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Early childhood social communication deficits in youth at clinical high-risk for psychosis: Associations with functioning and risk

Published online by Cambridge University Press:  08 May 2019

K. Juston Osborne*
Department of Psychology, Northwestern University, Evanston, IL, USA
Teresa Vargas
Department of Psychology, Northwestern University, Evanston, IL, USA
Vijay A. Mittal
Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
Author for Correspondence: K. Juston Osborne, Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL60208; E-mail:


Effective social functioning requires a broad range of social communication skills that are impaired in psychosis populations. However, little is known about early childhood (4- to 5-year period) social communication during the premorbid (pre-illness) stage of psychosis. The present study utilized retrospective parent reports to examine total early childhood social communication deficits, as well as deficits in two distinct domains, reciprocal social interaction (social smiling/eye gaze) and communication (social chat/gesture), in youth at clinical high-risk (CHR) for psychosis (ages 13–21; 37.2% female). Furthermore, associations between early childhood social communication and CHR youth's current functioning (social, academic/work), symptoms (positive/negative), and risk for conversion to psychosis were examined. Compared to healthy controls, CHR individuals had greater deficits in total and communication-specific early childhood social communication. Early childhood total, communication, and reciprocal social interaction deficits were associated with worse current functioning and greater current negative symptom severity (amotivation/anhedonia) in CHR youth. Early childhood total and reciprocal social interaction deficits were also associated with increased risk for conversion. These findings inform the field's understanding of the etiology and pathophysiology of psychosis by extending the current developmental literature on premorbid deficits in psychosis populations to specific domains of social behavior in a critical developmental period.

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