PRENATAL STRESS AND RISK FOR SCHIZOPHRENIA

几条证据表明胎儿暴露于产前危害， 包括母亲的压力，在精神分裂症的病因。 补充研究表明精神分裂症可能涉及 早期脑功能紊乱引起的神经心理缺陷 发展 这个项目的长期目标是开创一个新的 产前压力与妊娠结局的关系研究策略 和发展神经精神问题的风险，特别是 精神分裂症 这种策略利用“自然实验”（严重的自然 灾害袭击人口稠密地区）， 母亲的压力是有时间限制的，发生时几乎没有警告， 外部强加的（很难作为父母的附带现象而被忽视） 自然灾害是少数几种自然灾害之一， DSM-III-R轴IV评定为更严重的心理应激源的事件 （一）失去配偶。 拟议试点的自然灾害 研究将是1953年马萨诸塞州伍斯特市的龙卷风，这是美国历史上最致命的龙卷风之一。 美国历史上的自然灾害 研究表明， 经验 龙卷风袭击了人口稠密的社区， (a)有很高比例的年轻夫妇，和（B）位于一个小时的 从我们的实验室出发。 具体目的是进行一项试点研究，其研究设计 两个互补的方面。 第一个方面是确定 这一新的研究策略的可行性。 第二个方面是测试 假设（a）基于访谈的DSM-III-R诊断 精神分裂症和（B）与较高的- 大脑皮层功能障碍在受试者中显著增加 在产前暴露于压力之下 出生记录将被检查， 大约120名“指标”受试者在子宫内暴露于母体压力， 和120名“对照”受试者暴露在同样的环境中。 婴儿时期的灾难 将对受试者进行随访， 研究诊断访谈（SCID）和神经心理学测试 对认知缺陷敏感， 精神分裂症（威斯康星州卡片分类和线索制作测试）。 的母亲都会 也接受采访，以帮助评估他们的经验的压力 和龙卷风有关 统计功效检验表明， 检测到与先前研究相似的效应， 母亲在怀孕期间受到压力的后代中有更多的精神分裂症。

Several lines of evidence implicate fetal exposure to prenatal hazards, including maternal stress, in the etiology of schizophrenia. Complementary research suggests schizophrenia may involve neuropsychological deficits due to disturbances in early brain development. The long-term goal of this project is to pioneer a new research strategy for investigating associations between prenatal stress and risk of developing neuropsychiatric problems, particularly schizophrenia. This strategy makes use of "natural experiments" (severe natural disasters striking heavily populated areas) that provide a source of maternal stress that is time-limited and occurs with little warning, is externally imposed (difficult to dismiss as an epiphenomenon of parental characteristics, and is severe (natural disasters are one of the few events rated on DSM-III-R Axis IV as a more severe psychological stressor than loss of one's spouse). The natural disaster for the proposed pilot study will be the 1953 Worcester, MA, tornado -- one of the deadliest in American history -- that has several characteristics of natural disasters that research indicates tend to produce particularly stressful experiences. The tornado struck heavily populated neighborhoods which (a) had a high percentage of young couples, and (b) are located an hour's drive from our laboratory. The specific aim is to conduct a pilot study whose research design has two complementary aspects. The first aspect is to determine the feasibility of this new research strategy. The second aspect is to test the hypotheses that both (a) interview-based DSM-III-R diagnoses of schizophrenia and (b) neuropsychological deficits consistent with higher- order cortical dysfunction are significantly increased in subjects exposed to stress prenatally. Birth records will be checked to identify approximately 120 "index" subjects exposed in utero, to maternal stress caused by the tornado, and 120 "control" subjects exposed to the same disaster during infancy. Subjects will be followed up and given a research diagnostic interview (SCID) and neuropsychological tests sensitive to cognitive deficits that are especially prominent in schizophrenia (Wisconsin Card Sort and Trail Making tests). Mothers will also be interviewed to help assess the stressfulness of their experience with the tornado. Statistical power tests indicate high likelihood of detecting effects similar in size to those in previous studies finding more schizophrenia in offspring of mothers stressed while pregnant.