Offspring Hyperactivity
and
of
Schizophrenics
III
Neurological Soft Signs
Ronald O. Rieder, MD, Paul L. Nichols, PhD
\s=b\ Twenty-nine male offspring of "continuous schizophrenics" (chronic, borderline, and chronic schizoaffective schizophrenics), plus controls, were given neurological and psychological examinations at age 7. Eight of the 29 were found to have high ratings on a factor score that was termed "hyperactive" (increased activity, impulsivity, distractibility, and emotional lability), and three of these boys had high ratings for neurological signs as well. These frequencies were significantly greater than the control values. Mild incoordination, such as awkwardness in performing rapidly alternating movements, was the neurological
soft sign most elevated in the offspring of schizophrenics were
index group. Fifteen female not found to differ from their
controls on these measures. Previous studies of the childhoods of male schizophrenics have found behavior patterns similar to the behavior of the boys who scored high on our hyperactive factor. It is thus likely that the "hyperactive cases" in this sample are even more at risk for developing schizophrenia in later life than the other offspring of schizophrenic parents. (Arch Gen Psychiatry 36:665-674, 1979)
Several schizophrenia signs
studies have suggested a link between adult and certain behavioral or neurological in childhood. As part of a larger study to discover possible early manifestations of a genetic predisposition to schizophrenia, we attempted to determine if the offspring of schizophrenics have an increased frequency of behavior¬ al or neurological abnormalities by age 7. for publication Sept 5, 1978. From the Laboratory of Psychology and Psychopathology, Intramural Research, National Institute of Mental Health (Dr Rieder), and the Developmental Neurology Branch, Neurological Disorders Program, National Institute of Neurological and Communicative Diseases and Stroke (Dr Nichols), Bethesda, Md. Reprint requests to Laboratory of Psychology and Psychopathology, Intramural Research, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD 20014 (Dr Rieder).
Accepted
REVIEW
"Follow-back" studies—examinations of the childhood records of adult schizophrenics or childhood histories taken from those who are unaware of the schizophrenic outcome—have quite consistently supported a view that certain patterns of childhood behavior precede adult schizo¬ phrenia. Two major patterns, antisocial behavior and asocial (schizoid, withdrawn) behavior, have been found. Bower et al,1- in an investigation of the high school behavior of male preschizophrenics through teacher inter¬ views, found that about 50% had been quite withdrawn, 20% delinquent, and the other 30% had miscellaneous or no marked problems. A review of child guidance records of adult schizophrenics by Nameche et al1 also found both withdrawn and acting-out types of childhood behavior disorders. Watt et al,4 " in a follow-back study of elementa¬ ry and high school records, separated the data for males and females. They found that preschizophrenic boys were often disruptive in the later grades of school, and 52% of them they categorized as "unsocialized-aggressive." The specific indices that characterized the preschizophrenic boys were disagreeableness (less pleasant, less cooperative, less considerate, less well behaved) and emotional instabil¬ ity (less cheerful, more emotionally immature). The pre¬
schizophrenic girls were more introverted, more passive, and more emotionally unstable than their controls in elementary school, and continued to be more introverted as
adolescents. Thus, Watt's group found that the two patterns described previously were sex-related, boys being more antisocial and girls more socially withdrawn. The follow-up studies of children with certain psychiatric symptoms or diagnoses have been in general agreement with these reports, except that the results have shown
Downloaded From: http://archpsyc.jamanetwork.com/pdfaccess.ashx?url=/data/journals/psych/12314/ by a University of California - San Diego User on 02/02/2017
link between childhood antisocial behavior and than between asocial traits and schizophre¬ nia. Robins'" 30-year follow-up of children seen in a child guidance center found that "the potential schizophren¬ ic... was a boy referred for antisocial behavior. But to this picture was added his alienation from his contemporaries and overdependence on his mother. In addition to his antisocial behavior, he had somatic complaints, appeared worried and brooding."""3-7'*1 About 20% of the antisocial boys seen at the child guidance center later received a diagnosis of schizophrenia.7 In contrast, two studies have been done of shy, withdrawn children seen at a child guidance clinic,"" the second of males only. A low (
and
of
Schizophrenics
III
Neurological Soft Signs
Ronald O. Rieder, MD, Paul L. Nichols, PhD
\s=b\ Twenty-nine male offspring of "continuous schizophrenics" (chronic, borderline, and chronic schizoaffective schizophrenics), plus controls, were given neurological and psychological examinations at age 7. Eight of the 29 were found to have high ratings on a factor score that was termed "hyperactive" (increased activity, impulsivity, distractibility, and emotional lability), and three of these boys had high ratings for neurological signs as well. These frequencies were significantly greater than the control values. Mild incoordination, such as awkwardness in performing rapidly alternating movements, was the neurological
soft sign most elevated in the offspring of schizophrenics were
index group. Fifteen female not found to differ from their
controls on these measures. Previous studies of the childhoods of male schizophrenics have found behavior patterns similar to the behavior of the boys who scored high on our hyperactive factor. It is thus likely that the "hyperactive cases" in this sample are even more at risk for developing schizophrenia in later life than the other offspring of schizophrenic parents. (Arch Gen Psychiatry 36:665-674, 1979)
Several schizophrenia signs
studies have suggested a link between adult and certain behavioral or neurological in childhood. As part of a larger study to discover possible early manifestations of a genetic predisposition to schizophrenia, we attempted to determine if the offspring of schizophrenics have an increased frequency of behavior¬ al or neurological abnormalities by age 7. for publication Sept 5, 1978. From the Laboratory of Psychology and Psychopathology, Intramural Research, National Institute of Mental Health (Dr Rieder), and the Developmental Neurology Branch, Neurological Disorders Program, National Institute of Neurological and Communicative Diseases and Stroke (Dr Nichols), Bethesda, Md. Reprint requests to Laboratory of Psychology and Psychopathology, Intramural Research, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD 20014 (Dr Rieder).
Accepted
REVIEW
"Follow-back" studies—examinations of the childhood records of adult schizophrenics or childhood histories taken from those who are unaware of the schizophrenic outcome—have quite consistently supported a view that certain patterns of childhood behavior precede adult schizo¬ phrenia. Two major patterns, antisocial behavior and asocial (schizoid, withdrawn) behavior, have been found. Bower et al,1- in an investigation of the high school behavior of male preschizophrenics through teacher inter¬ views, found that about 50% had been quite withdrawn, 20% delinquent, and the other 30% had miscellaneous or no marked problems. A review of child guidance records of adult schizophrenics by Nameche et al1 also found both withdrawn and acting-out types of childhood behavior disorders. Watt et al,4 " in a follow-back study of elementa¬ ry and high school records, separated the data for males and females. They found that preschizophrenic boys were often disruptive in the later grades of school, and 52% of them they categorized as "unsocialized-aggressive." The specific indices that characterized the preschizophrenic boys were disagreeableness (less pleasant, less cooperative, less considerate, less well behaved) and emotional instabil¬ ity (less cheerful, more emotionally immature). The pre¬
schizophrenic girls were more introverted, more passive, and more emotionally unstable than their controls in elementary school, and continued to be more introverted as
adolescents. Thus, Watt's group found that the two patterns described previously were sex-related, boys being more antisocial and girls more socially withdrawn. The follow-up studies of children with certain psychiatric symptoms or diagnoses have been in general agreement with these reports, except that the results have shown
Downloaded From: http://archpsyc.jamanetwork.com/pdfaccess.ashx?url=/data/journals/psych/12314/ by a University of California - San Diego User on 02/02/2017
link between childhood antisocial behavior and than between asocial traits and schizophre¬ nia. Robins'" 30-year follow-up of children seen in a child guidance center found that "the potential schizophren¬ ic... was a boy referred for antisocial behavior. But to this picture was added his alienation from his contemporaries and overdependence on his mother. In addition to his antisocial behavior, he had somatic complaints, appeared worried and brooding."""3-7'*1 About 20% of the antisocial boys seen at the child guidance center later received a diagnosis of schizophrenia.7 In contrast, two studies have been done of shy, withdrawn children seen at a child guidance clinic,"" the second of males only. A low (
