Schizotypy 17 years on: Long-range endophenotype forecasting of psychotic symptoms using perceptual aberrations and...

Predicting the emergence of psychotic symptoms (e.g., hallucinations and delusions) and/or psychotic illness (e.g., schizophrenia) in persons with no prior history of psychosis has long been an aspirational aim of experimental psychopathology. The value of identifying a valid predictor has always been presumed to be useful both in illuminating the underlying pathological processes involved as well as holding out the clinical promises of intervention and prevention. The present study reports on the ability of two putative schizotypy endophenotypes, assessed in the same persons, to predict psychotic symptoms in adults in midlife (age 35), 17 years after their assessment in the laboratory at age 18 when all subjects were free of psychotic symptoms (Lenzenweger et al., 1991). In a sample of 70 individuals, both elevated scores on a measure of perceptual aberrations and lower scores on a measure of performance accuracy (d') on a measure of sustained attention, from the Continuous Performance Test-Identical Pairs version (Cornblatt et al., 1989), significantly predicted the presence of psychotic symptoms at age 35. The 17-year predictive associations remained significant even when considered jointly with mental state variables present at age 18. The results support the validity of endophenotypes, the psychometric high-risk method, and the general schizotypy model of schizophrenia. Finally, as long conjectured, the results provide support for a deficit in sustained attention as a predictor of psychotic symptoms over time. (PsycInfo Database Record (c) 2025 APA, all rights reserved).