Department of Psychology, University of California Davis, Davis, CA, USA.
Centre for Research in Human Development and Department of Psychology, Concordia University, Montréal, Québec, Canada.
Dev Psychopathol. 2020 May;32(2):465-479. doi: 10.1017/S095457941900021X.
Research showing that risk for schizophrenia, bipolar disorder with psychosis, and other psychosis-spectrum diagnoses in adulthood is multidetermined has underscored the necessity of studying the additive and interactive factors in childhood that precede and predict future disorders. In this study, risk for the development of psychosis-spectrum disorders was examined in a 2-generation, 30-year prospective longitudinal study of 3,905 urban families against a sociocultural backdrop of changing economic and social conditions. Peer nominations of aggression, withdrawal, and likeability and national census information on neighborhood-level socioeconomic disadvantage in childhood, as well as changes in neighborhood socioeconomic conditions over the lifespan, were examined as predictors of diagnoses of schizophrenia, bipolar disorder, and other psychosis-spectrum disorders in adulthood relative to developing only nonpsychotic disorders or no psychiatric disorders. Individuals who were both highly aggressive and highly withdrawn were at greater risk for other psychosis-spectrum diagnoses when they experienced greater neighborhood disadvantage in childhood or worsening neighborhood conditions over maturation. Males who were highly aggressive but low on withdrawal were at greater risk for schizophrenia diagnoses. Childhood neighborhood disadvantage predicted both schizophrenia and bipolar diagnoses, regardless of childhood social behavior. Results provided strong support for multiple-domain models of psychopathology, and suggest that universal preventive interventions and social policies aimed at improving neighborhood conditions may be particularly important for decreasing the prevalence of psychosis-spectrum diagnoses in the future.
研究表明，成年后患精神分裂症、伴有精神病性症状的双相情感障碍和其他精神病谱系障碍的风险是多因素决定的，这凸显了研究儿童时期与未来疾病相关的可叠加和交互因素的必要性。在这项研究中，在一项针对 3905 个城市家庭的 2 代、30 年前瞻性纵向研究中，在经济和社会条件不断变化的社会文化背景下，研究了精神病谱系障碍的发病风险。同伴提名的攻击性、退缩和受喜爱程度，以及儿童时期邻里层面社会经济劣势的全国人口普查信息，以及整个生命周期中邻里社会经济条件的变化，被作为预测成年后精神分裂症、双相情感障碍和其他精神病谱系障碍诊断的指标，而不是发展为非精神病性障碍或无精神障碍。当个体在儿童时期经历更大的邻里劣势或随着成熟而恶化的邻里条件时，如果他们同时表现出高度的攻击性和高度的退缩，那么他们患其他精神病谱系障碍的风险就会增加。高度攻击性但低退缩的男性患精神分裂症诊断的风险更大。无论儿童时期的社会行为如何，儿童时期的邻里劣势都可以预测精神分裂症和双相情感障碍的诊断。结果为精神病理学的多领域模型提供了强有力的支持，并表明旨在改善邻里条件的普遍预防干预措施和社会政策可能对未来降低精神病谱系障碍的患病率尤为重要。
