Recent Developments in High Risk Research

Abstract

In 1968, Mednick and McNeil published an influential article on the problems of interpreting the results from studies of the functioning of adult schizophrenics. They argued that differences on variables such as medication, length of hospitalization, and failure in educational, occupational, and social realms that were inextricably associated with the diagnosis of schizophrenia made the comparison of schizophrenics with any control group virtually impossible to interpret with regard to etiology. Differences obtained in performance between schizophrenics and control groups might be reasonably attributed either to schizophrenia or to differences on these other variables. Because schizophrenics generally have longer hospitalization histories than other diagnostic groups, and because the medication prescribed for schizophrenics differs from that prescribed for any other group, finding an adequate control group matched for all of the contaminating variables is virtually impossible. Attempting to disentangle the essence of the schizophrenic condition from concomitant differences on these nuisance variables could be attempted by examining retrospective data on what the individual was like before his or her first psychotic break, but this approach also has its disadvantages. Information obtained retrospectively from society’s records probably would not contain the variables of interest to an investigator beginning a study years after the records were made, and summarizing information from such records presents the additional problem that different informants may have used similar words in different ways. Furthermore, examining the information available only for those schizophrenics who are represented in society’s records may lead to the systematic elimination of individuals who have migrated away from the area, and these subjects may be quite different in many ways.