Family interactions in youth at clinical high risk for psychosis (CHR-P)

This study examined family interactions in 162 youths at clinical high risk for psychosis and their mothers and fathers, using both observational data (a family problem-solving task) and self-report measures. We evaluated the association between family communication and youths' symptoms of psychosis, depression, and anxiety. Youths, mothers, and fathers rated family communication as one of the top three sources of family tension. During a 10-min problem-solving discussion, parents communicated significantly more constructively than clinical high risk for psychosis youths. Constructive communication was moderately correlated across parents and youth, suggesting reciprocity. There was moderate convergence between observed and self-reported communication. Mothers' constructive communication was positively associated with youths' unusual thoughts, perceptual abnormalities, and blunted affect and negatively associated with youths' depression. Youth with more internalizing symptoms perceived family communication more negatively. In line with attribution theory, mothers may respond more supportively to symptoms they see as uncontrollable and more critically to symptoms viewed as controllable. The sensitivities to social stimulation observed in many clinical high risk for psychosis youths, particularly those with negative symptoms and depression or anxiety, may contribute to feeling overwhelmed and aggravated by family interactions. Clinical implications of these findings are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).