Chapman Psychosis Proneness Scales Research Articles

Mediating role of emotion regulation in the relationship between schizotypy and empathy.

Schizotypy is a set of personality traits existing in the general population that represents vulnerability for developing psychosis. Previous studies have suggested that negative schizotypy correlates with empathy, but mixed results have been shown for positive schizotypy. The present study aimed to explore the potential mediating role of emotion regulation upon schizotypy and empathy. The valid sample consisted of 595 college students who completed the Interpersonal Reactivity Index, the Emotion Regulation Questionnaire, and the Chapman Psychosis Proneness Scales. Pearson correlations between schizotypy, emotion regulation, and empathy were performed to build potential mediating models. Structural equation modeling and bootstrap analyses were used to examine the mediation effects of emotion regulation. Our results showed that negative schizotypy was correlated with both cognitive and affective empathy whereas positive schizotypy only correlated with the Fantasy and Personal Distress subscales after multiple comparisons corrections. The Cognitive Reappraisal subscale of the Emotion Regulation Questionnaire was positively correlated with empathy whereas the Expressive Suppression subscale was negatively associated with affective empathy. More importantly, there was a significant mediating effect of cognitive reappraisal on the relationship between negative schizotypy and cognitive empathy. Our findings suggest that a higher level of negative schizotypy is associated with poorer cognitive and affective empathy, and cognitive reappraisal may mediate the effect of negative schizotypy on cognitive empathy. These findings highlight the optimal usage of cognitive reappraisal in social interactions, and may help to improve empathy, especially for individuals with a high level of negative schizotypy.

Exploring the links between alexithymia, empathy and schizotypy in college students using network analysis

ABSTRACT Introduction: Impaired empathy is one of the major dysfunctions commonly found in patients with schizophrenia, with alexithymia being one possible underlying factor. Schizotypy represents a set of psychotic-like manifestations, investigation of which may contribute to our understanding of psychosis while minimising the confounding effects of illness chronicity and medication exposure. Few studies have specifically examined the associations among alexithymia, empathy and schizotypy. Methods: We investigated the relationships among alexithymia, empathy and schizotypy in college students using network analysis. The Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), and Chapman Psychosis-Proneness scales were captured, and network based on the subscales were estimated in 552 participants. Strength, closeness and betweenness of nodes were calculated to measure the centrality. Results: Network analyses revealed a pattern connecting alexithymia with empathy and schizotypy. Negative connections between empathy and physical/social anhedonia and positive edges linking alexithymia with empathy and social anhedonia were observed. Conclusions: Network constructed in the study demonstrated alexithymia’s role in empathic deficits. Our findings highlighted the connections between components of empathy, alexithymia and schizotypy.

Exploring the Relationship of Transdiagnostic Mood and Psychosis Symptom Domains with Motor Dysfunction

Background: A number of motor abnormalities have been reported in psychotic disorders, including dyskinesia and psychomotor slowing. There is also evidence for many of the same motor abnormalities in biological first-degree relatives and accruing evidence for motor abnormalities in bipolar disorder. In addition to motor dysfunction, there are also shared symptom domains amongst these populations. Objectives: We explored the associations of (1) current and lifetime psychosis and mood symptom domains and (2) domains of psychosis proneness with various domains of motor function in a transdiagnostic sample (n = 149). Method: Individuals with schizophrenia, schizoaffective disorder, or bipolar disorder, biological first-degree relatives of individuals with a psychotic disorder, and controls completed measures of psychomotor speed and movement fluidity, and neural activity related to motor preparation (stimulus-locked lateralized readiness potential, S-LRP) and execution (response-locked LRP) was assessed using EEG. All participants completed the Brief Psychiatric Rating Scale; patients were additionally assessed for lifetime psychosis and mood episode symptoms, and relatives and controls completed the Chapman psychosis proneness scales. Results: Multiple regression revealed levels of current negative symptoms and mania were significantly positively associated with psychomotor slowing even after accounting for current antipsychotic medication dosage and duration of illness. S-LRP onset latency was significantly positively associated with magical ideation. Conclusion: Domains of motor function are associated with various mood and psychosis symptom domains in a transdiagnostic sample, which may provide insight into brain abnormalities relevant to the expression of symptoms across disorders.

Childhood maltreatment impacts the early stage of facial emotion processing in young adults with negative schizotypy

Childhood maltreatment (CM) is a factor of risk for psychosis and is associated with alterations in facial emotion processing.Negative symptoms of schizophrenia-spectrum disorders are associated with deficits in facial emotion processing, but research findings on schizotypy are mixed. This study examined the early stage of facial emotion processing in young adults with high levels of negative schizotypy (NS) and explored the impact of childhood maltreatment. On the basis of the Social and Physical Anhedonia subscales of the Chapman Psychosis-Proneness Scales, a total of 74 high-NS and 52 low-NS individuals were recruited to complete the Childhood Trauma Questionnaire and the dot-probe task. The P100 and N170 components of event-related potentials were measured to assess the processing of four facial expressions of emotion. The high-NS group showed significantly reduced P100 amplitudes for all facial expressions. Angry and fearful expressions elicited larger N170 amplitudes than disgusted and happy expressions. Happy expressions elicited shorter N170 latencies than disgusted expressions. Compared to the high-NS group without CM, the high-NS group with CM had a longer latency of P100. Individuals with high NS, compared to individuals with low NS, have impaired fundamental visual processing, but intact processing of facial figurations. Childhood maltreatment may be a factor responsible for the pathological state of the visual pathway in high NS group.

The factor structure of the short form of the Wisconsin schizotypy scales

The Chapman psychosis-proneness scales—also known as Wisconsin schizotypy scales (WSS)—are among the most used tools to measure schizotypy. The factor structure of the short-form WSS was investigated in a mixed sample of patients with chronic mental disorders and of healthy subjects from the general population. One hundred patients with a chronic mental disorder were enrolled over a 6-month period. For each patient, two controls of same sex and similar age (±5 years) were enrolled; 131 accepted to take part in the study. The unidimensional, the correlated four-factor, the second-order two-factor models, and the bifactor model with two or four orthogonally independent factors of the short-form WSS were tested with confirmatory factor analysis. Good reliability of the short-form WSS was confirmed, as its capacity of differentiating people with and without schizotypy. The bifactor models were superior to other models. However, in both bifactor models the explained common variance (ECV) attributable to the general factor and the percentage of uncontaminated correlations (PUC) were too low to use a general summary score as a measure of a single latent schizotypy variable. Symptoms scores derived from the short-form WSS can be better appreciated within a multidimensional model of schizotypy.

S85. THE EFFECT OF LONG-TERM SOCIAL DEPRIVATION ON EFFORT ALLOCATION PATTERN IN PATIENTS WITH SCHIZOPHRENIA

BackgroundMotivational deficit is a common feature of negative symptoms in patients with schizophrenia. Patients with schizophrenia are impaired in goal-directed behaviour and effort allocation decision-making to pursue a potential reward. On the other hand, limited work has suggested that schizophrenia patients who experienced long-term social deprivation showed more severe negative symptoms. However, it is not yet fully clear the long-lasting impact of long-term social deprivation on motivation in these patients. The current study aimed to investigate the effect of long-term social deprivation on effort allocation pattern in patients with schizophrenia.MethodsWe recruited 21 patients with schizophrenia institutionalized for more than 15 years and 20 patients with schizophrenia dwelling in the community and 24 healthy controls for this study. We administered the Effort-Expenditure for Rewards Task (EEfRT) to capture reward-based motivational salience, which requires participants make decision to choose a hard or easy task based on reward probability and magnitude. Moreover, a set of self-reported checklists including the Chapman Psychosis Proneness Scales, the Temporal Experience of Pleasure Scale, the Anticipatory and Consummatory Interpersonal Pleasure Scale and the Emotional Expressivity Scale were also administered to all the participants. For patients with schizophrenia, they also received rating score on the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS).ResultsInstitutionalized patients had exhibited significantly more prominent negative symptoms, especially in alogia subscale, attention subscale, and a trend of statistical significance in anhedonia subscale of SANSS. The two clinical groups did not differ in positive symptoms subscale and general psychopathology symptoms subscale of PANSS. Findings from one-way ANOVA analysis showed that both institutionalized patients and community-dwelling patients with schizophrenia did not differ from healthy controls in experiential pleasure and emotion expression. For performance in the EEFRT, amotivation was only observed in institutionalized patients with schizophrenia, they were significantly less likely to expend effort to pursue a potential reward than healthy controls in both medium (50%) probability and high (80%) probability level. Hence, as the reward probability increased, unlike healthy controls, institutionalized patients could not increase their hard task choices.DiscussionInstitutionalized patients with schizophrenia exhibited significantly more motivational deficits than healthy controls, and such impairment was not observed in community-dwelling patients. However, both institutionalized patients and community-dwelling patients with schizophrenia showed no deficits in self-reported scales measuring pleasure experience and expression. These findings further revealed that long-term social deprivation may be a vital contributor to severe motivation deficits of patients with schizophrenia.

Clustering of Schizotypal Features in Unaffected First-Degree Relatives of Schizophrenia Patients.

Meehl conceptualized schizotypy as the phenotypic manifestations of a neural integrative defect resulting from a schizophrenia diathesis. The majority of schizotypy studies recruited subjects from the general population and revealed a multidimensional construct. This 2-phase investigation first examined the clustering of schizotypy in 194 unaffected relatives of schizophrenia patients using the Chapman Psychosis Proneness scales and then directly compared the cognitive profiles of negative schizotypal individuals and positive schizotypal individuals with schizophrenia patients and controls. In the first phase, cluster analysis categorized 194 unaffected relatives of schizophrenia patients into positive schizotypy (n = 33), negative schizotypy (n = 66), mixed schizotypy (n = 27), and low schizotypy (n = 64). Positive schizotypal participants showed more self-report pleasure experiences than negative schizotypal participants, replicating earlier cluster analytic findings. In the second phase, 27 negative schizotypal individuals, 18 positive schizotypal individuals, 19 schizophrenia patients, and 29 controls were recruited. Although the groups were matched in terms of age, gender, and IQ, they differed significantly in cognitive profiles. While schizophrenia patients exhibited the broadest cognitive impairments, negative schizotypal participants exhibited visual memory, working memory, and verbal fluency impairments, and positive schizotypal participants exhibited logical memory, visual memory, working memory, and theory-of-mind impairments. Among people with familial risk of schizophrenia, individuals exhibiting positive rather than negative schizotypal features resembled schizophrenia patients in cognitive profiles. Using the psychometric-familial method to identify schizotypy, our findings support the heterogeneity of schizotypy as well as the potential utility of the positive schizotypy dimension in genetically high-risk individuals to predict the risk of developing schizophrenia.

Schizophrenia spectrum personality disorders in psychometrically identified schizotypes at two-year follow-up

Earlier (Bolinskey et al., 2015), we reported that psychometrically identified schizotypes displayed greater symptom levels and higher incidences of schizophrenia spectrum (schizotypal, schizoid, paranoid, and avoidant) personality disorders (PDs). In this study, 49 schizotypes and 39 matched controls participated in follow-up assessments after two years. Participants were previously identified as schizotypes or controls based on scores on the Chapman Psychosis Proneness Scales (CPPS), and were interviewed at baseline and follow-up with the Personality Disorder Interview for DSM-IV (PDI-IV). At follow-up, schizotypes displayed significantly higher symptom levels compared to controls, with medium to large effects, and appeared to meet criteria for diagnosis of each PD more often than controls, although significant differences were only observed for paranoid PD. Overall, schizotypes were more likely to have met criteria for a diagnosis at either baseline or follow-up. Finally, we observed a widening disparity over time between schizotypes and controls in avoidant and schizoid PDs. These results suggest that schizophrenia spectrum PDs, as well as subthreshold symptoms of these disorders, can represent a greater liability for schizophrenia in individuals identified as at-risk on the basis of psychometric means only. Furthermore, these findings demonstrate that such differences persist, and in some cases increase, over time.

Evidence of structural invariance across three groups of Meehlian schizotypes.

According to Meehl’s model of schizotypy, there is a latent personality organization associated with the diathesis for schizophrenia that can be identified in several ways. We sought to examine the structural invariance of four Chapman psychosis–proneness scales (CPPS) across three groups of putative schizotypes, namely, clinically-, biologically-, and psychometrically-identified schizotypes. We examined the factor structure of the Perceptual Aberration (PER), Magical Ideation (MIS), Revised Social Anhedonia (RSAS), and Revised Physical Anhedonia (RPAS) scales in 196 schizophrenia patients, 197 non-psychotic first-degree relatives, and 1,724 non-clinical young adults. The confirmatory factor analyses indicated that the best-fitting model was one in which there is a two-factor model with negative schizotypy (RSAS and RPAS) and positive schizotypy (PER and MIS). All three samples fit the model well, with Comparative Fit Indices>0.95 and Tucker Lewis Indices>0.90. The root mean square error of approximations were all small (P values⩽0.01). We also observed that for both anhedonia scales, the groups’ mean scale scores varied in the hypothesized direction, as predicted by Meehl’s model of schizotypy. All three Chinese samples, namely, the patients (clinical schizotypes), relatives (biologically-identified schizotypes), and non-clinical young adults (containing psychometrically-identified schizotypes) showed the same factorial structure. This finding supports the suitability of the CPPS for cross-cultural and/or genetic investigations of schizotypy.

Further examination of the factor structure of the Chapman Psychosis Proneness Scales (CPPS)

Results of recent analyses of the Chapman Psychosis Proneness Scales (CPPS) have been inconsistent with regard to their factor structure. This inconsistency has involved whether the Revised Social Anhedonia Scale (SocAnh) reflects only the negative or both the negative and positive dimensions of schizotypy, along with the degree of correlation between these two dimensions. In the present study, confirmatory factor analysis was used to compare models created by Chan et al. and Kwapil et al.; a third model was constructed based on adjustments to these prior models and consideration of the schizotypy construct. Following Kwapil et al., our model allowed for bi-loading of SocAnh scale, but eliminated the correlation between positive and negative factors. Although fitness for each of the previously offered models was adequate, RMSEA and chi-square indicators suggested ideal fit for the model proposed by Kwapil and our new model, which redirects variance thought to be shared among the positive and negative dimensions to its specific source, SocAnh. The implications of these competing models with regard to our conceptualization of schizotypy are addressed. It is suggested that the cross loading of SocAnh reflects the notion of social anhedonia as the core of schizotypic personality organization.

The Chapman psychosis-proneness scales: Consistency across culture and time

The purpose of the present study was to examine the factor structure and the temporal stability of the Chapman psychosis-proneness scales in a representative sample of nonclinical Chinese young adults. The four psychosis-proneness scales evaluated were the Perceptual Aberration (PAS), Magical Ideation (MIS), revised Social Anhedonia (RSAS), and revised Physical Anhedonia (RPAS) scales. The sample consisted of 1724 young adults with a mean age of 18.8 years (S.D.=0.84). The results of the confirmatory factor analyses indicated that the best fitting model was a two-factor model with positive schizotypy (PER and MIS) scales and negative schizotypy (RSAS and RPAS) scales. The data add to the growing literature indicating that the measurement of schizotypal traits is consistent across cultures. In addition, the results support the measurement invariance of the Chapman psychosis-proneness scales across time, i.e., there was ample evidence of test–retest reliability over a test interval of 6 months.

The association between psychosis proneness and sensory gating in cocaine-dependent patients and healthy controls

This was a naturalistic study of 23 abstinent cocaine-dependent patients and 38 controls who were studied using a paired-stimulus paradigm to elicit three mid-latency auditory evoked responses (MLAERs), namely, the P50, N100, and P200. Sensory gating was defined as the ratio of the S2 amplitude to the S1 amplitude. Psychosis-proneness was assessed using four Chapman psychosis proneness scales measuring perceptual aberration, magical ideation, social anhedonia, and physical anhedonia. Omnibus correlations based upon the entire sample revealed significant and differential relationships between the MLAER components and psychosis-proneness. Social Anhedonia scale scores accounted for the largest proportion of variance in the P50 gating ratio, while Perceptual Aberration scores accounted for the largest proportion of variance in P200 gating. Psychosis proneness and sensory gating appear to be associated. In particular, poorer P50 gating is related to higher scores on the Social Anhedonia scale in healthy controls and across mixed samples of cocainede-pendent patients and controls. These findings hold significance for the further understanding of the relationship between deficient sensory gating ability and the propensity to developing psychotic symptoms in a vulnerable population like cocaine-dependent individuals.

Cognitive empathy partially mediates the association between negative schizotypy traits and social functioning

The present study aimed to examine empathy in individuals with schizotypy and to explore whether empathy mediates the associations between schizotypy traits and social functioning in college students. 1083 (376 males, mean age 18.78±0.86 years) Chinese university students completed questionnaires measuring empathy, social functioning, and schizotypy. Participants were categorized into four groups based on their scores on the Chapman Psychosis Proneness scales: mixed schizotypy, positive schizotypy, negative schizotypy, and healthy controls. Participants in the negative schizotypy group reported significantly poorer scores on both affective and cognitive empathy than those in the positive schizotypy and healthy control groups. The mixed schizotypy group showed lower affective empathy than the healthy control group. Scores on both cognitive and affective empathy in the positive schizotypy group were similar to those in the healthy control group. In addition, cognitive empathy was found to be a partial mediator of the association between negative schizotypy traits and social functioning. Results suggest that while individuals with negative schizotypy have deficits in empathy, individuals with positive schizotypy show empathy abilities comparable to that of healthy controls. Moreover, only cognitive empathy partially mediated the relationship between negative schizotypy and social functioning.

Season of birth, mixed-handedness, and psychometric schizotypy: Preliminary results from a prospective study

Season of birth and hand preference were examined in a sample of 42 (7 males, 35 females) individuals who were identified as schizotypic based on their scores on selected scales of the Chapman Psychosis Proneness Scales (CPPS) and a matched comparison sample of 42 individuals with non-deviant CPPS scores. Presence or absence of schizotypy was analyzed using chi square tests of independence with the presence or absence of each risk factor serving as the independent variable. Further analyses incorporated independent means t tests to examine mean scores on the CPPS with the presence or absence of each risk factor again serving as the independent variable. Results supported the hypothesis that winter/early-spring birth would be associated with psychometric schizotypy, although the results for mixed-handedness fell just short of statistical significance. However, mixed hand preference was associated with higher scores on MagId and PerAb scales of the CPPS, but not the RSA scale, which suggests that mixed laterality is associated with the more cognitive-perceptual aspects of schizotypy. Results are discussed in relation to previous literature and their relevance to the prediction of schizophrenia-related psychosis.

S.08.01 Potential biomarkers and genetic findings in ADHD

This was a naturalistic study of 23 abstinent cocaine-dependent patients and 38 controls who were studied using a paired-stimulus paradigm to elicit three mid-latency auditory evoked responses (MLAERs), namely, the P50, N100, and P200. Sensory gating was defined as the ratio of the S2 amplitude to the S1 amplitude. Psychosis-proneness was assessed using four Chapman psychosis proneness scales measuring perceptual aberration, magical ideation, social anhedonia, and physical anhedonia. Omnibus correlations based upon the entire sample revealed significant and differential relationships between the MLAER components and psychosis-proneness. Social Anhedonia scale scores accounted for the largest proportion of variance in the P50 gating ratio, while Perceptual Aberration scores accounted for the largest proportion of variance in P200 gating. Psychosis proneness and sensory gating appear to be associated. In particular, poorer P50 gating is related to higher scores on the Social Anhedonia scale in healthy controls and across mixed samples of cocainede-pendent patients and controls. These findings hold significance for the further understanding of the relationship between deficient sensory gating ability and the propensity to developing psychotic symptoms in a vulnerable population like cocaine-dependent individuals.

Social anhedonia and aggressive behavior

The inability to derive pleasure from social relationships, or social anhedonia, is associated with both psychopathology and impaired social functioning. Much of the research on social anhedonia (SA) has focused on its role in psychosis proneness (or schizotypy), which is the predisposition toward psychosis. Recent research suggests that SA may be related to aggression, but it is unclear whether this association is explained by the overlap between SA and positive aspects of schizotypy, namely perceptual aberrations (PA) and magical ideation (MI). The purpose of this study was to determine if SA uniquely predicts aggression in a nonclinical sample using a multi-modal approach to assess aggression. One hundred twenty undergraduates (60 men and 60 women) completed the Chapman psychosis proneness scales and self-report and behavioral measures of aggression. Results suggest that PA and MI were correlated with self-reported history of aggression, but that SA uniquely predicted provoked aggressive behavior observed in the laboratory. SA was also found to predict aggressive behavior over and above the effects of gender, anger and hostility. The results suggest that SA, and possibly low positive affect more broadly, may be associated with an increased risk of aggression in response to provocation.

A cross-validation study of clustering of schizotypy using a non-clinical Chinese sample

This study aimed to examine whether the same clusters of individuals with schizotypy as reported in Western samples are present in a Chinese sample. Cluster analysis was conducted on the responses of 418 individuals to the Chapman Psychosis-Proneness Scales. Results revealed that similar clusters of schizotypy exist in Chinese and Western samples, and that the emotional and neuropsychological symptoms they manifest are consistent with their cluster type.

Psychopathology, social adjustment and personality correlates of schizotypy clusters in a large nonclinical sample

IntroductionCorrelational methods, unlike cluster analyses, cannot take into account the possibility that individuals score highly on more than one symptom dimension simultaneously. This may account for some of the inconsistency found in the literature of correlates of schizotypy dimensions. This study explored the clustering of positive and negative schizotypy dimensions in nonclinical subjects and whether schizotypy clusters have meaningful patterns of adjustment in terms of psychopathology, social functioning, and personality. MethodsPositive and negative schizotypy dimensional scores were derived from the Chapman Psychosis-Proneness Scales for 6137 college students and submitted to cluster analysis. Of these, 780 completed the NEO-PI-R and Social Adjustment Scale-self report version, and a further 430 were interviewed for schizophrenia-spectrum, mood, and substance use psychopathology. ResultsFour clusters were obtained: low (nonschizotypic), high positive, high negative, and mixed (high positive and negative) schizotypy. The positive schizotypy cluster presented high rates of psychotic-like experiences, schizotypal and paranoid symptoms, had affective and substance abuse pathology, and was open to experience and extraverted. The negative schizotypy cluster had high rates of negative and schizoid symptoms, impaired social adjustment, high conscientiousness and low agreeableness. The mixed cluster was the most deviant on almost all aspects. ConclusionsOur cluster solution is consistent with the limited cluster analytic studies reported in schizotypy and schizophrenia, indicating that meaningful profiles of schizotypy features can be detected in nonclinical populations. The clusters identified displayed a distinct and meaningful pattern of correlates in different domains, thus providing construct validity to the schizotypy types defined.

Premorbid personality indicators of schizophrenia-related psychosis in a hypothetically psychosis-prone college sample

Research into psychosis proneness has established the Chapman Psychosis Proneness Scales (CPPS), certain personality disorders, certain response patterns on the MMPI-2, and social withdrawal as being valid indicators of liability. The current study extends our understanding of premorbid indicators of schizophrenia-related psychosis (SRP) by examining whether individuals identified as hypothetically psychosis prone (HPP) by virtue of their CPPS scores also show differences on other premorbid indicators of SRP. Results indicate that HPP individuals evidence more deviancy in the schizophrenic direction. By providing additional construct validity for the CPPS and other endophenotypic indicators of premorbid processes, strategies for understanding the development of SRP are enhanced.

Psychopathology among offspring of parents with schizophrenia: Relationship to premorbid impairments

IntroductionA broad range of psychopathology, including externalizing disorders is seen in offspring at genetic risk for schizophrenia. However, it is unclear whether such psychopathology may underlie a higher predisposition to the premorbid antecedents of schizophrenia. We examined the prevalence and correlates of psychopathology in an ongoing study of offspring genetically at risk for schizophrenia. MethodsSeventy five consenting high risk offspring (HR: offspring, age 15.68±3.27 years; male/female 34/41) and 82 matched comparison subjects (40 males and 42 females; age 15.92±3.0 years) participated in this study. Diagnoses were ascertained using structured psychiatric interviews and consensus meetings, including all available clinical information. ResultsSixty (60%) of the HR offspring had one or more lifetime diagnosis of axis I psychiatric disorder. HR subjects with axis I psychopathology had significantly more soft neurological signs, poorer premorbid adjustment, and higher schizotypy scores as measured by Chapman psychosis proneness scales. Among those with psychopathology, HR subjects with externalizing disorders showed the most abnormal scores in schizotypy. DiscussionA substantial proportion of HR offspring of parents with schizophrenia manifest a broad range of childhood psychiatric disorders. Psychopathology, especially externalizing disorders such as attention deficit hyperactivity disorder (ADHD) may represent a subgroup with an increased risk for schizophrenia spectrum disorders. This possibility needs to be examined by prospective follow-up studies, and would be of considerable importance to early diagnosis and intervention efforts in schizophrenia.