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Cannabis use and psychosis: re-visiting the role of childhood trauma

Published online by Cambridge University Press:  18 April 2011

J. E. Houston ,
J. Murphy ,
M. Shevlin  and
G. Adamson
J. E. Houston*
Affiliation:
Division of Psychology, Nottingham Trent University, Nottingham, UK
J. Murphy
Affiliation:
School of Psychology, University of Ulster, Magee, Londonderry, UK
M. Shevlin
Affiliation:
School of Psychology, University of Ulster, Magee, Londonderry, UK
G. Adamson
Affiliation:
School of Psychology, University of Ulster, Magee, Londonderry, UK
*
*Address for correspondence: J. E. Houston, Ph.D., Division of Psychology, Nottingham Trent University, Burton Street, Nottingham NG1 4BU, UK. (Email: [email protected])
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Abstract

Background

Cannabis consumption continues to be identified as a causal agent in the onset and development of psychosis. However, recent findings have shown that the effect of cannabis on psychosis may be moderated by childhood traumatic experiences.

Method

Using hierarchical multivariate logistic analyses the current study examined both the independent effect of cannabis consumption on psychosis diagnosis and the combined effect of cannabis consumption and childhood sexual abuse on psychosis diagnosis using data from the Adult Psychiatric Morbidity Survey 2007 (n=7403).

Results

Findings suggested that cannabis consumption was predictive of psychosis diagnosis in a bivariate model; however, when estimated within a multivariate model that included childhood sexual abuse, the effect of cannabis use was attenuated and was not statistically significant. The multivariate analysis revealed that those who had experienced non-consensual sex in childhood were over six times [odds ratio (OR) 6.10] more likely to have had a diagnosis of psychosis compared with those who had not experienced this trauma. There was also a significant interaction. Individuals with a history of non-consensual sexual experience and cannabis consumption were over seven times more likely (OR 7.84) to have been diagnosed with psychosis compared with those without these experiences; however, this finding must be interpreted with caution as it emerged within an overall analytical step which was non-significant.

Conclusions

Future studies examining the effect of cannabis consumption on psychosis should adjust analyses for childhood trauma. Childhood trauma may advance existing gene–environment conceptualisations of the cannabis–psychosis link.

Keywords

Cannabischildhood traumapsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 11 , November 2011 , pp. 2339 - 2348
Copyright
Copyright © Cambridge University Press 2011

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References

Agosti, V, Nunes, E, Levin, F (2002). Rates of psychiatric comorbidity among U.S. residents with lifetime cannabis dependence. American Journal of Drug and Alcohol Abuse 28, 643–652.CrossRefGoogle ScholarPubMed
Andreasson, S, Engstrom, A, Allebeck, P, Rydberg, U (1987). Cannabis and schizophrenia: a longitudinal study of Swedish conscripts. Lancet 330, 1483–1486.CrossRefGoogle Scholar
Arseneault, L, Cannon, M, Witton, J, Murray, RM (2004). Causal association between cannabis and psychosis: examination of the evidence. British Journal of Psychiatry 184, 110–117.CrossRefGoogle ScholarPubMed
Bebbington, P, Nayani, T (1995). The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research 5, 11–19.Google Scholar
Bebbington, PE (2009). Childhood sexual abuse and psychosis: aetiology and mechanism [Editorial]. Epidemiologia e Psichiatria Sociale 18, 284–293.CrossRefGoogle ScholarPubMed
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004). Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. British Journal of Psychiatry 185, 220–226.CrossRefGoogle ScholarPubMed
Beck, JC, van der Kolk, B (1987). Reports of childhood incest and current behaviour in chronically hospitalised psychotic women. American Journal of Psychiatry 144, 1474–1476.Google ScholarPubMed
Berry, K, Barrowclough, C, Wearden, A (2008). Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis. Behaviour Research and Therapy 46, 1275–1282.CrossRefGoogle ScholarPubMed
Caspari, D (1999). Cannabis and schizophrenia: results of a follow-up study. European Archives of Psychiatry and Clinical Neuroscience 249, 45–49.CrossRefGoogle ScholarPubMed
Caspi, A, Moffitt, TE, Cannon, M, McClay, J, Murray, R, Harrington, H, Taylor, A, Arseneault, L, Williams, B, Braithwaite, A, Poulton, R, Craig, IW (2005). Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Biological Psychiatry 57, 1117–1127.CrossRefGoogle ScholarPubMed
Cloiter, M, Tardiff, K, Marzuk, PM, Leon, AC, Portera, L (2001). Consequences of childhood abuse among male psychiatric inpatients: dual roles as victims and perpetrators. Journal of Traumatic Stress 14, 47–60.CrossRefGoogle Scholar
Compton, MT, Furman, AC, Kaslow, NJ (2004). Lower negative symptom scores among cannabis-dependent patients with schizophrenia-spectrum disorders: preliminary evidence from an African American first-episode sample. Schizophrenia Research 71, 61–64.CrossRefGoogle ScholarPubMed
Corcoran, CM, Kimhy, D, Stanford, A, Khan, S, Walsh, J, Thompson, J, Schobel, S, Harkavy-Friedman, J, Goetz, R, Colibazzi, T, Cressman, V, Malaspina, D (2008). Temporal association of cannabis use with symptoms in individuals at clinical high risk for psychosis. Schizophrenia Research 106, 286–293.CrossRefGoogle ScholarPubMed
Cornelius, J, Kirisci, L, Reynolds, M, Clark, D, Hayes, J, Tarter, R (2010). PTSD contributes to teen and young adult cannabis use disorders. Addictive Behaviors 35, 91.CrossRefGoogle Scholar
Cougnard, A, Marcelis, M, Myin-Germeys, I, De Graaf, R, Volleburgh, W, Krabbendam, L, Leb, R, Wittchen, HU, Henquiet, C, Spauwen, J, van Os, J (2007). Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model. Psychological Medicine 37, 513–527.CrossRefGoogle ScholarPubMed
Dixon, L, Haas, G, Weiden, PJ, Sweeney, J, Frances, AJ (1991). Drug abuse in schizophrenic patients: clinical correlates and reasons for use. American Journal of Psychiatry 148, 224–230.Google ScholarPubMed
Enders, CK (2001). The performance of the full information maximum likelihood estimator in multiple regression models with missing data. Educational and Psychological Measurement 61, 713–740.CrossRefGoogle Scholar
Fergusson, DM, Poulton, R, Smith, PF, Boden, JM (2006). Cannabis and psychosis. British Medical Journal 332, 172–176.CrossRefGoogle ScholarPubMed
Friedman, S, Harrison, G (1984). Sexual histories, attitudes and behavior of schizophrenic women and normal women. Archives of Sexual Behavior 13, 555–567.CrossRefGoogle ScholarPubMed
Friedman, S, Smith, L, Fogel, D, Paradis, C, Viswanathan, R, Ackerman, R, Trappler, B (2002). The incidence and influence of early traumatic life events in patients with panic disorder: a comparison with other psychiatric outpatients. Journal of Anxiety Disorders 16, 259–272.CrossRefGoogle ScholarPubMed
Galea, S, Tracy, M (2007). Participation rates in epidemiologic studies. Annals of Epidemiology 17, 643–653.CrossRefGoogle ScholarPubMed
Grech, A, Van Os, J, Jones, PB, Lewis, SW, Murray, RM (2005). Cannabis use and outcome of recent onset psychosis. European Psychiatry 20, 349–353.CrossRefGoogle ScholarPubMed
Hall, W, Degenhardt, L (2000). Cannabis use and psychosis: a review of clinical and epidemiological evidence. Australian and New Zealand Journal of Psychiatry 34, 26–34.CrossRefGoogle ScholarPubMed
Harley, M, Kelleher, I, Clarke, M, Lynch, F, Arseneault, L, Connor, D, Fitzpatrick, C, Cannon, M (2010). The role of childhood trauma in mediating the association between cannabis use and psychotic symptoms in adolescence. Psychological Medicine 40, 1627–1634.CrossRefGoogle Scholar
Henquet, C, Di Forti, M, Morrison, P, Kuepper, R, Murray, R (2008). Gene–environment interplay between cannabis and psychosis. Schizophrenia Bulletin 34, 1111–1121.CrossRefGoogle ScholarPubMed
Henquet, C, Murray, R, Linszen, D, van Os, J (2005). The environment and schizophrenia: the role of cannabis use. Schizophrenia Bulletin 31, 608–612.CrossRefGoogle ScholarPubMed
Houston, JE, Murphy, J, Adamson, G, Stringer, M, Shevlin, M (2008). Childhood sexual abuse, early cannabis use and psychosis: testing an interaction model based on the National Comorbidity Survey. Schizophrenia Bulletin 34, 580–585.CrossRefGoogle ScholarPubMed
Janssen, I, Krabbendam, L, Bak, M, Hanssen, M, Vollebergh, W, de Graaf, R, van Os, J (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica 109, 38–45.CrossRefGoogle ScholarPubMed
Kessler, RC, Sonnega, A, Bromet, E, Hughers, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.CrossRefGoogle ScholarPubMed
Kilcommons, AM, Morrison, AP (2005). Relationships between trauma and psychosis: an exploration of cognitive and dissociative factors. Acta Psychiatrica Scandinavica 351–359.CrossRefGoogle ScholarPubMed
Linszen, DH, Dingemans, P, Lenior, M (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.CrossRefGoogle ScholarPubMed
McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (2007). Adult psychiatric morbidity in England: results of a household survey. UK Data Archive Study Number 6379. National Centre for Social Research (http://www.natcen.ac.uk/).Google Scholar
Molnar, BE, Buka, SL, Kessler, RC (2001). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health 91, 753–760.Google ScholarPubMed
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, RE, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Moskowitz, A, Schafer, I, Dorahy, MJ (2009). Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology. Wiley: London.Google Scholar
Mueser, KT, Yarnold, PR, Levinson, DF (1990). Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophrenia Bulletin 16, 31–56.CrossRefGoogle ScholarPubMed
Murray, RM, Morrison, PD, Henquet, C, Di Forti, M (2007). Cannabis, the mind and society: the hash realities. Nature Reviews Neuroscience 8, 885–895.CrossRefGoogle Scholar
Muthén, LK, Muthén, BO (1998–2009). Mplus User's Guide. Muthén & Muthén: Los Angeles, CA.Google Scholar
Peralta, V, Cuesta, MJ (1992). Influence of cannabis abuse on schizophrenic psychopathology. Acta Psychiatrica Scandinavica 85, 127–130.CrossRefGoogle ScholarPubMed
Peters, BD, de Koning, P, Dingemans, P, Becker, H, Linszen, DH, de Haan, L (2009). Subjective effects of cannabis before the first psychotic episode. Australian and New Zealand Journal of Psychiatry 43, 1155–1162.CrossRefGoogle ScholarPubMed
Read, J, Bentall, R, Fosse, R (2009). Time to abandon the bio-bio-bio model of psychosis: exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms. Epidemiologia e Psichiatria Sociale 18, 299–310.CrossRefGoogle ScholarPubMed
Read, J, Fraser, A (1998). Abuse histories of psychiatric inpatients: to ask or not to ask. Psychiatric Services 49, 355–359.CrossRefGoogle ScholarPubMed
Read, J, Perry, BD, Moskowitz, A, Connolly, J (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64, 319–345.CrossRefGoogle ScholarPubMed
Read, J, van Os, J, Morrison, A, Ross, C (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.CrossRefGoogle ScholarPubMed
Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, Goodwin, FK (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Journal of the American Medical Association 264, 2511–2518.CrossRefGoogle ScholarPubMed
Saunders, J, Aasland, O, Babor, T, De La Fuente, J, Grant, M (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction 88, 791–804.CrossRefGoogle ScholarPubMed
Schafer, JL, Graham, JW (2002). Missing data: our view of the state of the art. Psychological Methods 7, 147–177.CrossRefGoogle ScholarPubMed
Shevlin, M, Dorahy, MJ, Adamson, G (2007). Trauma and psychosis: an analysis of the National Comorbidity Survey. American Journal of Psychiatry 164, 66–169.CrossRefGoogle ScholarPubMed
Shevlin, M, Murphy, J, Houston, JE, Adamson, G (2009). Childhood sexual abuse, early cannabis use, and psychosis: testing the effects of different temporal orderings based on the National Comorbidity Survey. Psychosis: Psychological, Social and Integrative Approaches 1, 19–28.CrossRefGoogle Scholar
Tanda, G, Pontieri, F, Di Chiara, G (1997). Cannabinoid and heroin activation of mesolimbic dopamine transmission by a common μ opoid receptor mechanism. Science 276, 2048–2050.CrossRefGoogle Scholar
van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R, Verdoux, H (2002). Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 19–27.CrossRefGoogle ScholarPubMed
Whitfield, C, Dube, S, Felitti, V, Anda, RF (2005). Adverse childhood experiences and hallucinations. Child Abuse and Neglect 29, 797–810.CrossRefGoogle ScholarPubMed
World Health Organization (1999). Schedules for Clinical Assessment in Neuropsychiatry (Version 2.1). WHO – Assessment, Classification and Epidemiology. WHO: Geneva.Google Scholar
Zammit, S, Allebeck, P, Andreasson, S, Lundberg, I, Lewis, G (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. British Medical Journal 325, 1199–1201.CrossRefGoogle ScholarPubMed