Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder

Dominika A Osicka, Jiasi Hao, Natalia Tiles-Sar, Mariam P Ali GROUP Investigators, Richard Bruggeman, Lisette van der Meer and Behrooz Z Alizadeh

International Journal of Social Psychiatry, 2025, vol. 71, issue 3, 520-535

Abstract: Background: Due to prior emphasis on clinical recovery in Schizophrenia Spectrum Disorder (SSD), improving social functioning (SF) was oftentimes neglected, with ⩽15% of patients achieving social recovery. Priorly, we and others have shown that life-course factors, including childhood adversities, play a role in the occurrence and severity of postmorbid SF impairments, highlighting the need to understand these factors for effective interventions. Aim: This study investigates the mechanisms influencing SF in SSD and examines the causal roles of childhood trauma, premorbid adjustment, perceived stigma, self-esteem, and quality of life. Methods: This longitudinal study utilized data of 1,057 SSD patients, with measures at baseline, 3 and 6-year follow-up, from the Genetic Risk and Outcome of Psychosis cohort, to unravel the causal mechanism underlying SF utilizing Structural Equation Modeling. Determinants were assessed using validated retrospective and self-report questionnaires. Model development and testing involved a multistage process, encompassing relationships exploration, fit evaluation and model comparison. Results: We developed a probable causal model. Impaired premorbid adjustment emerged as a crucial factor, exerting negative influence on long-term SF, with a direct effect of β = −.252, p  

Keywords: Schizophrenia spectrum disorder; social functioning; structural equation modeling; premorbid adjustment; personalized psychiatry (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:71:y:2025:i:3:p:520-535

DOI: 10.1177/00207640241298894

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