent evaluation of premorbid adjustment (using the Premorbid Adjustment Scale), intellectual functioning, and psychiatric symptoms. Using confirmatory factor analysis, a two-factor model of premorbid adjustment was identified that included an academic domain and a social domain. The social domain was associated with symptom variables, while the academic domain was associated with measures of intelligence. Results provide evidence for at least two domains of premorbid adjustment in schizophrenia. Distinguishing between these two premorbid domains may be theoretically important because of potential differences in incidence rates and deterioration courses; some individuals with schizophrenia may exhibit adequate academic adjustment but poor social adjustment, while others may exhibit the opposite pattern.
由于精神分裂症被认为是一种神经发育障碍，病前适应情况尤其令人关注。病前适应可能并非一个单一的概念，而是在多个发育领域有所体现。当前的研究考察了一个双因素模型的有效性，该模型区分了社会和学业领域的病前适应情况，并评估了这些病前适应领域与其他相关变量之间的关系。精神分裂症患者（n = 141）接受了病前适应评估（使用病前适应量表）、智力功能评估和精神症状评估。通过验证性因素分析，确定了一个病前适应的双因素模型，其中包括一个学业领域和一个社会领域。社会领域与症状变量相关，而学业领域与智力测量指标相关。研究结果为精神分裂症的病前适应至少存在两个领域提供了证据。区分这两个病前领域在理论上可能很重要，因为发病率和恶化过程可能存在潜在差异；一些精神分裂症患者可能学业适应良好但社会适应较差，而另一些患者可能呈现相反的模式。
