| Objective:This study sought to examine specific cognitive deficits in the real-life environment among adolescents genetically at high risk for schizophrenia and understand the role of the genetic risk, poly-victimization and family functioning, and their interaction on the deficits.Methods:The study included98non-affected adolescent offspring and siblings of patients with schizophrenia in the high-risk group (HR) and198healthy adolescents in the healthy control group (HC), all aged between9and20years. All participants completed assessments of executive functions (EFs), prospective and retrospective memory, poly-victimization, and family functioning.Results:(1) The HR group scored significantly higher than the HC group on the JVQ (Z=-2.30, P=0.022), with more exposure to poly-victimization and non-poly-victimization (χ2=6.69, df=2,P=0.035). Furthermore, no significant differences between groups were detected in conventional crime, child maltreatment, or peer and sibling victimization (P>0.05), but more adolescents in the HR group experienced witnessing and indirect victimization than those in the HC group (χ2=6.69, df=2,P=0.035). While the HR group scored significantly higher than the HC group on the Adaptability dimension of the FACES Ⅱ-CV (t (294)=-2.36, P=0.019), there was no significant difference on the Cohesion dimension of the FACES Ⅱ-CV (P>0.05).(2) The multivariate analysis revealed that significant main effects were found for group on the Plan/Organize, Task Completion, MI, and Prospective and Retrospective Memory Scale (F (1,280)=5.11～14.76, P<0.05, Partial η=0.022-0.050), with more difficulties reported in the HR group. There were significant main effects for victimization level on all BRIEF-SR scales, BRI, MI, GEC, and Prospective and Retrospective Memory Scales (F (2,280)=4.61-16.42, P<0.05, Partial η2=0.032～0.105), and group X victimization level interactions were significant for Shift, Working Memory, Task Completion, MI, GEC and Prospective and Retrospective Memory Scales (F (2,280)=3.24-5.27, P<0.05, Partial η2=0.023～0.036). Significant main effects were also detected for adaptability level on Emotional Control, Working Memory, Plan/Organize, Task Completion, BRI, MI and GEC (F (2,280)=3.22～6.56,P<0.05,Partial η2=0.023～0.045). There were no significant group x adaptability level interactions on any of the BRIEF-SR scales (P>0.05). Furthermore, neither cohesion level main effects nor group×cohesion level interactions were significant for any of the BRIEF-SR scales (P>0.05).(3) Post hoc analyses revealed that among the HR group, scores on all BRIEF-SR scales and Prospective and Retrospective Memory scales (P<0.05) were significantly higher amongst high victimization level compared with no victimization. Additionally, scores on Shift, Emotional Control, Working Memory, and Task Completion, BRI, MI, GEC and Prospective and Retrospective Memory scales were significantly higher amongst high victimization levels compared to low victimization levels (P<0.05). The HC group had significantly higher scores on Emotional Control and BRI amongst high victimization levels compared with no victimization (P<0.05). Scores on Inhibit, Working Memory, Plan/Organize, Task Completion, MI and GEC were significantly lower amongst high adaptability compared with the middle adaptability level (P<0.05), and scores on the Plan/Organize scale were significantly lower amongst high adaptability compared with low adaptability levels in the HC group (P<0.05). Surprisingly, differences among the three adaptability levels were not significant in the HR group (P>0.05).(4) Simple effect analyses indicated that HR and HC groups did not differ on Shift, Working Memory, Task Completion, MI and GEC when comparing no victimization and low victimization levels (p>0.05), whereas the HR group exhibited significantly elevated scores on above scales (p<0.05) compared with the HC group within the high victimization level. HR and HC groups did not differ on Prospective and Retrospective Memory scales within no victimization (p>0.05), whereas the HR group exhibited significantly elevated scores on above scales (p<0.05) compared with the HC group within the low and high victimization level.(5) Among adolescents in the HR group, except for the Monitor scale, JVQ item-level scores were significantly associated with scores on all BRIEF-SR scales, BRI, MI, GEC and Prospective and Retrospective Memory scales (r=0.24-0.35, P<0.05). Moreover, cohesion scores were significantly associated with scores on the Prospective Memory scale (r=-0.21, P<0.05). For the HC group, JVQ item-level scores were significantly correlated with scores on Emotional Control and Monitor scales (r=0.15-0.17, P<0.05).(6) Hierarchical regression analysis revealed that group accounted for significant variance on Prospective and Retrospective scales (β=0.15, P<0.01;P=0.18, P <0.01),with the HR group scoring significantly higher than the HC group on these two scales. Except for the Plan/Organize and Organization of Materials, JVQ item scores accounted for significant variance on other BRIEF-SR scales, BRI, MI, GEC and Prospective and Retrospective scales(β=0.12～0.30, P<0.05). The interaction terms were significant for Prospective and Retrospective scales(P=0.15,P<0.05; β=0.16, P<0.05).(7) Among the HR group, scores on Prospective Memory scale were significantly associated with scores on all BRIEF-SR scales, BRI, MI and GEC (r=0.34～0.62,P<0.05), while scores on Retrospective Memory scale were also significantly associated with scores on all BRIEF-SR scales,BRI,MI and GEC (r=0.27～0.53,P<0.05).For the HC group, scores on Prospective Memory scale significantly correlated with scores on all BRIEF-SR scales, BRI, MI and GEC (r=0.22-0.42, P<0.05), while scores on Retrospective Memory scale also significantly correlated with scores on all BRIEF-SR scales,BRI,MI and GEC(r=0.18～0.39,P<0.05).Conclusions: (1) Adolescents genetically at risk for schizophrenia experience more poly-victimization, non-poly-victimization and witnessing and indirect victimization than the healthy controls.(2) Compared with controls, adolescents genetically at risk for schizophrenia performed more poorly on Plan/Organize, Task Completion, MI, Prospective and Retrospective Memory.(4) For adolescents genetically at risk for schizophrenia, poly-victims show more deficits in most of executive components and prospective and retrospective memory than non-poly-victims and non-victims. Poly-victimization may be related to deficits in EFs and prospective and retrospective memory.(5) Prospective and retrospective memory is associated with EFs. |
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