The New York high-risk project: Observations on the rating of early manifestations of schizophrenia

The neurodevelopmental paradigm of schizophrenia (Sz) proposes a lifelong process of brain pathology as the cause of the disorder. Investigating the early phenotype of Sz, we rated videotapes of children at risk for Sz for early manifestations of thought disorder and Sz-related symptoms, using the Scale for the Assessment of Thought, Language, and Communication and parts of a diagnostic interview designed for psychiatric assessment of children. We found that thought disorder as well as negative symptoms were elevated in children with adulthood Sz-related psychosis. This discussion focuses on methodological problems that arise in making clinical judgments on early and still subtle functional deviations.