Title: Translational Clinical Science in the Psychosis Prodrome: From Motor Dysfunction to Early Intervention
Abstract: A body of evidence suggest that up to one-third of clinical high-risk youth (adolescents who exhibit recent subtle positive symptoms as well as declines in social, emotional, motor and cognitive functioning) will go on develop a psychotic disorder such as schizophrenia within a two-year period. While the clinical high-risk or prodromal period represents an promising opportunity to improve etiological understanding and intervene prior to onset (when third variable confounds can cloud research and treatment), to date, we are unclear about what differentiates those who do go on to develop a psychotic disorder, from the phenotypically similar adolescents who do not. Furthermore, preliminary evidence suggests that while early interventions may be effective in reducing transition rates, the available treatments are associated with significant costs and side-effects, and factors unique to this population significantly limit efficacy. Taken together, this suggests a critical need for effective risk markers (that tie into mechanisms driving emerging psychosis) and targeted interventions. As psychosis onset typically occurs at the end of the adolescent period, promising empirically driven conceptualizations point to the significant role that adolescent neurodevelopment may play. To this end, understanding aberrant processes during adolescent neuroreorganization may help to significantly improve etiological understanding, bolster early identification, and inform interventions. In this presentation, I discuss characteristics and research priorities in the psychosis prodrome and then review ongoing studies designed to translate basic psychopathology research to impactful early identification and targeted intervention. Specifically, I focus on distinct patterns of motor dysfunction, and present longitudinal research that suggests that abnormalities in movement reflect several trajectories of aberrant neurodevelopment that can eventually lead to the onset of psychosis. In addition, I will discuss plans for future projects and emphasize the significant utility of cross-disciplinary collaboration in this area.