University of California at Los Angeles, 300 Medical Plaza, Box 666824, Los Angeles, CA 90095, United States.
Schizophr Res. 2010 May;118(1-3):69-75. doi: 10.1016/j.schres.2010.01.017. Epub 2010 Feb 19.
The current study examined the relationship between the family environment and symptoms and functioning over time in a group of adolescents and young adults at clinical high risk for psychosis (N=63). The current study compared the ability of interview-based versus self-report ratings of the family environment to predict the severity of prodromal symptoms and functioning over time. The family environmental factors were measured by interviewer ratings of the Camberwell Family Interview (CFI), self-report questionnaires surveying the patient's perceptions of criticism and warmth, and parent reported perceptions of their own level of criticism and warmth. Patients living in a critical family environment, as measured by the CFI at baseline, exhibited significantly worse positive symptoms at a 6-month follow-up, relative to patients living in a low-key family environment. In terms of protective effects, warmth and an optimal level of family involvement interacted such that the two jointly predicted improved functioning at the 6-month follow-up. Overall, both interview-based and self-report ratings of the family environment were predictive of symptoms and functioning at follow-up; however patient's self-report ratings of criticism had stronger predictive power. These results suggest that the family environment should be a specific target of treatment for individuals at risk for psychosis.
本研究考察了临床高风险精神分裂症前期青少年和年轻人（N=63）的家庭环境与症状和功能随时间变化的关系。本研究比较了基于访谈的家庭环境评估与自我报告评分对前驱症状严重程度和随时间变化的功能的预测能力。家庭环境因素通过访谈者对坎伯韦尔家庭访谈（CFI）的评分、调查患者对批评和温暖感知的自我报告问卷以及父母对自己批评和温暖程度的感知来衡量。与生活在低调家庭环境中的患者相比，在基线时通过 CFI 测量处于批评性家庭环境中的患者在 6 个月随访时表现出明显更严重的阳性症状。就保护作用而言，温暖和家庭参与的最佳水平相互作用，两者共同预测 6 个月随访时的功能改善。总体而言，家庭环境的访谈和自我报告评估都可以预测随访时的症状和功能；然而，患者对批评的自我报告评分具有更强的预测能力。这些结果表明，家庭环境应该是精神病风险个体治疗的特定目标。
