June 6, 2016
By: Dominic A. Sisti, PhD, and Monica E. Calkins, PhD
Schizophrenia and other psychosis spectrum disorders do not develop de novo but emerge from prodromal stages that are named and operationalized differently depending on the research group or consortium and its theoretical orientation. As a result, a complex lexicon now exists for characterizing individuals’ risk of subclinical symptoms converting to psychosis. Researchers aim to develop instruments and methods to identify people at risk of psychosis, better understand their risks, and offer preventative treatments to arrest conversion to psychosis; ethical and policy questions loom large with each of these projects. In this paper, we canvass the lexical complexities of the at-risk status for psychosis and then consider ethical and policy challenges that researchers and clinicians face in disclosing, preventing, and treating psychosis risk.
Dominic A. Sisti, PhD, is director of the Scattergood Program for Applied Ethics of Behavioral Health Care and an assistant professor of medical ethics and psychiatry in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
Monica E. Calkins, PhD, is an associate professor of psychology and the director of clinical research assessment in the Department of Psychiatry, Neuropsychiatry Section, at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
The authors acknowledge the support of the Greenwall Foundation and the Thomas Scattergood Behavioral Health Foundation.
The Foundation does not necessarily endorse the positions expressed by its grantees. The Foundation does endorse an open and honest debate about the limitations of mental health care delivery in the US.