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Impact of childhood adversities on specific symptom dimensions in first-episode psychosis

Published online by Cambridge University Press:  18 September 2015

O. Ajnakina ,
A. Trotta ,
E. Oakley-Hannibal ,
M. Di Forti ,
S. A. Stilo ,
A. Kolliakou ,
P. Gardner-Sood ,
F. Gaughran ,
A. S. David  and
P. Dazzan
...Show all authors
O. Ajnakina
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
A. Trotta
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
E. Oakley-Hannibal
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
M. Di Forti
Affiliation:
MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
S. A. Stilo
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
A. Kolliakou
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
P. Gardner-Sood
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
F. Gaughran
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
A. S. David
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
P. Dazzan
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
C. Pariante
Affiliation:
National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
V. Mondelli
Affiliation:
National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
C. Morgan
Affiliation:
National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK Centre for Epidemiology and Public Health, Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
E. Vassos
Affiliation:
MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
R. M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
H. L. Fisher*
Affiliation:
MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
*
*Address for correspondence: H. L. Fisher, MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

The relationship between childhood adversity (CA) and psychotic disorder is well documented. As the adequacy of the current categorical diagnosis of psychosis is being increasingly questioned, we explored independent associations between different types of CA and specific psychotic symptom dimensions in a well-characterized sample of first-episode psychosis (FEP) patients.

Method

This study involved 236 FEP cases aged 18–65 years who presented for the first time to psychiatric services in South London, UK. Psychopathology was assessed with the Positive and Negative Syndrome Scale and confirmatory factor analysis was used to evaluate the statistical fit of the Wallwork/Fortgang five-factor model of psychosis. CA prior to 17 years of age (physical abuse, sexual abuse, parental separation, parental death, and being taken into care) was retrospectively assessed using the Childhood Experience of Care and Abuse Questionnaire.

Results

Childhood sexual abuse [β = 0.96, 95% confidence interval (CI) 0.40–1.52], childhood physical abuse (β = 0.48, 95% CI 0.03–0.93) and parental separation (β = 0.60, 95% CI 0.10–1.11) showed significant associations with the positive dimension; while being taken into care was associated with the excited dimension (β = 0.36, 95% CI 0.08–0.65), independent of the other types of CA. No significant associations were found between parental death and any of the symptom dimensions.

Conclusions

A degree of specificity was found in the relationships between different types of CA and psychosis symptom dimensions in adulthood, suggesting that distinct pathways may be involved in the CA–psychosis association. These potentially different routes to developing psychosis merit further empirical and theoretical exploration.

Keywords

Child abusedimensionsfactor analysisfirst-episode psychosismaltreatment
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 2 , January 2016 , pp. 317 - 326
Copyright
Copyright © Cambridge University Press 2015 

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References

Babor, TF, de la Fuente, JR, Saunders, J, Grant, M (1992). AUDIT. The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Health Care. World Health Organization: Geneva.Google Scholar
Bell, MD, Lysaker, PH, Beam-Goulet, JL, Milstein, RM, Lindenmayer, JP (1994). Five-component model of schizophrenia: assessing the factorial invariance of the Positive and Negative Syndrome Scale. Psychiatry Research 52, 295–303.Google Scholar
Bendall, S, Jackson, HJ, Hulbert, CA, McGorry, PD (2008). Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophrenia Bulletin 34, 568–579.Google Scholar
Bentall, R, de Sousa, P, Varese, F, Wickham, S, Sitko, K, Haarmans, M, Read, J (2014). From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology 49, 1011–1022.Google Scholar
Bentall, RP, Rowse, G, Kinderman, P, Blackwood, N, Howard, R, Moore, R, Cummins, S, Corcoran, R (2008). Paranoid delusions in schizophrenia and depression: the transdiagnostic role of expectations of negative events and negative self-esteem. Journal of Nervous and Mental Disease 196, 375–383.Google Scholar
Bentall, RP, Wickham, S, Shevlin, M, Varese, F (2012). Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 Adult Psychiatric Morbidity Survey. Schizophrenia Bulletin 38, 734–740.Google Scholar
Bifulco, A, Bernazzani, O, Moran, PM, Jacobs, C (2005). The Childhood Experience of Care and Abuse Questionnaire (CECA.Q): validation in a community series. British Journal of Clinical Psychology 44, 563–581.Google Scholar
Bifulco, A, Brown, GW, Adler, Z (1991). Early sexual abuse and clinical depression in adult life. British Journal of Psychiatry 159, 115–122.Google Scholar
Cohen, P, Brown, J, Smaile, E (2001). Child abuse and neglect and the development of mental disorders in the general population. Development and Psychopathology 13, 981–999.Google Scholar
Collip, D, Myin-Germeys, I, van Os, J (2008). Does the concept of “sensitization” provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophrenia Bulletin 34, 220–225.Google Scholar
Costello, CG (1992). Research on symptoms versus research on syndromes. Arguments in favour of allocating more research time to the study of symptoms. British Journal of Psychiatry 160, 304–308.Google Scholar
Cuthbert, BN (2014). The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 13, 28–35.Google Scholar
Demjaha, A, Morgan, K, Morgan, C, Landau, S, Dean, K, Reichenberg, A, Sham, P, Fearon, P, Hutchinson, G, Jones, PB, Murray, RM, Dazzan, P (2009). Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? Psychological Medicine 39, 1943–1955.Google Scholar
Di Forti, M, Morgan, C, Dazzan, P, Pariante, C, Mondelli, V, Marques, TR, Handley, R, Luzi, S, Russo, M, Paparelli, A, Butt, A, Stilo, SA, Wiffen, B, Powell, J, Murray, RM (2009). High-potency cannabis and the risk of psychosis. British Journal of Psychiatry 195, 488–491.Google Scholar
Dikeos, DG, Wickham, H, McDonald, C, Walshe, M, Sigmundsson, T, Bramon, E, Grech, A, Toulopoulou, T, Murray, R, Sham, PC (2006). Distribution of symptom dimensions across Kraepelinian divisions. British Journal of Psychiatry 189, 346–353.Google Scholar
Dvir, Y, Denietolis, B, Frazier, JA (2013). Childhood trauma and psychosis. Child and Adolescent Psychiatric Clinics 22, 629–641.Google Scholar
Emsley, R, Rabinowitz, J, Torreman, M (2003). The factor structure for the Positive and Negative Syndrome Scale (PANSS) in recent-onset psychosis. Schizophrenia Research 61, 47–57.Google Scholar
Fisher, HL, Craig, TK, Fearon, P, Morgan, K, Dazzan, P, Lappin, J, Hutchinson, G, Doody, GA, Jones, PB, McGuffin, P, Murray, RM, Leff, J, Morgan, C (2011). Reliability and comparability of psychosis patients’ retrospective reports of childhood abuse. Schizophrenia Bulletin 37, 546–553.Google Scholar
Fisher, HL, Hosang, GM (2010). Childhood maltreatment and bipolar disorder: a critical review of the evidence. Mind and Brain: The Journal of Psychiatry 1, 75–85.Google Scholar
Fisher, HL, Jones, PB, Fearon, P, Craig, TK, Dazzan, P, Morgan, K, Hutchinson, G, Doody, GA, McGuffin, P, Leff, J, Murray, RM, Morgan, C (2010). The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychological Medicine 40, 1967–1978.Google Scholar
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.Google Scholar
Gilbert, R, Widom, CS, Browne, K, Fergusson, D, Webb, E, Janson, S (2009). Burden and consequences of child maltreatment in high-income countries. Lancet 373, 68–81.Google Scholar
Gilman, SE, Ni, MY, Dunn, EC, Breslau, J, McLaughlin, KA, Smoller, JW, Perlis, RH (2015). Contributions of the social environment to first-onset and recurrent mania. Molecular Psychiatry 20, 329–336.Google Scholar
Jaffee, SR, Caspi, A, Moffitt, TE, Taylor, A (2004). Physical maltreatment victim to antisocial child: evidence of an environmentally mediated process. Journal of Abnormal Psychology 113, 44–55.Google Scholar
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.Google Scholar
Kay, SR, Fiszbein, A, Opler, LA (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.Google Scholar
Kay, SR, Sevy, S (1990). Pyramidical model of schizophrenia. Schizophrenia Bulletin 16, 537–545.Google Scholar
Kendler, KS, Aggen, SH (2014). Clarifying the causal relationship in women between childhood sexual abuse and lifetime major depression. Psychological Medicine 44, 1213–1221.Google Scholar
Lançon, C, Aghababian, V, Llorca, PM, Auquier, P (1998). Factorial structure of the Positive and Negative Syndrome Scale (PANSS): a forced five-dimensional factor analysis. Acta Psychiatrica Scandinavica 98, 369–376.Google Scholar
Langeveld, J, Andreassen, OA, Auestad, B, Færden, A, Hauge, LJ, Joa, I, Johannessen, JO, Melle, I, Rund, BR, Røssberg, JI, Simonsen, E, Vaglum, P, Larsen, TK (2013). Is there an optimal factor structure of the Positive and Negative Syndrome Scale in patients with first-episode psychosis? Scandinavian Journal of Psychology 54, 160–165.Google Scholar
Levy, KN (2013). Introduction: attachment theory and psychotherapy. Journal of Clinical Psychology 69, 1133–1135.Google Scholar
Liemburg, E, Castelein, S, Stewart, R, van der Gaag, M, Aleman, A, Knegtering, H (2013). Two subdomains of negative symptoms in psychotic disorders: established and confirmed in two large cohorts. Journal of Psychiatric Research 47, 718–725.Google Scholar
Lindenmayer, JP, Bernstein-Hyman, R, Grochowski, S (1994). A new five factor model of schizophrenia. Psychiatric Quarterly 65, 299–322.Google Scholar
Lysaker, PH, France, CM, Hunter, NL, Davis, LW (2005). Personal narratives of illness in schizophrenia: associations with neurocognition and symptoms. Psychiatry 68, 140–151.Google Scholar
Mallett, R, Leff, J, Bhugra, D, Pang, D, Zhao, JH (2002). Social environment, ethnicity and schizophrenia. A case–control study. Social Psychiatry and Psychiatric Epidemiology 37, 329–335.Google Scholar
McCann, JB, James, SW, Wilson, S, Dunn, G (1996). Prevalence of psychiatric disorders in young people in the care system. British Medical Journal 313, 1529–1530.Google Scholar
McGuffin, P, Farmer, A, Harvey, I (1991). A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry 48, 764–770.Google Scholar
Morgan, C, Abdul-Al, R, Lappin, JM, Jones, P, Fearon, P, Leese, M, Croudace, T, Morgan, K, Dazzan, P, Craig, T, Leff, J, Murray, R (2006). Clinical and social determinants of duration of untreated psychosis in the AESOP first-episode psychosis study. British Journal of Psychiatry 189, 446–452.Google Scholar
Morgan, C, Kirkbride, J, Leff, J, Craig, T, Hutchinson, G, McKenzie, K, Morgan, K, Dazzan, P, Doody, GA, Jones, P, Murray, R, Fearon, P (2007). Parental separation, loss and psychosis in different ethnic groups: a case–control study. Psychological Medicine 37, 495–503.Google Scholar
Radford, L, Corral, S, Bradley, C, Fisher, HL (2013). The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse and Neglect 37, 801–813.Google Scholar
Read, J, Agar, K, Argyle, N, Aderhold, V (2003). Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder. Psychology and Psychotherapy 76, 1–22.Google Scholar
Read, J, Bentall, RP (2012). Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications. British Journal of Psychiatry 200, 89–91.Google Scholar
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.Google Scholar
Rutter, M (2006). Genes and Behaviour: Nature–Nurture Interplay Explained. Blackwell Publishing: Oxford.Google Scholar
Sarchiapone, M, Carli, V, Cuomo, C, Marchetti, M, Roy, A (2009). Association between childhood trauma and aggression in male prisoners. Psychiatry Research 165, 187–192.Google Scholar
Schürhoff, F, Laguerre, A, Fisher, H, Etain, B, Méary, A, Soussy, C, Szöke, A, Leboyer, M (2009). Self-reported childhood trauma correlates with schizotypal measures in schizophrenia but not bipolar pedigrees. Psychological Medicine 39, 365–370.Google Scholar
Sideli, L, Mule, A, La Barbera, D, Murray, RM (2012). Do child abuse and maltreatment increase risk of schizophrenia? Psychiatry Investigation 9, 87–99.Google Scholar
Singh, SP, Cooper, J, Fisher, HL, Tarrant, CJ, Lloyd, T, Banjo, J, Corfe, S, Jones, P (2005). Determining the chronology and components of psychosis onset: the Nottingham Onset Schedule (NOS). Schizophrenia Research 80, 117–130.Google Scholar
Sitko, K, Bentall, RP, Shevlin, M, O'Sullivan, N, Sellwood, W (2014). Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey. Psychiatry Research 217, 202–209.Google Scholar
Smith, PN, Gamble, SA, Cort, NA, Ward, EA, Conwell, Y, Talbot, NL (2012). The relationships of attachment style and social maladjustment to death ideation in depressed women with a history of childhood sexual abuse. Journal of Clinical Psychology 68, 78–87.Google Scholar
Stefanovics, EA, Elkis, H, Zhening, L, Zhang, XY, Rosenheck, RA (2014). A cross-national factor analytic comparison of three models of PANSS symptoms in schizophrenia. Psychiatry Research 219, 283–289.Google Scholar
Stilo, SA, Di Forti, M, Mondelli, V, Falcone, AM, Russo, M, O'Connor, J, Palmer, E, Paparelli, A, Kolliakou, A, Sirianni, M, Taylor, H, Handley, R, Dazzan, P, Pariante, C, Marques, TR, Zoccali, R, David, A, Murray, RM, Morgan, C (2013). Social disadvantage: cause or consequence of impending psychosis? Schizophrenia Bulletin 39, 1288–1295.Google Scholar
Trotta, A, Di Forti, M, Iyegbe, C, Green, P, Dazzan, P, Mondelli, V, Morgan, C, Murray, RM, Fisher, HL (2015). Familial risk and childhood adversity interplay in the onset of psychosis. British Journal of Psychiatry Open 1, 6–13.Google Scholar
van Os, J, Fahy, TA, Jones, P, Harvey, I, Sham, P, Lewis, S, Bebbington, P, Toone, B, Williams, M, Murray, R (1996). Psychopathological syndromes in the functional psychoses: associations with course and outcome. Psychological Medicine 26, 161–176.Google Scholar
van Os, J, Gilvarry, C, Bale, R, Van Horn, E, Tattan, T, White, I, Murray, R (1999). A comparison of the utility of dimensional and categorical representations of psychosis. UK700 Group. Psychological Medicine 29, 595–606.Google Scholar
Vassos, E, Sham, PC, Cai, G, Deng, H, Liu, X, Sun, X, Zhao, J, Murray, RM, Collier, DA, Li, T (2008). Correlation and familial aggregation of dimensions of psychosis in affected sibling pairs from China. British Journal of Psychiatry 193, 305–310.Google Scholar
Velikonja, T, Fisher, HL, Mason, O, Johnson, S (2015). Childhood trauma and schizotypy: a systematic literature review. Psychological Medicine 45, 947–963.Google Scholar
Wallwork, RS, Fortgang, R, Hashimoto, R, Weinberger, DR, Dickinson, D (2012). Searching for a consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia. Schizophrenia Research 137, 246–250.Google Scholar
White, L, Harvey, PD, Opler, L, Lindenmayer, JP (1997). The PANSS Study Group empirical assessment of the factorial structure of clinical symptoms in schizophrenia. Psychopathology 30, 263–274.Google Scholar
Whitfield, CL, Dube, SR, Felitti, VJ, Anda, RF (2005). Adverse childhood experiences and hallucinations. Child Abuse and Neglect 29, 797–810.Google Scholar
Wickham, S, Sitko, K, Bentall, RP (2015). Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem. Psychological Medicine 45, 1495–1507.Google Scholar
World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
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