The “high risk” paradigm: childhood predictors of schizophrenic disorders

The general strategy of the high-risk paradigm is to focus on individuals considered to be at risk for a particular illness but who are not clinically symptomatic at the time they are studied. In schizophrenia research, a major goal of such studies is to identify biologically based abnormalities that will serve as predictors of illness in young, asymptomatic individuals. The findings that have emerged from the most widely studied risk population, the offspring of schizophrenic parents, indicate that information processing difficulties may be the most promising predictors of illness. Data collected over the course of the New York High Risk Project (NYHRP), a study of the offspring of schizophrenic parents that has been conducted since 1972, suggest that these dysfunctions are likely indicators of a brain abnormality that is present very early in development. In this presentation, evidence will be presented from the NYHRP supporting the predictive potential of a specific class of information processing abnormalities-attentional dysfunctions. In addition, the impact of such dysfunctions on the subsequent expression of clinical symptoms will be described. Particular focus will be directed at data suggesting that in subjects with schizophrenia-related Axis II disorders, disturbed attention plays a critical role in the development of deficient social skills. New high-risk strategies derived from these findings will also be discussed.