The UCLA High-Risk Project

The UCLA High Risk Project studied a cohort of 64 families over a 15-year followup period. At entry to the study, the families each contained one adolescent who was having behavioral difficulties for whom help was sought from a psychological clinic. Two criteria of the degree of risk for schizophrenia were devised initially, one based on the form of the adolescent's problem and the other on the parental attributes of communication deviance (CD), affective style (AS), and expressed emotion (EE). It was hypothesized that schizophrenia would be the likely outcome when certain patterns of adolescent disturbance and negative communicational and affective patterns were present in the family. The index offspring of 54 of the 64 families were successfully followed up over the 15-year period (mean age = 30 at last followup), and blind psychiatric diagnoses were done. Contrary to the initial hypothesis, the form of the adolescent problem had limited prognostic value; however, the combination of CD and AS correctly identified the overwhelming number of cases who developed schizophrenia and related disorders. CD did even better if the dependent variable was the risk for schizophrenia spectrum disorder in any offspring in the family.