Cognitive and behavioral precursors of schizophrenia

Attentional deficits are well-established characteristics of patients with schizophrenia and their at-risk offspring, suggesting a biological connecti on between attention and schizophrenia. The goal of this study is to clarif y the developmental role of attention in the illness. Data has been collect ed from 87 subjects at high and low risk for schizophrenia who have partici pated in the New York High-Risk Project from 1977 to the present. Individua ls are considered to be at high risk if either or both of their parents has schizophrenia. Analyses of attention and global behaviors, measured at int ervals from about 12 to 26 years of age, indicate (a) attentional deficits can be reliably detected in high-risk children who will develop future schi zophrenia-spectrum disorders (the prespectrum [PSP] group): (b) these defic its at-e stable, enduring over time, and appear to reflect a compromised at tentional capacity; (c) attention is not affected by the onset of illness i n the PSP group; (d) for all subjects, attention and global behaviors follo w independent developmental pathways; and (e) behavioral difficulties, but not attention deficits, appear to be highly sensitive to environmental fact ors, especially rearing by a mentally ill parent. It is concluded that in P SP individuals impaired attention probably results from prenatal developmen tal abnormalities (possibly on the cellular level) and is likely to be a ma rker of a biological vulnerability to schizophrenia. In addition, attention al deficits, as opposed to early behavioral difficulties, are concluded to be a useful first step in screening for youngsters in need of early interve ntion.