A developmental look at the attentional system in the at risk and first episode of psychosis: Age related changes in attention along the psychosis spectrum

Abstract

Introduction. Neurodevelopmental processes of adolescence, when superimposed on a vulnerable brain, may produce additive effects reflecting the subthreshold psychotic symptoms, cognitive, and functional deterioration that are the hallmark of the early stages of schizophrenia. Methods. As part of a longitudinal study, we investigated Continuous Performance Task, Identical Pairs Version (CPT-IP) performance in a sample of 301 participants (at risk for psychosis: 109; first episode–FE: 90; and controls: 102). Performance across groups was compared using d' of fast and slow, spatial and verbal conditions over two time points. Age effects were investigated using a regression model. Results. Across all four CPT-IP conditions FE patients performed significantly worse than controls while AR individuals significantly differed from healthy subjects in the verbal condition. Age-related performance associations across groups significantly differed in the slow verbal condition because the FE sample did not show a significant association with increasing age like the AR and NC samples. CPT performance was stable over time. Conclusions. Sustained attention in the putative prodrome of psychosis is not only impaired but associated with age. Research focusing on cognitive and neurobiological age-related changes can help to address fundamental questions about the nature of the disorder, including whether the underlying pathophysiology of early psychosis is static or deteriorating.