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Screening for Thinking Skills May Flag Children at Risk for Psychosis

February 17, 2014. Children who report psychotic-like experiences lag behind in their mental skills compared to their peers who do not have these experiences, according to a study published February 5 in JAMA Psychiatry. The study, led by Ruben Gur and Raquel Gur at the University of Pennsylvania in Philadelphia, suggests that screening children as early as eight years of age with a computer test of their mental abilities could eventually flag those at risk for developing psychosis later in life.

Based on evaluations of over 9,000 children between the ages of eight and 21, the study charts how the ability to think and reason develops as children age. Similar to the height and weight growth charts used by pediatricians, the researchers developed “cognitive growth charts” that could be used to track a child’s mental development in different kinds of mental skills, including memory, reasoning, and emotion recognition. The study found that those who had had some kind of psychotic experience, including hearing a voice no one else heard or seeing something no one else had seen, or being excessively suspicious, fell off the charts in tests of reasoning and social skills. In fact, their scores estimated their “mental age” to be about a year younger than their actual age, pointing to a lag in their mental skill development.

Previous studies have found such impairments in young adults with mild signs of psychosis or full-blown psychosis, but the new study suggests that this link is apparent even earlier. If future studies find that these kids do indeed develop a psychotic disorder such as schizophrenia more often than those without these symptoms, then routine screening of mental abilities could be a way to flag them early on. If safe and effective interventions were also available, it might be possible to decrease their risk for psychosis. (For more details, see the related news story.)—Michele Solis.

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