The Relationship Between Advanced Paternal Age and Clinical Indicators Among Individuals at Clinical High Risk for Psychosis 公开

Ryan, Arthur Thomas (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/t148fh17x?locale=zh
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Abstract

Since the middle of the twentieth century, researchers have demonstrated that children born to fathers of advanced age are at increased risk for a variety of health conditions, including psychotic disorders such as schizophrenia. Modern research has shown that this effect may be due to accumulating de novo mutations in the germ line sperm cells of older men. During the last twenty years, researchers have begun to investigate the pre-morbid period before the development of psychotic illnesses. Much of this research has focused on individuals determined to be at increased risk of developing a psychotic illness on the basis of clinical signs and symptoms, i.e., at clinical high risk (CHR) for psychosis. This dissertation seeks to combine these two lines of research. The relationship between paternal and maternal age with attenuated positive symptoms, negative symptoms, social functioning, and family history of psychotic illness was examined within a sample of CHR individuals. No significant relationship between paternal age and these variables was found. Maternal age was shown to have a mixed relationship with positive symptoms, in that increased maternal age predicted the presence of attenuated positive symptoms, but was inversely correlated with their severity. The null results for paternal age are interpreted in the context of the established findings linking paternal age and offspring risk for schizophrenia. Ideas for future studies to further elucidate the relationship between parental ages and psychotic illnesses are discussed.

Table of Contents

Table of Contents
Background Literature Review 1
The Clinical High Risk Syndrome for Psychotic Illness 1
Advanced Paternal Age and Offspring Outcomes 4
Underpinnings of Link Between Father's Age and Offspring Outcomes 9
Background Summary and Hypotheses 22
Method 23
Participants 23
Symptom and Functioning Measures. 23
Familial Measures. 25
Procedures 27
Analyses and Results 28
Hypothesis One Analysis Plan 28
Hypothesis One Results 34
Hypothesis One Summary and Conclusions 39
Hypothesis Two Analysis Plan 41
Hypothesis Two Results 45
Hypothesis Two Summary and Conclusions 46
Hypothesis Three Analysis Plan 46
Hypothesis Three Results 47
Hypothesis Three Summary and Conclusions 48
Hypothesis Four Analysis Plan 48
Hypothesis Four Results 51
Hypothesis Four Summary and Conclusions 53
Further Supplemental Analyses 53
Discussion 58
Findings Related to Participant's Age and Mother's Age 59
Findings Related to Father's Age 63
Limitations and Future Directions 67
Conclusion 69
References 70
Table 1 Key Psychosis Related Terms 85
Table 2 Parent's Education Rating Values 87
Table 3 Characteristics of CHR Individuals by Positive Symptom Score 88
Table 4 Hypothesis One Summary of Correlation Coefficients Between Independent Variables / Covariates and Positive Symptom Score 89
Table 5 Hypothesis One Pair-wise Vuong Closeness Tests Comparing Regression Models 90
Table 6 Hypothesis One Zero Inflated Poisson Regression Predictors of Positive Symptom Score 91
Table 7 Hypothesis One Results of Hierarchical Analysis, Zero-Inflated Poisson Regression, Significance of Adding Father's Age 92
Table 8 Hypothesis One Results of Hierarchical Analysis, Zero-Inflated Poisson Regression, Significance of Adding Mother's Age 93
Table 9 Hypothesis One Ordinary Least Squares Regression Predicting Positive Symptom Scores 94
Table 10 Hypothesis Two Zero-Order Correlations Between Predictors / Potential Covariates and Negative Symptom Scores 95
Table 11 Hypothesis Two Ordinary Least Squares Regression Predicting Negative Symptom Score 96
Table 12 Hypothesis Two Follow-up Ordinary Least Squares Regression Predicting Negative Symptom Score with Hypothesis One Covariates 97
Table 13 Hypothesis Two Follow-up Negative Binomial Regression Predicting Negative Symptom Score 98
Table 14 Hypothesis Three Zero-Order Correlations Between Predictors / Potential Covariates and Social Functioning Scores 99
Table 15 Hypothesis Three Ordinary Least Squares Regression Predicting Social Functioning Score 100
Table 16 Hypothesis Three Follow-up Ordinary Least Squares Regression Predicting Social Functioning Scores with Hypothesis One Covariates 101
Table 17 Hypothesis Four Family History of Psychosis Group Differences on Potential Covariates 102
Table 18 Hypothesis Four ANCOVA Comparing Father's Age between Family History of Psychosis Groups 103
Table 19 Hypothesis Four T-Test Comparing Father's Age between Family History of Psychosis Groups 104
Table 20 Supplemental Analysis- Cross Tab Analysis of Family History of Psychosis and Zero vs. Non-Zero Symptom Score 105
Table 21 Supplemental Analysis- Zero Inflated Poisson Regression for Positive Symptom Score with Family History x Parent's Age Interaction Terms 106
Figure 1. Bar plot of distribution of positive symptom scores among CHR participants 107
Figure 2. Subject exclusion flow chart 108
Figure 3. Bar plot of distribution of sum of negative symptom scores among CHR participants 109
Figure 4. Histogram of current social functioning scores among CHR participants 110

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