A Study of the Relationships Between Cognitive Functioning, Prodromal Cognitive Decline, and Predictors of Psychosis in an Adolescent Inpatient Population

There is strong evidence that people with limited cognitive functioning are at higher risk of developing schizophrenia (SC) and other psychotic disorders. However, it is also known that the occurrence of severe psychopathology in children and adolescents is likely to have a deleterious effect on cognitive functioning. The present study looked at the associations between cognitive deficits, estimated premorbid cognitive decline, clinical symptomology, and psychotic disorders in adolescents. The sample was drawn from a larger sample of 819 males and 742 females, ages 13–18, who were referred for psychological evaluation in an inpatient hospital setting. The sample was administered cognitive, performance, self-report, and therapist report measures in order to examine cognitive, symptom, and personality patterns. Results revealed significant relationships between patterns of cognitive deficits in adolescents and psychotic symptoms. Specifically, older adolescents are more likely to demonstrate prodromal cognitive decline. Further, results demonstrated that general cognitive ability, cognitive efficiency skills, and verbal fluency abilities significantly predicted psychotic symptoms on self-report and therapist ratings but limitedly on a performance based measure. Visual-motor abilities demonstrated variable and less robust relationships with psychotic symptoms across the measures. Overall the study supports past research, done primarily with adults, that has found psychosis to be associated with significant and widespread impairments in neurocognitive functioning. These findings have important implications for school-clinical child psychologists