Neurocognitive and familial moderators of psychiatric risk in velocardiofacial (22q11.2 deletion) syndrome: a longitudinal study.

[22q11.2 deletion syndrome]

Although risk for psychosis in velocardiofacial (22 q 11 .2 deletion ) syndrome (VCFS ) is well established , the cognitive and familial factors that moderate that risk are poorly understood .A total of 75 youth with VCFS were assessed at three time points , at 3 -year intervals . Time 1 (T 1 ) psychiatric risk was assessed with the Behavior Assessment System for Children (BASC ). Data reduction of BASC scores yielded avoidance-anxiety and dysregulation factors . Time 2 (T 2 ) neuropsychological and family function and time 3 (T 3 ) prodromal /overt psychosis were assessed . Poisson regression models tested associations between T 3 positive prodromal symptoms /overt psychosis and T 1 psychiatric risk , T 2 cognitive and familial factors , and their interactions .T 1 avoidance-anxiety ratings predicted T 3 prodromal /overt psychosis . T 2 verbal learning scores moderated this association , such that individuals with low avoidance-anxiety scores and stronger verbal learning skills were the least likely to demonstrate prodromal /overt psychosis at T 3 . Low scores on a T 2 visual vigilance task also predicted T 3 prodromal /overt psychosis , independently of the effect of T 1 avoidance-anxiety scores . T 1 dysregulation scores did not predict T 3 prodromal /overt psychosis in a linear manner . Instead , the association between dysregulation and prodromal /overt psychosis was amplified by T 2 levels of family organization , such that individuals with low dysregulation scores and low family organization scores were the most likely to exhibit T 3 prodromal /overt psychosis .Significant moderators of psychiatric risk in VCFS include verbal learning skills as well as levels of family organization , carrying implications for early identification and preventative treatment of youth with VCFS at highest risk for psychosis .