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The risk paid off. Abnormalities in eye movement and attention — targeted as indicators of schizophrenia risk by earlier studies — turned out to be useful predictors. The smaller of the two groups in Lenzenweger’s study contained individuals who displayed dilute forms of schizophrenia-like symptoms even though they had never had the illness. Study of these people revealed schizophrenia in their relatives, but not other psychiatric illnesses.
“What was exciting for us is that this method allows you to assign a probability to every person in the sample with respect to likelihood of risk for schizophrenia,” Lenzenweger said. “By doing this, one can generate precise estimates of where individuals fall on the risk dimension.”
Professor Brendan A. Maher, the Edward C. Henderson professor emeritus at Harvard University and primary architect of the field of experimental psychopathology as well as a colleague and collaborator of Lenzenweger’s, said Lenzenweger’s work has “extraordinary potential.” One day it could even help lead the way to ensuring that individuals at risk for schizophrenia can be treated before they ever become ill.
“The promise, particularly in the measurement and early identification of schizophrenia, which is still in its infancy, is huge,” Maher said. “The promise is that we would get good, solid data on early identification and be able to develop preventative techniques.”
The next step for Lenzenweger will be to use mixture modeling to help identify people who might be gene carriers for schizophrenia risk.
DNA assays on such individuals would contribute to the growing body of work on the 10 genes of highest interest to schizophrenia researchers. And it has become so much easier to gather DNA that Lenzenweger is optimistic about the work progressing further.
“We can dig deeper,” he said, “because the technology has advanced yet again.”
Lenzenweger also studies what are termed personality disorders. Different from a psychotic illness such as schizophrenia, people with personality disorders exhibit traits that cause them to feel and behave in socially distressing ways and show marked occupational impairment.
In a major epidemiological study, Lenzenweger recently reported that about 9 percent of adults in the United States have one or more personality disorders, which often limit their ability to function in relationships and at work. This work, conducted as part of the National Comorbidity Study-Replication, confirmed Lenzenweger’s earlier finding suggesting that 1 in 10 people suffers from a diagnosable personality disorder.
Another part of Lenzenweger’s focus on personality disorders involves his National Institute of Mental Health-funded Longitudinal Study of Personality Disorders (LSPD). In 1990, he began this study of the longitudinal course of personality disorders, personality and temperament. The first study of its kind in the world, it has been yielding fascinating results regarding the fundamental nature of personality disorders.
The study has challenged traditional beliefs about personality disorders more than once. For example, he first used a statistical procedure known as growth curve analysis, as well as data from the LSPD, to show that personality disorders are flexible and may change over time, rather than being fixed in regard to severity over a person’s lifetime.
More recently, in collaboration with his Harvard colleague John B. Willett, Lenzenweger showed that the changes that occur in personality disorders over time are not caused by changes in a variety of systems thought to underpin personality in general. This study also was published in 2007 in the Journal of Abnormal Psychology.
“These data cracked open the notion that any change in personality disorder must come from changes in personality per se,” Lenzenweger said, “and they open the door to exploring the causes of change, especially considering possibilities that fall outside the box of conventional wisdom in psychiatry and clinical psychology.”
These findings offer new hope and possibilities for treatment to those stigmatized by misperceptions and misinformation.
— Rachel Coker
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