Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
School of Psychological Science, University of Western Australia, Perth, WA, Australia.
Br J Clin Psychol. 2023 Mar;62(1):228-242. doi: 10.1111/bjc.12405. Epub 2022 Dec 2.
Childhood disturbances in social, emotional, language, motor and cognitive functioning, and schizotypy have each been implicated as precursors of schizophrenia-spectrum disorders. We investigated whether relationships between early childhood developmental vulnerabilities and childhood schizotypy are mediated by educational underachievement in middle childhood.
Participants were members of a large Australian (n = 19,216) population cohort followed longitudinally. Path analyses were used to model relationships between developmental vulnerabilities at age ~5 years, educational underachievement from ages ~8 to 10 years and three distinct profiles of schizotypy at age ~11 years (true, introverted and affective schizotypy).
Early childhood developmental vulnerabilities on five broad domains (related to physical, emotional, social, cognitive and communication development) were associated with schizotypy profiles in middle childhood. Educational underachievement in middle childhood was associated with all schizotypy profiles, but most strongly with the true schizotypy profile (OR = 3.92, 95% CI = 3.12, 4.91). The relationships between schizotypy profiles and early childhood developmental vulnerabilities in 'language and cognitive skills (school-based)' and 'communication skills and general knowledge' domains were fully mediated by educational underachievement in middle childhood, and the relationships with early childhood 'physical health and well-being' and 'emotional maturity' domains were partially mediated.
Developmental continuity from early childhood developmental vulnerabilities to schizotypy in middle childhood is mediated by educational underachievement in middle childhood. While some domains of early developmental functioning showed differential relationships with distinct schizotypy profiles, these findings support a developmental pathway to schizotypy in which cognitive vulnerability operates from early childhood through to middle childhood.
儿童在社交、情感、语言、运动和认知功能方面的障碍,以及精神分裂症特质,都被认为是精神分裂症谱系障碍的前兆。我们研究了儿童早期发展脆弱性与儿童精神分裂症特质之间的关系是否通过儿童中期教育成就不足来中介。
参与者是澳大利亚一个大型(n=19216)人群队列的成员,进行了纵向随访。路径分析用于建模5 岁时的发育脆弱性、8 至 10 岁时的教育成就不足以及~11 岁时的三种不同精神分裂症特质(真实、内向和情感精神分裂症特质)之间的关系。
五个广泛领域(与身体、情感、社会、认知和沟通发展相关)的儿童早期发育脆弱性与儿童中期的精神分裂症特质谱有关。儿童中期的教育成就不足与所有精神分裂症特质谱有关,但与真实精神分裂症特质谱关系最密切(OR=3.92,95%CI=3.12,4.91)。在“语言和认知技能(基于学校)”和“沟通技能和一般知识”领域,精神分裂症特质谱与儿童早期发育脆弱性之间的关系完全由儿童中期教育成就不足所中介,而与儿童早期“身体健康和幸福感”和“情绪成熟”领域之间的关系部分由其介导。
从中期儿童期发展脆弱性到精神分裂症特质的发展连续性由儿童中期的教育成就不足所介导。虽然早期发展功能的某些领域与不同的精神分裂症特质谱有不同的关系,但这些发现支持了一种从早期到儿童中期的精神分裂症发展途径,其中认知脆弱性从儿童早期开始运作。