Family functioning moderates the impact of psychosis-risk symptoms on social and role functioning

Elizabeth Thompson, Pamela Rakhshan, Steven C. Pitts, Caroline Demro, Zachary B. Millman, Kristin Bussell, Jordan DeVylder, Emily Kline, Gloria M. Reeves, Jason Schiffman

Research output: Contribution to journalArticlepeer-review


Background: Youth at clinical high-risk (CHR) for psychosis often experience difficulties in social and role functioning. Given evidence that family stress and support can impact psychosis-risk symptoms, as well as an individual's ability to fulfill social and role functions, family dynamics are hypothesized to moderate the effect of psychosis-risk symptoms on functioning. Methods: Participants at CHR (N = 52) completed the clinician-administered Structured Interview for Psychosis-risk Syndromes (SIPS) and the Family Assessment Device (FAD) General Functioning Scale, a self-report measure of family functioning including cohesion and support. Interviewers rated participants’ current social and role functioning using the Global Functioning: Social and Role Scales. Results: Regression results indicated that positive symptoms, but not ratings of family functioning, statistically predicted social and role functioning. Perceived family functioning, however, moderated the effect of symptoms on social/role functioning. For individuals who perceived lower levels of family functioning, symptoms were moderately associated with social and role functioning (f 2 = 0.17 and f 2 = 0.23, respectively). In contrast, psychosis-risk symptoms were not significantly associated with social/role functioning for individuals with higher levels of perceived family functioning. Notably, positive symptoms and perceived family functioning were not associated with one another, suggesting that perceived family functioning did not directly impact symptom severity, or vice versa. Conclusions: Findings support the notion that family functioning may be a clinically meaningful factor for individuals at CHR. Although this cross-sectional data limits our discussion of potential mechanisms underlying the pattern of findings, results suggest that familial support may be beneficial for individuals at risk for psychosis.

Original languageEnglish (US)
Pages (from-to)337-342
Number of pages6
JournalSchizophrenia Research
StatePublished - Feb 2019


  • Attenuated psychosis
  • Clinical high risk
  • Family support
  • Functioning

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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