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

Author

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

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  

Suggested Citation

  • Dominika A Osicka & Jiasi Hao & Natalia Tiles-Sar & Mariam P Ali GROUP Investigators & Richard Bruggeman & Lisette van der Meer & Behrooz Z Alizadeh, 2025. "Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder," International Journal of Social Psychiatry, , vol. 71(3), pages 520-535, May.
    • Handle: RePEc:sae:socpsy:v:71:y:2025:i:3:p:520-535
    DOI: 10.1177/00207640241298894
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    References listed on IDEAS

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    1. Francisca Vargas Lopes & Pieter Bakx & Sam Harper & Bastian Ravesteijn & Tom Van Ourti, 2022. "The effects of supported housing for individuals with mental disorders," Health Economics, John Wiley & Sons, Ltd., vol. 31(S2), pages 115-133, October.
    2. Yvonne T. M. Vanneste & Caren I. Lanting & Symone B. Detmar, 2022. "The Preventive Child and Youth Healthcare Service in the Netherlands: The State of the Art and Challenges Ahead," IJERPH, MDPI, vol. 19(14), pages 1-10, July.
    3. Christian Dippel & Andreas Ferrara & Stephan Heblich, 2020. "Causal mediation analysis in instrumental-variables regressions," Stata Journal, StataCorp LLC, vol. 20(3), pages 613-626, September.
    4. Shulamit Ramon, 2018. "The Place of Social Recovery in Mental Health and Related Services," IJERPH, MDPI, vol. 15(6), pages 1-14, May.
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