Identifying Latent Groups of Individuals with First Episode Psychosis Based on Social Relationships: A Reconsideration of Social Functioning

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  • March 21, 2019
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  • Gagen, Emily
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
Abstract
  • First episode psychosis (FEP) occurs at an important developmental time for adolescents and young adults when social relationships are of particular importance. The concept of social functioning in psychosis has frequently utilized concepts from the chronic serious mental illness (SMI) literature and as such, can lack emphasis on these relationships as being critical components of an individual’s illness and recovery. Ascertaining potential patterns of social functioning in FEP individuals can help guide treatment and identify important ways in which individuals differ in this area. The current study used latent class analysis (LCA) to identify subgroups of FEP individuals presenting for treatment at three coordinated specialty care clinics (n=134). Groups were identified based on satisfaction with social relationships and frequency of in-person and electronic communication with peers, family, and significant others. Groups were further characterized using demographic and clinical features. Linear and multinomial logistic regression models were utilized to determine the potential predictive relationships between duration of untreated psychosis (DUP), class membership, and for a subset of the sample, 6-month outcomes. Treatment goals set at baseline were also examined for their potential relationship to 6-month outcomes. LCA resulted in three classes: Class 1 (Dissatisfied) demonstrated the least satisfaction with their social relationships, reported the least frequent contact with others and greatest degree of symptom severity, particularly with regard to depression and avolition. Class 2 (Satisfied) reported the greatest degree of satisfaction and reported frequent contact with peers and family, as well as the lowest degree of symptom severity. Class 3 (In-Between) reported mixed satisfaction and dissatisfaction as well as some contact with peers and family and moderate levels of symptoms. DUP was not found to be a significant predictor of class membership or of 6-month outcomes. Neither class membership nor treatment goals were predictive of 6-month outcomes. Results are consistent with previous efforts in this area, and they extend the findings of other studies that have based classification on premorbid adjustment. Nuanced approaches to defining social functioning in FEP are indicated, as are varied approaches to treatment based on objective and subjective indicators of social interactions and social relationships.
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  • In Copyright
Advisor
  • Baucom, Donald
  • Jones, Deborah
  • Perkins, Diana
  • Wise, Erica
  • Algoe, Sara
  • Penn, David
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2018
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