Previous research has found that trauma is a risk factor for developing early-onset psychosis (EOP), both exhibiting widespread structural abnormalities and social cognitive dysfunction (Hoy et al., 2012; Nair et al., 2020; Rotiker et al., 2018). However, few studies have investigated the association between trauma, neural architecture, and social behaviors. The current study examines whether trauma exposure moderates the association between cortical volume and thickness and social cognition in EOP.

T1-weighted whole-brain magnetic resonance data were acquired on a 3T Siemens scanner for 23 adolescents with EOP aged 12-21 years (M = 16.12), and 20 age-matched controls (M = 17.22). Cortical volume and thickness were calculated using the Freesurfer software suite (v5.3; Reuter et al., 2012). Based on prior research, bilateral structures of interest included the rostral anterior cingulate cortex (rACC), insula, precuneus, and superior frontal cortex. Social measures included the WebCNP Emotion Recognition (KER40) and Emotion Differentiation Test (MED36) accuracy score (Gur et al., 2010), The Awareness of Social Inference Test Total Score (TASIT; McDonald et al., 2003), and Social Responsiveness Scale, 2nd Edition (SRS-2; Constantino & Gruber, 2012). Trauma exposure was assessed using the Structured Clinical Interview Diagnostic (controls n = 5; EOP n = 9; First et al., 2015). Pearson’s correlations and independent t-tests were used to examine the relationship between cortical measurements and social cognition. Additionally, PROCESS macro (Hayes, 2018) was used to examine if trauma history statistically moderated the relationship between cortical measurements and social cognition performance.

Significant group differences in SRS-2 scores were observed, as EOP participants scored 24.272 points higher than controls (t = 20.724, p < .001). Across both groups, there was a negative correlation between the SRS-2 score and precuneus volume (r = -.438, p = .011) and thickness (r = -.383, p = .028), TASIT total and superior frontal volume (r = -.349, p = .023), and KER40 and insular volume (r = -.437, p = .20). Further, the moderation analysis revealed that the relationships between precuneus volume and SRS-2 scores, precuneus thickness and MED36 scores, and rACC thickness and KER40 scores depended on experiencing trauma across both groups. Participants with trauma across groups had increased precuneus volume associated with higher SRS-2 scores (p = .0442). Experiencing trauma was also associated with lower precuneus cortical thickness and lower MED36 scores (p = .0172). Conversely, lack of trauma experience was associated with greater rACC thickness and higher KER40 scores (p = .0119).

Our findings indicate that past traumatic experiences may be a moderating factor in the relationship between atypical volume and thickness of social brain regions and social cognition. Overall, the significant interactions between trauma exposure and increased volume and thickness in both EOP and control participants were associated with increased impairment on social cognition measures. These findings emphasize the importance of accounting for the impact of early life adversities on brain development and how it may be relevant to social impairments, especially in individuals experiencing psychosis.