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Rosenbaum D, Int-Veen I, Laicher H, Woloszyn L, Wiegand A, Ladegast S, Eßer U, Kroczek A, Sippel D, Menkor S, Lawyer G, Albasini F, Frischholz C, Mössner R, Nieratschker V, Leehr EJ, Rubel J, Fallgatter AJ, Ehlis AC. Neural correlates of stress-reactive rumination in depression - The role of childhood trauma and social anxiety. Neurobiol Stress 2024; 31:100640. [PMID: 38800538 PMCID: PMC11127161 DOI: 10.1016/j.ynstr.2024.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
Recent work showed an association of prefrontal dysfunctions in patients with Major Depressive Disorder (MDD) and social stress induced rumination. However, up to date it is unclear which etiological features of MDD might cause prefrontal dysfunctions. In the study at hand, we aimed to replicate recent findings, that showed prefrontal activation alterations during the Trier Social Stress Test (TSST) and subsequently increased stress-reactive rumination in MDD compared to healthy controls. Moreover, we aimed to explore the role of adverse childhood experiences and other clinical variables in this relationship. N = 55 patients currently suffering from MDD and n = 42 healthy controls (HC) underwent the TSST, while cortical activity in areas of the Cognitive Control Network (CCN) was measured via functional near-infrared spectroscopy (fNIRS). The TSST successfully induced a stress reaction (physiologically, as well as indicated by subjective stress ratings) and state rumination in all subjects with moderate to large effect sizes. In comparison to HC, MDD patients showed elevated levels of state rumination with large effect sizes, as well as a typical pattern of reduced cortical oxygenation during stress in the CCN with moderate effect sizes. Self-reported emotional abuse and social anxiety were moderately positively associated with increased stress-reactive rumination. Within the MDD sample, emotional abuse was negatively and social anxiety positively associated with cortical oxygenation within the CCN with moderate to large effect sizes. In conclusion, our results replicate previous findings on MDD-associated prefrontal hypoactivity during stress and extends the research toward specific subtypes of depression.
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Affiliation(s)
- David Rosenbaum
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Hendrik Laicher
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Leonie Woloszyn
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Ariane Wiegand
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Sandra Ladegast
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Ute Eßer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Daniel Sippel
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Sebastian Menkor
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | | | - Francesco Albasini
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- Central Institute of Mental Health (CIMH), Mannheim, Germany
- Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Christian Frischholz
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Rainald Mössner
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
| | | | - Julian Rubel
- Psychotherapy Research Lab, Psychology and Sport Sciences, Justus-Liebig-University Giessen, Giessen, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
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Sætren SS, Bjørnestad JR, Ottesen AA, Fisher HL, Olsen DAS, Hølland K, Hegelstad WTV. Unraveling the Concept of Childhood Adversity in Psychosis Research: A Systematic Review. Schizophr Bull 2024:sbae085. [PMID: 38811352 DOI: 10.1093/schbul/sbae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies. STUDY DESIGN This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis. STUDY RESULTS Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show "childhood trauma" being the most frequently examined construct, followed by "child maltreatment" or "child abuse." The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets. CONCLUSION This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area.
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Affiliation(s)
- Sjur S Sætren
- Department for Child and Adolescent Research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Jone R Bjørnestad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Institute of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Akiah A Ottesen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Daniel A S Olsen
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Kari Hølland
- Institute of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Institute of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
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3
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Beals K, Torregrossa LJ, Smith R, Lane RD, Sheffield JM. Impaired emotional awareness is associated with childhood maltreatment exposure and positive symptoms in schizophrenia. Front Psychiatry 2024; 14:1325617. [PMID: 38283891 PMCID: PMC10811959 DOI: 10.3389/fpsyt.2023.1325617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives Evidence suggests that emotional awareness-the ability to identify and label emotions-may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms. Methods The current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ). Results Patients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect. Conclusion These data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.
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Affiliation(s)
- Kendall Beals
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Social Cognition and Recovery in Schizophrenia Lab, Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Lénie J. Torregrossa
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Richard David Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Julia M. Sheffield
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Tiles-Sar N, Habtewold TD, Liemburg EJ, van der Meer L, Bruggeman R, Alizadeh BZ. Understanding Lifelong Factors and Prediction Models of Social Functioning After Psychosis Onset Using the Large-Scale GROUP Cohort Study. Schizophr Bull 2023; 49:1447-1459. [PMID: 37104875 PMCID: PMC10686366 DOI: 10.1093/schbul/sbad046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND HYPOTHESIS Current rates of poor social functioning (SF) in people with psychosis history reach 80% worldwide. We aimed to identify a core set of lifelong predictors and build prediction models of SF after psychosis onset. STUDY DESIGN We utilized data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) longitudinal Dutch cohort. First, we applied group-based trajectory modeling to identify premorbid adjustment trajectories. We further investigated the association between the premorbid adjustment trajectories, six-year-long cognitive deficits, positive, and negative symptoms trajectories, and SF at 3-year and 6-year follow-ups. Next, we checked associations between demographics, clinical, and environmental factors measured at the baseline and SF at follow-up. Finally, we built and internally validated 2 predictive models of SF. STUDY RESULTS We found all trajectories were significantly associated with SF (P < .01), explaining up to 16% of SF variation (R2 0.15 for 3- and 0.16 for 6-year follow-up). Demographics (sex, ethnicity, age, education), clinical parameters (genetic predisposition, illness duration, psychotic episodes, cannabis use), and environment (childhood trauma, number of moves, marriage, employment, urbanicity, unmet needs of social support) were also significantly associated with SF. After validation, final prediction models explained a variance up to 27% (95% CI: 0.23, 0.30) at 3-year and 26% (95% CI: 0.22, 0.31) at 6-year follow-up. CONCLUSIONS We found a core set of lifelong predictors of SF. Yet, the performance of our prediction models was moderate.
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Affiliation(s)
- Natalia Tiles-Sar
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Edith J Liemburg
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Lisette van der Meer
- Department of Clinical and Developmental Neuropsychology, Universityof Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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5
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Huang YH, Hu HX, Wang LL, Zhang YJ, Wang X, Wang Y, Wang Y, Wang YY, Lui SSY, Chan RCK. Relationships between childhood trauma and dimensional schizotypy: A network analysis and replication. Asian J Psychiatr 2023; 85:103598. [PMID: 37119684 DOI: 10.1016/j.ajp.2023.103598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVES Childhood trauma (CT) has been found to increase the risk of developing schizophrenia and other psychiatric disorders. Little is known regarding the complex interplay between CT, subclinical psychotic, and affective symptoms in the general population. This cross-sectional study adopted network analysis to examine such a complex relationship. We hypothesized that CT would show strong connections with schizotypy dimensions, and the high schizotypy subgroup would show a network with higher global strength compared with the low schizotypy subgroup. METHODS A total of 1813 college students completed a set of self-report questionnaires measuring CT, schizotypal features, bipolar traits, and depressive symptoms. The subscales of these questionnaires were used as nodes, and the partial correlations between nodes were used as edges to construct a network. Network Comparison Tests were used to investigate the differences between participants with high schizotypy and low schizotypy. An independent sample (n = 427) was used to examine the replicability of the results. RESULTS Findings from the main dataset showed that CT was closely connected with schizotypy and motivation, after controlling for the inter-relationships between all nodes in the network. Relative to the low schizotypy subgroup, the network of the high schizotypy subgroup showed higher global strength. The two subgroups did not differ in network structure. Network analysis using the replication dataset showed comparable global strength and network structure. CONCLUSIONS Our findings support specific links between CT and schizotypy dimensions in healthy youth populations, and such links appear to become stronger in those with high schizotypy.
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Affiliation(s)
- Yi-Hang Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xuan Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yan-Yu Wang
- School of Psychology, Weifang Medical University, Shandong, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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6
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Riehle M, Pillny M, Lincoln TM. Expanding the positivity offset theory of anhedonia to the psychosis continuum. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:47. [PMID: 35853895 PMCID: PMC9261090 DOI: 10.1038/s41537-022-00251-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/22/2022] [Indexed: 06/15/2023]
Abstract
People with schizophrenia and negative symptoms show diminished net positive emotion in low-arousing contexts (diminished positivity offset) and co-activate positive and negative emotion more frequently (increased ambivalence). Here, we investigated whether diminished positivity offset and increased ambivalence covary with negative symptoms along the continuum of psychotic symptoms. We conducted an online-study in an ad-hoc community sample (N = 261). Participants self-reported on psychotic symptoms (negative symptoms, depression, positive symptoms, anhedonia) and rated positivity, negativity, and arousal elicited by pleasant, unpleasant, and neutral stimuli. The data were analyzed with multilevel linear models. Increasing levels of all assessed symptom areas showed significant associations with diminished positivity offset. Increased ambivalence was related only to positive symptoms. Our results show that the diminished positivity offset is associated with psychotic symptoms in a community sample, including, but not limited to, negative symptoms. Ecological validity and symptom specificity require further investigation.
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Affiliation(s)
- Marcel Riehle
- Clinical Psychology and Psychotherapy, Institute for Psychology, Universität Hamburg, Hamburg, Germany.
| | - Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute for Psychology, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute for Psychology, Universität Hamburg, Hamburg, Germany
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Pionke-Ubych R, Frydecka D, Cechnicki A, Krężołek M, Nelson B, Gawęda Ł. Integrating trauma, self-disturbances, cognitive biases, and personality into a model for the risk of psychosis: a longitudinal study in a non-clinical sample. Eur Arch Psychiatry Clin Neurosci 2022; 272:1073-1085. [PMID: 34859297 PMCID: PMC9388435 DOI: 10.1007/s00406-021-01355-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/08/2021] [Indexed: 11/28/2022]
Abstract
The hypothesis of the psychosis continuum enables to study the mechanisms of psychosis risk not only in clinical samples but in non-clinical as well. The aim of this longitudinal study was to investigate self-disturbances (SD), a risk factor that has attracted substantial interest over the last two decades, in combination with trauma, cognitive biases and personality, and to test whether SD are associated with subclinical positive symptoms (PS) over a 12-month follow-up period. Our study was conducted in a non-clinical sample of 139 Polish young adults (81 females, age M = 25.32, SD = 4.51) who were selected for frequent experience of subclinical PS. Participants completed self-report questionnaires for the evaluation of SD (IPASE), trauma (CECA.Q), cognitive biases (DACOBS) and personality (TCI), and were interviewed for subclinical PS (CAARMS). SD and subclinical PS were re-assessed 12 months after baseline measurement. The hypothesized model for psychosis risk was tested using path analysis. The change in SD and subclinical PS over the 12-month period was investigated with non-parametric equivalent of dependent sample t-tests. The models with self-transcendence (ST) and harm avoidance (HA) as personality variables were found to be well-fitted and explained 34% of the variance in subclinical PS at follow-up. Moreover, we found a significant reduction of SD and subclinical PS after 12 months. Our study suggests that combining trauma, cognitive biases, SD and personality traits such as ST and HA into one model can enhance our understanding of appearance as well as maintenance of subclinical PS.
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Affiliation(s)
- Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378 Warsaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
| | - Martyna Krężołek
- II Department of Psychiatry, The Medical University of Warsaw, Warszaw, Poland
| | - Barnaby Nelson
- Orygen, Parkville, VIC Australia ,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC Australia
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378, Warsaw, Poland.
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8
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Kitamura S, Makinodan M, Matsuoka K, Takahashi M, Yoshikawa H, Ishida R, Kishimoto N, Yasuno F, Yasuda Y, Hashimoto R, Miyasaka T, Kichikawa K, Kishimoto T. Association of adverse childhood experiences and precuneus volume with intrusive reexperiencing in autism spectrum disorder. Autism Res 2021; 14:1886-1895. [PMID: 34185397 DOI: 10.1002/aur.2558] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 11/07/2022]
Abstract
Compared to typically developing (TD) children, people with autism spectrum disorder (ASD) have an increased risk of adverse childhood experiences (ACEs). Exposure to ACEs is associated with adult ASD psychological comorbidities, such as posttraumatic stress disorder (PTSD). Occurrence of intrusive event reexperiencing, characteristic of PTSD, often causes social dysfunction in adults with ASD, but its pathological basis is unclear. This study examined brain regions related to the severity of intrusive reexperiencing and explored whether ACE severity was associated with that of intrusive reexperiencing and/or extracted regional gray matter volume. Forty-six individuals with ASD and 41 TD subjects underwent T1-weighted magnetic resonance imaging and evaluation of ACEs and intrusive reexperiencing. Brain regions related to the severity of intrusive reexperiencing in both groups were identified by voxel-based whole brain analyses. Associations among the severity of intrusive reexperiencing, that of ACEs, and gray matter volume were examined in both groups. The severities of intrusive reexperiencing and ACEs were significantly associated with reduced gray matter volume in the right precuneus in individuals with ASD but not in TD subjects. Although the right precuneus gray matter volume was smaller in individuals with ASD and severe ACEs than in those with mild ACEs or TD subjects, it was similar in the latter two groups. However, ACE-dependent gray matter volume reduction in the right precuneus led to intrusive reexperiencing in individuals with ASD. This suggests that exposure to ACEs is associated with right precuneus gray matter reduction, which is critical for intrusive reexperiencing in adults with ASD. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) are at increased risk of adverse childhood experiences (ACEs) and of subsequent manifestation of intrusive reexperiencing of stressful life events. The present study found that reduced gray matter volume in the right precuneus of the brain was associated with more severe intrusive reexperiencing of ACEs by individuals with ASD. These results suggest that ACEs affect neural development in the precuneus, which is the pathological basis of intrusive event reexperiencing in ASD.
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Affiliation(s)
- Soichiro Kitamura
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.,Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kiwamu Matsuoka
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.,Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masato Takahashi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Hiroaki Yoshikawa
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Rio Ishida
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Fumihiko Yasuno
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.,Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka, University, Osaka, Japan.,Medical Corporation Foster, Osaka, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | | | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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9
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Prokopez CR, Vallejos M, Farinola R, Alberio G, Caporusso GB, Cozzarin LG, Chiapella LC, Fuentes P, Daray FM. The history of multiple adverse childhood experiences in patients with schizophrenia is associated with more severe symptomatology and suicidal behavior with gender-specific characteristics. Psychiatry Res 2020; 293:113411. [PMID: 32890864 DOI: 10.1016/j.psychres.2020.113411] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/05/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
The current study aims to compare the prevalence of adverse childhood experiences (ACEs) between patients with schizophrenia and non-psychiatric control group, and to analyze the association of having suffered multiple ACEs with clinical symptoms of schizophrenia and suicidal behavior. A multicenter, cross-sectional study was conducted across three facilities in Buenos Aires, Argentina. One-hundred patients with schizophrenia and 50 healthy subjects were assessed with the Adverse Childhood Experiences questionnaire (ACE-Q), the Positive and Negative Syndrome Scale (PANSS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). We observed that the prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the non-psychiatric control group. Multiple ACEs were associated with persistent auditory hallucinations and lower negative symptoms in both sexes. Higher frequency of death ideation and a higher number of suicide attempts were reported among women. The strength of this study is the possibility of comparing the presence of ACEs between schizophrenic patients and non-psychiatric control using the same questionnaire in an under-reported sample of low socio-economic patients assisted in public hospitals. A limitation is that the history of ACEs relied on the retrospective assessment of childhood experiences, and adults could over-report ACEs because of recall bias.
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Affiliation(s)
- Cintia R Prokopez
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina; University of Buenos Aires, School of Medicine, Institute of Pharmacology, Argentina
| | - Miguel Vallejos
- José Tiburcio Borda Hospital, City of Buenos Aires, Argentina
| | - Romina Farinola
- José Tiburcio Borda Hospital, City of Buenos Aires, Argentina
| | - Germán Alberio
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina
| | | | | | - Luciana C Chiapella
- National Scientific and Technical Research Council (CONICET). Ciudad Autónoma de Buenos Aires, Argentina; Pharmacology Area, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Argentina
| | - Pamela Fuentes
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina
| | - Federico M Daray
- University of Buenos Aires, School of Medicine, Institute of Pharmacology, Argentina; National Scientific and Technical Research Council (CONICET). Ciudad Autónoma de Buenos Aires, Argentina.
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10
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Sheffield JM, Rogers BP, Blackford JU, Heckers S, Woodward ND. Insula functional connectivity in schizophrenia. Schizophr Res 2020; 220:69-77. [PMID: 32307263 PMCID: PMC7322763 DOI: 10.1016/j.schres.2020.03.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/17/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
The insula is structurally abnormal in schizophrenia, demonstrating reductions in volume, cortical thickness, and altered gyrification during prodromal, early and chronic stages of the illness. Despite compelling structural alterations, less is known about its functional connectivity, limited by studies considering the insula as a whole or only within the context of resting-state networks. There is evidence, however, from healthy subjects that the insula is comprised of sub-regions with distinct functional profiles, with dorsal anterior insula (dAI) involved in cognitive processing, ventral anterior insula (vAI) involved in affective processing, and posterior insula (PI) involved in somatosensory processing. The current study builds on this prior work and characterizes insula resting-state functional connectivity sub-region profiles in a large cohort of schizophrenia (N = 191) and healthy (N = 196) participants and hypothesizes specific associations between insula sub-region connectivity abnormalities and clinical characteristics related to their functional profiles. Functional dysconnectivity of the insula in schizophrenia is broadly characterized by reduced connectivity within insula sub-networks and greater connectivity with regions not normally connected with that sub-region, reflected in significantly greater similarity of dAI and PI connectivity profiles and significantly lower similarity of dAI and vAI connectivity profiles (p < .05). In schizophrenia, reduced connectivity of dAI correlates with cognitive function (r = 0.18, p = .014), whereas stronger connectivity between vAI and superior temporal sulcus correlates with negative symptoms (r = 0.27, p < .001). These findings reveal altered insula connectivity in all three sub-regions and converge with recent evidence of reduced differentiation of insula connectivity in schizophrenia, implicating functional dysconnectivity of the insula in cognitive and clinical symptoms.
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Affiliation(s)
- Julia M. Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, TN, USA
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA,Tennessee Valley Health Service, Department of Veterans Affairs Medical Center, Nashville, TN, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
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11
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Antonucci LA, Pergola G, Pigoni A, Dwyer D, Kambeitz-Ilankovic L, Penzel N, Romano R, Gelao B, Torretta S, Rampino A, Trojano M, Caforio G, Falkai P, Blasi G, Koutsouleris N, Bertolino A. A Pattern of Cognitive Deficits Stratified for Genetic and Environmental Risk Reliably Classifies Patients With Schizophrenia From Healthy Control Subjects. Biol Psychiatry 2020; 87:697-707. [PMID: 31948640 DOI: 10.1016/j.biopsych.2019.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Schizophrenia risk is associated with both genetic and environmental risk factors. Furthermore, cognitive abnormalities are established core characteristics of schizophrenia. We aim to assess whether a classification approach encompassing risk factors, cognition, and their associations can discriminate patients with schizophrenia (SCZs) from healthy control subjects (HCs). We hypothesized that cognition would demonstrate greater HC-SCZ classification accuracy and that combined gene-environment stratification would improve the discrimination performance of cognition. METHODS Genome-wide association study-based genetic, environmental, and neurocognitive classifiers were trained to separate 337 HCs from 103 SCZs using support vector classification and repeated nested cross-validation. We validated classifiers on independent datasets using within-diagnostic (SCZ) and cross-diagnostic (clinically isolated syndrome for multiple sclerosis, another condition with cognitive abnormalities) approaches. Then, we tested whether gene-environment multivariate stratification modulated the discrimination performance of the cognitive classifier in iterative subsamples. RESULTS The cognitive classifier discriminated SCZs from HCs with a balanced accuracy (BAC) of 88.7%, followed by environmental (BAC = 65.1%) and genetic (BAC = 55.5%) classifiers. Similar classification performance was measured in the within-diagnosis validation sample (HC-SCZ BACs, cognition = 70.5%; environment = 65.8%; genetics = 49.9%). The cognitive classifier was relatively specific to schizophrenia (HC-clinically isolated syndrome for multiple sclerosis BAC = 56.7%). Combined gene-environment stratification allowed cognitive features to classify HCs from SCZs with 89.4% BAC. CONCLUSIONS Consistent with cognitive deficits being core features of the phenotype of SCZs, our results suggest that cognitive features alone bear the greatest amount of information for classification of SCZs. Consistent with genes and environment being risk factors, gene-environment stratification modulates HC-SCZ classification performance of cognition, perhaps providing another target for refining early identification and intervention strategies.
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Affiliation(s)
- Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy.
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland
| | - Alessandro Pigoni
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | | | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Raffaella Romano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Barbara Gelao
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Silvia Torretta
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Grazia Caforio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy.
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12
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Edwards CJ, Garety P, Hardy A. The relationship between depressive symptoms and negative symptoms in people with non-affective psychosis: a meta-analysis. Psychol Med 2019; 49:2486-2498. [PMID: 31530319 DOI: 10.1017/s0033291719002381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The negative symptoms of psychosis and depressive symptomatology share several features, e.g. low motivation, apathy and reduced activity. Understanding the associations between these two sets of symptoms will support improved assessment and the development of interventions targeting these difficulties in people with psychosis. This is the first large systematic review and meta-analysis to quantify the relationship between these two categories of symptoms, as measured in studies to date. PsycInfo, Embase and Medline were systematically searched to identify eligible studies. Inclusion criteria ensured the studies measured both depression and negative symptoms using validated measures in a sample of over 8000 participants with non-affective psychosis diagnoses. The search led to 2020 records being screened and 56 included in the meta-analysis and review. Both meta-analyses and meta-regressions were conducted to explore the main effect and potential moderating variables. A clear pattern emerges showing that higher ratings of negative symptoms are associated with higher levels of depressive symptoms, with a small effect [standardised effect size = 0.19, p < 0.05). This did not vary greatly with the measures used (SES = 0.19-0.26) and was not moderated by demographic variables or quality ratings. Interestingly, higher depressive symptoms predict a significant relationship with co-occurring negative symptoms. However, higher negative symptoms predict that it is less likely there will be a relationship with co-occurring depressive symptoms. Heterogeneity was high across these analyses. The findings support the adoption of a symptom-specific approach to understanding the interplay between negative and depressive symptoms in psychosis, to improve assessment and intervention.
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Affiliation(s)
- Clementine Jane Edwards
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Philippa Garety
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Amy Hardy
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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13
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Zhou J, Feng L, Hu C, Pao C, Xiao L, Wang G. Associations Among Depressive Symptoms, Childhood Abuse, Neuroticism, Social Support, and Coping Style in the Population Covering General Adults, Depressed Patients, Bipolar Disorder Patients, and High Risk Population for Depression. Front Psychol 2019; 10:1321. [PMID: 31231288 PMCID: PMC6560051 DOI: 10.3389/fpsyg.2019.01321] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/21/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Exposure to childhood abuse has been identified as a salient risk factor for the development of depression. However, the mediating factors between childhood abuse and depressive symptoms have not been sufficiently elucidated. This study aims to investigate the mediating effects of neuroticism, social support, and coping style between childhood abuse and depressive symptoms in population covering general adults, depressed patients, bipolar disorder patients, and high risk population for depression. METHODS This is a cross-sectional study. Five validated questionnaires were used to measure the psychological outcomes (Childhood Trauma Questionnaire CTQ-SF, Eysenck Personality Questionnaire EPQR-S, Social Support Rating Scale SSRS, Simplified Coping Style Questionnaire SCSQ, and Patient Health Questionnaire-9 PHQ-9) of 312 participants. Multiple regressions and structural equation modeling (SEM) were used to conduct data analysis. RESULTS Multiple regression analysis and SEM showed a significant association between childhood emotional abuse and depression symptoms. Neuroticism, use of social support, and active coping style were important mediating variables of this association. The R 2 for our model was 0.456, indicating that 45.6% of the variability in depressive symptoms can be explained by the model. CONCLUSION This study suggested that neuroticism, active coping, and use of social support play important role in mediating the effects of childhood abuse on adult depressive symptoms.
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Affiliation(s)
- Jia Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Changqing Hu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Christine Pao
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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14
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Luther L, Fischer MW, Firmin RL, Salyers MP. Clarifying the overlap between motivation and negative symptom measures in schizophrenia research: A meta-analysis. Schizophr Res 2019; 206:27-36. [PMID: 30577993 PMCID: PMC6525651 DOI: 10.1016/j.schres.2018.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
Motivation and negative symptom research has recently been hampered by a series of inconsistent findings, leading to calls for a greater consensus on the type of measures used across studies. To inform this issue, we conducted a meta-analysis that quantified the association between motivation measures (self-report, performance-based) and clinician-rated negative symptom measures as well as a series of moderator analyses to develop a greater understanding of the measurement factors impacting this relationship. Forty-seven eligible studies with people with schizophrenia-spectrum disorders were included. Using a random-effects meta-analytic model, a small but significant overall effect size emerged between motivation and clinician-rated negative symptoms (r = -0.18). Several significant moderators were identified, including the generation of negative symptom measures such that there was a significantly stronger relationship between motivation and second-generation (r = -0.38) than first-generation negative symptom measures (r = -0.17). Further, the type of performance-based measure used moderated the relationship, with effort discounting tasks most strongly related to negative symptoms (r = -0.44). The domain of motivation assessed (intrinsic, extrinsic, amotivation) also moderated the relationship. These findings help to identify sources of inconsistencies observed in prior studies and point to both second-generation and effort discounting tasks as the most promising types of measures, particularly for those interested in validating motivation measures or assessing the effectiveness of motivation treatments. Although additional research is needed, our results suggest that using these measures may help to reduce inconsistencies across studies and move the field forward.
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Affiliation(s)
- Lauren Luther
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA; University of Illinois at Chicago, Department of Psychiatry, 1747 West Roosevelt Road, 279, Chicago, IL 60608, USA.
| | - Melanie W Fischer
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA.
| | - Ruth L Firmin
- University of California Los Angeles, Semel Institute, 760 Westwood Plaza, Los Angeles, CA 90046, USA.
| | - Michelle P Salyers
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA.
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15
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Devi F, Shahwan S, Teh WL, Sambasivam R, Zhang YJ, Lau YW, Ong SH, Fung D, Gupta B, Chong SA, Subramaniam M. The prevalence of childhood trauma in psychiatric outpatients. Ann Gen Psychiatry 2019; 18:15. [PMID: 31428182 PMCID: PMC6694480 DOI: 10.1186/s12991-019-0239-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this present study was to compare the prevalence and type of trauma experienced by community sample with the outpatient sample with mental disorders. METHODS A total of 354 outpatients, aged 14-35 years old, with mood disorders, schizophrenia and other psychotic disorders, adjustment disorder and anxiety disorder were recruited from a tertiary psychiatric hospital. A total of 100 healthy controls were recruited from the Singapore general population by snowballing. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) designed to measure childhood trauma and the severity (e.g., physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) was administered to participants. Socio-demographic and clinical characteristics were obtained from interviews with the participants and from outpatients' medical records, respectively. Independent sample t tests and Chi-square tests were used to investigate the differences between the outpatient and community samples. RESULTS Overall the CTQ-SF total and domain scores indicated that outpatient sample experienced higher rate of traumatic life events in childhood than community sample. Two most reported trauma types were emotional abuse (n = 81, 59.1%) and physical neglect (n = 74, 54%) reported by the mood disorder group. In the community sample, emotional neglect (n = 46, 46%) and physical neglect (n = 18, 18%) were the most commonly reported trauma type. Overall outpatient sample (n = 80, 22.6%) and community sample (n = 28, 28%) reported at least one type of trauma. CONCLUSION The findings indicate higher rates of CTQ-SF total and domain scores in outpatient sample demonstrating a higher rate of traumatic life events in childhood compared to community sample. Further research in childhood trauma is needed to improve the knowledge in psychiatric clinic practices.
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Affiliation(s)
- Fiona Devi
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Shazana Shahwan
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Wen Lin Teh
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Rajeswari Sambasivam
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Yun Jue Zhang
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ying Wen Lau
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Say How Ong
- 3Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Daniel Fung
- 3Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Bhanu Gupta
- 2Department of Mood & Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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16
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Blair MA, Nitzburg G, DeRosse P, Karlsgodt KH. Relationship between executive function, attachment style, and psychotic like experiences in typically developing youth. Schizophr Res 2018; 197:428-433. [PMID: 29510927 PMCID: PMC6120806 DOI: 10.1016/j.schres.2018.02.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 02/12/2018] [Accepted: 02/17/2018] [Indexed: 11/25/2022]
Abstract
Psychotic like experiences (PLE's) are common in the general population, particularly during adolescence, which has generated interest in how PLE's emerge, and the extent to which they reflect either risk for, or resilience to, psychosis. The "attachment-developmental-cognitive" (ADC) model is one effort to model the effect of risk factors on PLEs. The ADC model proposes attachment insecurity as an early environmental insult that can contribute to altered neurodevelopment, increasing the likelihood of PLE's and psychosis. In particular, early-life attachment disruptions may negatively impact numerous aspects of executive function (EF), including behavioral inhibition and emotion regulation. Yet despite the relationship of disrupted attachment to EF impairments, no studies have examined how these factors may combine to contribute to PLE's in adolescents. Here, we examined the relative contributions of daily-life EF and attachment difficulties (avoidance and anxiety) to PLEs in typically developing youth (N=52; ages 10-21). We found that EF deficits and high attachment insecurity both accounted for a significant proportion of the variance in PLE's, and interacted to predict PLE manifestation. Specifically, positive PLEs were predicted by greater trouble monitoring behavioral impact, less difficulty completing tasks, greater difficulty regulating emotional reactions, greater difficulty controlling impulses and higher attachment anxiety. Negative PLEs were predicted by greater difficulty in alternating attention, transitioning across situations, and regulating emotional reactions as well as higher attachment anxiety. These results are consistent with the ADC model, providing evidence that early-life attachment disruptions may impact behavioral regulation and emotional control, which together may contribute to PLEs.
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Affiliation(s)
- Melanie A. Blair
- Graduate Center—City University of New York, New York, NY, United States,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the Northwell Health System, Glen Oaks, NY, United States
| | - George Nitzburg
- Teachers College, Columbia University, New York, NY, United States,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the Northwell Health System, Glen Oaks, NY, United States
| | - Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the Northwell Health System, Glen Oaks, NY, United States,Hofstra Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, United States
| | - Katherine H. Karlsgodt
- Depts of Psychology and Psychiatry & Biobehavioral Sciences, UCLA, Los Angeles, CA, United States,Corresponding author at: Dept of Psychology, UCLA, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, United States, (K.H. Karlsgodt)
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17
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DeRosse P, Nitzburg GC, Blair M, Malhotra AK. Dimensional symptom severity and global cognitive function predict subjective quality of life in patients with schizophrenia and healthy adults. Schizophr Res 2018; 195:385-390. [PMID: 29056491 PMCID: PMC5908765 DOI: 10.1016/j.schres.2017.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/23/2017] [Accepted: 10/09/2017] [Indexed: 11/28/2022]
Abstract
Over the last several decades Quality of Life (QoL) has become increasingly important as an indicator of treatment outcomes; particularly in schizophrenia spectrum disorders because of its close association with functional disability. Numerous studies seeking to elucidate the factors that contribute to QoL in this population have implicated both symptom severity and cognition in determining QoL but the findings have been mixed. The critical factors that appear to impede the lack of consensus in the extant literature examining determinants of QoL include the heterogeneity of the samples and measures examined as well as medication effects across different studies. Thus, the present study sought to address some of these issues by examining the relationship between subjective QoL and both symptom severity and cognitive function in a relatively homogeneous patient sample of patients and a community control sample assessed for dimensional symptom severity. Our results suggest that both global cognitive function and psychiatric symptoms have a significant impact on the subjective QoL of both people with schizophrenia spectrum disorders and psychiatrically healthy adults. Specifically, we found that a global index of cognition as well as self-reported avolitional and depressive symptoms were significantly predictive of QoL in both samples. These findings highlight the importance of addressing cognitive, depressive and avolitional symptoms in the treatment of patients with schizophrenia spectrum disorders and suggest that improvements in these domains may have a meaningful impact on their overall QoL.
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Affiliation(s)
- Pamela DeRosse
- Hofstra-Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA.
| | - George C. Nitzburg
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA,Teachers College, Columbia University, New York, NY, USA
| | - Melanie Blair
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA,Graduate Center, City University of New York, New York, NY, USA
| | - Anil K. Malhotra
- Hofstra-Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
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18
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Luther L, Firmin RL, Lysaker PH, Minor KS, Salyers MP. A meta-analytic review of self-reported, clinician-rated, and performance-based motivation measures in schizophrenia: Are we measuring the same "stuff"? Clin Psychol Rev 2018; 61:24-37. [PMID: 29751942 DOI: 10.1016/j.cpr.2018.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 03/27/2018] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
An array of self-reported, clinician-rated, and performance-based measures has been used to assess motivation in schizophrenia; however, the convergent validity evidence for these motivation assessment methods is mixed. The current study is a series of meta-analyses that summarize the relationships between methods of motivation measurement in 45 studies of people with schizophrenia. The overall mean effect size between self-reported and clinician-rated motivation measures (r = 0.27, k = 33) was significant, positive, and approaching medium in magnitude, and the overall effect size between performance-based and clinician-rated motivation measures (r = 0.21, k = 11) was positive, significant, and small in magnitude. The overall mean effect size between self-reported and performance-based motivation measures was negligible and non-significant (r = -0.001, k = 2), but this meta-analysis was underpowered. Findings suggest modest convergent validity between clinician-rated and both self-reported and performance-based motivation measures, but additional work is needed to clarify the convergent validity between self-reported and performance-based measures. Further, there is likely more variability than similarity in the underlying construct that is being assessed across the three methods, particularly between the performance-based and other motivation measurement types. These motivation assessment methods should not be used interchangeably, and measures should be more precisely described as the specific motivational construct or domain they are capturing.
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Affiliation(s)
- Lauren Luther
- Indiana University-Purdue University at Indianapolis (IUPUI), 402 N. Blackford St., Indianapolis, IN 46202, United States.
| | - Ruth L Firmin
- Indiana University-Purdue University at Indianapolis (IUPUI), 402 N. Blackford St., Indianapolis, IN 46202, United States
| | - Paul H Lysaker
- Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN 46202, United States; Roudebush VA Medical Center, 1481 W 10th St, Indianapolis, IN 46202, United States
| | - Kyle S Minor
- Indiana University-Purdue University at Indianapolis (IUPUI), 402 N. Blackford St., Indianapolis, IN 46202, United States
| | - Michelle P Salyers
- Indiana University-Purdue University at Indianapolis (IUPUI), 402 N. Blackford St., Indianapolis, IN 46202, United States
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Kocsis-Bogár K, Mészáros V, Perczel-Forintos D. Gender differences in the relationship of childhood trauma and the course of illness in schizophrenia. Compr Psychiatry 2018; 82:84-88. [PMID: 29452966 DOI: 10.1016/j.comppsych.2018.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/12/2018] [Accepted: 01/13/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Different types of childhood trauma have been repeatedly shown to contribute to psychotic symptoms. Gender differences in schizophrenia are well known. Some studies argue that trauma history means a significantly higher risk of psychosis for women than men. However, there is evidence of early adverse life events to be associated with higher stress-sensitivity in men. Little is known about the connection of specific type of trauma and specific psychotic symptoms as well as the course of illness with explicit regard to gender differences. METHODS 102 men and women with schizophrenia spectrum disorder were tested using Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Scale for Assessing Positive Symptoms, Early Trauma Inventory-SR. RESULTS Although, women had a later age at onset without regarding trauma history (d = 0.74), this difference became non-significant when introducing trauma variables. Patients reporting physical abuse had a significantly earlier age at onset, regardless of their sex (V = 0.13, F = 3.11, p = 0.03. Physical abuse predicted an earlier age at onset only in women (R2 = 0.23). History of general trauma predicted more frequent hospitalizations only in men (R2 = 0.55). CONCLUSIONS Although women generally tend to have a more favorable course of illness including a later age at onset men, women with CPA seem to lose this "advantage". It is necessary to investigate the contribution of gender interacting with adverse life events in contribution to the phenomenology and etiology of schizophrenia.
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Affiliation(s)
- Krisztina Kocsis-Bogár
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary; Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Austria.
| | - Veronika Mészáros
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
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Childhood trauma in schizophrenia spectrum disorders as compared to substance abuse disorders. Psychiatry Res 2018; 261:481-487. [PMID: 29360053 DOI: 10.1016/j.psychres.2018.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/24/2017] [Accepted: 01/07/2018] [Indexed: 01/05/2023]
Abstract
The prevalence of childhood trauma (CT) in schizophrenia spectrum disorders (SSDs) and substance abuse disorders (SUDs) is high. Direct comparisons of CT in these disorders are lacking, and it is not known whether there are differences in self-reported CT in SSDs as compared to SUDs. We aimed to compare the frequency, severity and types of CT in SDDs and SUDs. Patients with SSDs (n = 57) and SUDs (n = 57) were matched for age and gender. Overall levels of CT and CT subtypes were measured retrospectively by the Childhood Trauma Questionnaire Short-Form (CTQ-SF), and grouped into none/low and moderate/severe levels of CT. Group differences in CTQ-SF sum score and subscale scores, as well as differences in the severity of overall CT and CT subtypes were all non-significant. In both groups, 64.9% reported ≥ 1 subtypes of CT above cut-off. Of those who reported CT above the cut-off, 13.5% in the psychosis group reported ≥ 4 subtypes, as compared to 2.7% in the substance abuse group. We did not find statistically significant differences between SSDs and SUDs in terms of exposure to CT frequency or severity, all effect sizes were small (r < 0.15).
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Xie P, Wu K, Zheng Y, Guo Y, Yang Y, He J, Ding Y, Peng H. Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China. J Affect Disord 2018; 228:41-48. [PMID: 29223913 DOI: 10.1016/j.jad.2017.11.011] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/20/2017] [Accepted: 11/04/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Childhood trauma has long-term adverse effects on physical and psychological health. Previous studies demonstrated that suicide and mental disorders were related to childhood trauma. In China, there is insufficient research available on childhood trauma in patients with mental disorders. METHODS Outpatients were recruited from a psychiatric hospital in southern China, and controls were recruited from local communities. The demographic questionnaire, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Social Support Rating Scale (SSRS) were completed by all participants, and the Self-rating Idea of Suicide Scale (SIOSS) were completed only by patients. Prevalence rates of childhood trauma were calculated. Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups. Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores. Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support. RESULTS The final sample comprised 229 patients with depression, 102 patients with bipolar, 216 patient with schizophrenia, and 132 healthy controls. In our sample, 55.5% of the patients with depression, 61.8% of the patients with bipolar disorder, 47.2% of the patients with schizophrenia, and 20.5% of the healthy people reported at least one type of trauma. In patient groups, physical neglect (PN) and emotional neglect (EN) were most reported, and sexual abuse (SA) and physical abuse (PA) were least reported. CTQ-SF and SSRS total scores, and most of their subscale scores in patient groups were significantly different from the control group. After controlling demographic characteristics, mental disorders were associated with higher CTQ-SF scores and lower SSRS scores. CTQ-SF scores and number of trauma types were positively correlated with the SIOSS score. Negative correlations existed between SSRS scores and the SIOSS score. LIMITATIONS Our sample may not be sufficiently representative. Some results might have been interfered by demographic characteristics. The SIOSS was not completed by controls. Data from self-report scales were not sufficiently objective. CONCLUSIONS In southern China, childhood trauma is more severe and more prevalent in patients with mental disorders (depression, bipolar disorder and schizophrenia) than healthy people. Among patients with mental disorders in southern China, suicidal ideation is associated with childhood trauma and poor social support.
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Affiliation(s)
- Peng Xie
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yangbo Guo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yuling Yang
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Jianfei He
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yi Ding
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China.
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Seo J, Choi JY. Social defeat as a mediator of the relationship between childhood trauma and paranoid ideation. Psychiatry Res 2018; 260:48-52. [PMID: 29172098 DOI: 10.1016/j.psychres.2017.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 10/20/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
Abstract
Social defeat, the subjective experience of viewing oneself as a failure or social outsider, is associated with various psychiatric disorders. Recent studies suggest that social defeat may play an important role in the development of psychotic disorders. This study examined the role of social defeat in the relationship between childhood trauma and paranoid ideation, a symptom of psychosis, in non-psychotic mental disorders. Psychiatric patients (N = 199) completed the Korean version of the Childhood Trauma Questionnaire, the Korean version of the Defeat Scale, and Restructured Clinical Scale 6 (Ideas of Persecution) of the Korean version of the Minnesota Multiphasic Personality Inventory-2. A partial correlation analysis revealed that childhood trauma was significantly related to social defeat and paranoid ideation after controlling for age and gender. Structural equation modeling confirmed that the relationship between childhood trauma and paranoid ideation was partially mediated by social defeat. Thus, social defeat is a possible psychological mechanism underlying the association between childhood trauma and paranoia.
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Affiliation(s)
- Jihyeon Seo
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, Republic of Korea
| | - Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, Republic of Korea.
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Vallejos M, Cesoni OM, Farinola R, Bertone MS, Prokopez CR. Adverse Childhood Experiences among Men with Schizophrenia. Psychiatr Q 2017; 88:665-673. [PMID: 27957657 DOI: 10.1007/s11126-016-9487-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Individuals who suffered traumatic events or adverse experiences during their childhood have an increased risk of developing during adulthood physical problems, aggressive behavior, and psychiatric disorders, such as schizophrenia. Patients diagnosed with schizophrenia have higher rates of traumatic experiences during childhood than the general population, and those who suffered multiple traumatic events have an increased risk of disease relapse. The current study aims to determine the prevalence of different types of adverse experiences during childhood among a male patient sample with schizophrenia. An Observational descriptive cross-sectional study was conducted at Jose T. Borda Hospital, in Buenos Aires, Argentina. Participants included 51 male patients between the ages of 18 and 63 years with a diagnosis of schizophrenia. Semi-structured interviews were conducted, applying a socio-demographic questionnaire, SCID I and II scales to assess psychiatric diagnosis, and the Adverse Childhood Experiences (ACE) Questionnaire to evaluate the presence of adverse childhood experiences. Statistical analyses were conducted using SPSS 22 software. We observed that 94% of participants had experienced at least one adverse childhood experience. Most (63%) suffered from 4 or more disruptive child events. A high prevalence of family history of mental illness was found, also emotional abuse and neglect. Most traumatic events occurred within the family group. It was found a moderately significant relationship between patients who suffered adverse events and the presence of auditory hallucinations.
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Affiliation(s)
- Miguel Vallejos
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Oscar M Cesoni
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Romina Farinola
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Matías S Bertone
- Belgrano University, Zabala 1837, C1426DQG, Buenos Aires, Argentina
| | - Cintia R Prokopez
- Braulio A. Moyano Hospital, Brandsen 2570, C1287ABJ, Buenos Aires, Argentina.
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24
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Okubo R, Inoue T, Hashimoto N, Suzukawa A, Tanabe H, Oka M, Narita H, Ito K, Kako Y, Kusumi I. The mediator effect of personality traits on the relationship between childhood abuse and depressive symptoms in schizophrenia. Psychiatry Res 2017; 257:126-131. [PMID: 28755602 DOI: 10.1016/j.psychres.2017.06.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 05/09/2017] [Accepted: 06/10/2017] [Indexed: 01/22/2023]
Abstract
Previous studies indicated that personality traits have a mediator effect on the relationship between childhood abuse and depressive symptoms in major depressive disorder and nonclinical general adult subjects. In the present study, we aimed to test the hypothesis that personality traits mediate the relationship between childhood abuse and depressive symptoms in schizophrenia. We used the following questionnaires to evaluate 255 outpatients with schizophrenia: the Child Abuse and Trauma Scale, temperament and character inventory, and Patients Health Questionnire-9. Univariate analysis, multiple regression analysis, and structured equation modeling (SEM) were used to analyze the data. The relationship between neglect and sexual abuse and the severity of depressive symptoms was mostly mediated by the personality traits of high harm avoidance, low self-directedness, and low cooperativeness. This finding was supported by the results of stepwise multiple regression analysis and the acceptable fit indices of SEM. Thus, our results suggest that personality traits mediate the relationship between childhood abuse and depressive symptoms in schizophrenia. The present study and our previous studies also suggest that this mediator effect could occur independent of the presence or type of mental disorder. Clinicians should routinely assess childhood abuse history, personality traits, and their effects in schizophrenia.
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Affiliation(s)
- Ryo Okubo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan.
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akio Suzukawa
- Hokkaido University Public Policy School, Sapporo, Japan
| | - Hajime Tanabe
- Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Japan
| | - Matsuhiko Oka
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Koki Ito
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuki Kako
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Yang S, Li J, Han L, Zhu G. Early maternal separation promotes apoptosis in dentate gyrus and alters neurological behaviors in adolescent rats. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:10812-10820. [PMID: 31966424 PMCID: PMC6965815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 10/24/2017] [Indexed: 06/10/2023]
Abstract
Adverse early-life experience such as maternal separation (MS) affects the behavior of adult, and may also aggravate the outcome of neurological insults. In this study, we aimed to investigate the effects of early MS on hippocampus-related behaviors, and to assess the mechanisms. Newborn rats were randomly divided into normal control and MS groups. Our data showed that MS (P3-P21) impaired learning ability as well as memory retrieval, and caused depression-like activity, but decreased anxiety-like activity. Glutamate receptor 1 (GluR1) expression in the dentate gyrus (DG) region was significantly reduced in the adults (P60). Mechanically, MS promoted apoptosis, and reduced protein kinase B (AKT) phosphorylation in the DG region in the early phase (P21). By contrast, MS did not affect ERK phosphorylation. Our data implicate that the inactivation of AKT pathway and apoptosis of DG cells might contribute to MS-induced behavioral changes. This study would provide useful evidence implicating the pathological changes for MS.
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Affiliation(s)
- Sanjuan Yang
- Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese MedicineHefei 230038, China
| | - Junyao Li
- Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese MedicineHefei 230038, China
| | - Lan Han
- School of Pharmacy, Anhui University of Chinese MedicineHefei 230038, China
| | - Guoqi Zhu
- Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese MedicineHefei 230038, China
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26
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Akün E. Relations among adults' remembrances of parental acceptance-rejection in childhood, self-reported psychological adjustment, and adult psychopathology. Compr Psychiatry 2017; 77:27-37. [PMID: 28551411 DOI: 10.1016/j.comppsych.2017.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 01/22/2023] Open
Abstract
AIMS The aim of the study was to examine relationships among recollections of maternal and paternal acceptance-rejection in childhood and the level of psychological adjustment among adults diagnosed with schizophrenia, social anxiety, and nonclinical control. The study focused primarily on adults with schizophrenia and social anxiety in comparison to nonclinical adults. METHODS Fifty-three adults diagnosed with schizophrenia, 51 adults with self-reported social anxiety, and 147 nonclinical controls between the ages of 18 and 62 participated in the study. Data were collected using adult versions of the Parental Acceptance-Rejection Questionnaire for mothers and for fathers, Personality Assessment Questionnaire, Brief Symptom Inventory, Liebowitz Social Anxiety Scale, and the Demographic Information Form. RESULTS Findings of analyses showed that participants in the schizophrenia and social anxiety groups remembered having experienced significantly more maternal rejection in childhood than did the nonclinical group. Patient with schizophrenia also reported more recollections of paternal rejection than the nonclinical group. Both clinical groups self-reported more psychological maladjustment than did the nonclinical group. Regression analysis indicated that even though the overall psychological adjustment of adults diagnosed with schizophrenia was predicted by both maternal and paternal acceptance-rejection, psychological adjustment of adults in the social anxiety group was predicted only by maternal (but not paternal) acceptance-rejection. CONCLUSION This study provides evidence about the long-lasting associations between adults' recollections of parental acceptance-rejection in childhood and their psychological adjustment in two mental disorders, in which genetic and environmental factors have a different weight.
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Affiliation(s)
- Ebru Akün
- Department of Psychology, Ankara University Faculty of Letters, Turkey.
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27
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Seidenfaden D, Knorr U, Soendergaard MG, Poulsen HE, Fink-Jensen A, Jorgensen MB, Jorgensen A. The relationship between self-reported childhood adversities, adulthood psychopathology and psychological stress markers in patients with schizophrenia. Compr Psychiatry 2017; 72:48-55. [PMID: 27736667 DOI: 10.1016/j.comppsych.2016.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 08/15/2016] [Accepted: 09/21/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Childhood adversity is a well-established risk factor for the development of schizophrenia. In particular, there is evidence that childhood adversity increases the occurrence of positive symptoms, possibly through glucocorticoid influences on dopaminergic neurotransmission. AIMS To compare levels of childhood trauma in schizophrenia patients vs. healthy control persons, and to study the association between childhood adversity and the symptomatology of adulthood schizophrenia, as well as subjective and biological markers of psychological stress. METHODS Thirty-seven patients fulfilling ICD-10 criteria for schizophrenia and 39 healthy control persons filled out the comprehensive Childhood Abuse and Trauma Scale (CATS). Data were analyzed after a data-driven dichotomization into two groups of either high or low CATS score in patients and controls, respectively. The psychopathology of the patients was measured by the Positive and Negative Syndrome Scale (PANSS) and analyzed by a five-factor PANSS model. Measures of perceived stress (Perceived Stress Scale) and hypothalamic-pituitary-adrenal (HPA)-axis activity (9AM plasma cortisol and daytime salivary cortisol output) were recorded. RESULTS As expected, patients had significantly higher total CATS scores than the control persons (>3-fold, P<0.001), reflecting significantly higher scores across all subscales of the CATS. In patients, the total PANSS score did not significantly differ between the high and the low CATS score group (P=0.2). However, there was a statistically significant higher level of positive symptoms in the high CATS group (P=0.014), and no difference in other psychopathological domains. Correspondingly, when using the CATS score as a continuous variable, a strong association with positive PANSS scores was found (P=0.009). The high CATS score group showed higher levels of perceived stress (P=0.02), but there was no difference between the high vs. low CATS group in HPA-axis activity. CONCLUSION Although causal inferences cannot be made from this cross-sectional study, the study adds support to the suggestion that childhood adversity specifically increases the occurrence of positive symptoms in adulthood schizophrenia in a manner that appears to leave HPA-axis activity unaltered.
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Affiliation(s)
- Dea Seidenfaden
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark
| | - Ulla Knorr
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark
| | | | - Henrik Enghusen Poulsen
- Laboratory of Clinical Pharmacology Q7642, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
| | - Martin Balslev Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
| | - Anders Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark.
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Cole CL, Newman-Taylor K, Kennedy F. Dissociation mediates the relationship between childhood maltreatment and subclinical psychosis. J Trauma Dissociation 2016; 17:577-592. [PMID: 27046664 DOI: 10.1080/15299732.2016.1172537] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
More than a third of the population report childhood adversity, and these experiences are associated with an increased risk of clinical and subclinical psychosis. The reason why some people go on to develop mental health problems and others do not is a key question for study. It has been hypothesized that dissociative processes mediate the relationship between early adversity and psychosis. The current study assessed whether dissociation, and specifically depersonalization (one component of dissociation), plays a mediating role in the relationship between childhood maltreatment and both hallucination proneness and delusional ideation. The study used a cross-sectional design and recruited a student sample to assess these relationships in a nonclinical group. Dissociation mediated the relationship between early maltreatment and both hallucination proneness and delusional ideation. In terms of specific dissociative processes, depersonalization did not mediate hallucination proneness or delusional ideation. Absorption mediated hallucination proneness; dissociative amnesia (negatively) and absorption mediated delusional ideation. It is likely that dissociation interferes with the encoding of traumatic information in nonclinical as well as clinical groups and in certain ways. Absorption may be particularly relevant. For some people, traumatic memories may intrude into conscious awareness in adulthood as psychotic-type experience.
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Affiliation(s)
- Charles Lewis Cole
- a Department of Psychology , University of Southampton , Southampton , United Kingdom
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29
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Mørkved N, Endsjø M, Winje D, Johnsen E, Dovran A, Arefjord K, Kroken RA, Helle S, Anda-Ågotnes LG, Rettenbacher MA, Huber N, Løberg EM. Childhood trauma in schizophrenia spectrum disorder as compared to other mental health disorders. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2016.1201135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- N. Mørkved
- Mosjøen District Psychiatric Centre, Helgeland Hospital, Mosjøen, Norway
- Department of Psychology, University of Tromsø, Tromsø, Norway
| | - M. Endsjø
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - D. Winje
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - E. Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - A. Dovran
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - K. Arefjord
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - R. A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - S. Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - M. A. Rettenbacher
- Division of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Austria
| | - N. Huber
- Deptartment of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - E. M. Løberg
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Morgan C, Gayer‐Anderson C. Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry 2016; 15:93-102. [PMID: 27265690 PMCID: PMC4911761 DOI: 10.1002/wps.20330] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities - particularly exposure to multiple adversities involving hostility and threat - do, in some people, contribute to the onset of psychotic experiences and psychotic disorders.
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Affiliation(s)
- Craig Morgan
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, 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 LondonLondonUK
| | - Charlotte Gayer‐Anderson
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, 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 LondonLondonUK
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31
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Adams RE, Ritter C, Bonfine N. Epidemiology of trauma: Childhood adversities, neighborhood problems, discrimination, chronic strains, life events, and daily hassles among people with a severe mental illness. Psychiatry Res 2015; 230:609-15. [PMID: 26603337 DOI: 10.1016/j.psychres.2015.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/16/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
Trauma during childhood and adolescence is a common event among people with a serious psychological disorder. Few studies assess a wide range of stressors for this population. This is surprising given that these stressful events are implicated in poorer outcomes related to course and treatment of mental health problems. This study of 214 people with serious mental illness examines the prevalence of childhood traumas, perceived neighborhood problems, discrimination, chronic strains, negative life events, and daily hassles. We use regression analyses to determine if these stressors are associated with quality of life. Results show that 95% of the sample report at least one childhood adversity. Perceived neighborhood problems, experiences of discrimination, chronic strains, life events, and daily hassles were also common. Examining the relationship between demographic factors and stressors suggests that older respondents, Whites, those who have never been married, and people diagnosed with Schizophrenia reported fewer stressors compared to those who are older, non-White, ever married, or suffering from other types of mental health problems. Finally, three of the six types of stressors were related to lower quality of life and depression. We discuss the implications of these findings for the treatment of severe psychological problems.
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The Community Assessment of Psychic Experiences measures nine clusters of psychosis-like experiences: A validation of the German version of the CAPE. Schizophr Res 2015; 169:274-279. [PMID: 26545299 DOI: 10.1016/j.schres.2015.10.034] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 10/19/2015] [Accepted: 10/22/2015] [Indexed: 01/02/2023]
Abstract
AIM This study examined the factorial and criterion validity of the Community Assessment of Psychic Experiences (CAPE). We compared the validity of the original three-dimensional model and a recently proposed multidimensional model, in which positive symptoms are subdivided into the subfactors hallucinations, bizarre experiences, paranoia, grandiosity and magical thinking and negative symptoms are subdivided into social withdrawal, affective flattening and avolition. METHODS Eleven community (n=934) and three patient samples (n=112) were combined and the proposed models were tested using confirmatory factor analysis. Criterion validity was calculated based on self-report measures for depression and paranoia as well as observer-based ratings for positive and negative symptoms. RESULTS The multidimensional model showed better relative quality (AIC, BIC) than the original three-dimensional model of the CAPE, but both models showed acceptable absolute model-fit (RMSEA, SRMR). The criterion validity was good for the positive symptom scales and negative symptom subfactors social withdrawal and affective flattening. CONCLUSION Factorial validity was found for the three-dimensional and multidimensional model for the CAPE. The multidimensional model, however, shows better comparative fit and promising results in regard to criterion validity. Thus, we recommend a hierarchical multidimensional structure of positive and negative symptoms for future use of the CAPE.
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Choi JY, Choi YM, Kim B, Lee DW, Gim MS, Park SH. The effects of childhood abuse on self-reported psychotic symptoms in severe mental illness: Mediating effects of posttraumatic stress symptoms. Psychiatry Res 2015; 229:389-93. [PMID: 26144585 DOI: 10.1016/j.psychres.2015.05.112] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 04/14/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022]
Abstract
The present study examined the role of posttraumatic stress symptoms in the relationship between childhood abuse and self-reported psychotic symptoms in severe mental illness. A total of 126 patients diagnosed with major psychiatric conditions with comorbid symptoms of psychosis participated in the present study. The representative psychiatric diagnoses included schizophrenia, bipolar disorder with psychotic features, major depressive disorder with psychotic features, schizoaffective disorder, schizophreniform disorder, and delusional disorder. The Korean Child Trauma Questionnaire measured the type and degree of childhood abuse including emotional, physical, and sexual abuse. Korean version of the Impact of Event Scale-Revised assessed posttraumatic stress symptoms, and PSYC subscale of the PSY-5 Factor Scale of the MMPI-2 was used as a measure of self-reported psychotic symptoms. There was a significant relationship between childhood physical, emotional, sexual abuse and psychotic symptoms. Posttraumatic stress symptoms partially mediated the relationship between childhood abuse and psychotic symptoms. This implies that childhood abuse is significantly associated with the experience of chronic posttraumatic stress symptoms, and that such symptoms in turn increases the likelihood of experiencing psychotic symptoms. The results highlight the need for appropriate assessment and intervention concerning childhood abuse and posttraumatic stress symptoms in severe mental illness.
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Affiliation(s)
- Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Young Min Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Bongseog Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Dong Woo Lee
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Min Sook Gim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Soo Hyun Park
- Department of Psychology, Yonsei University, Shinchon-dong, Suhdaemun-gu, Seoul, Republic of Korea.
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Trauelsen AM, Bendall S, Jansen JE, Nielsen HGL, Pedersen MB, Trier CH, Haahr UH, Simonsen E. Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis. Schizophr Res 2015; 165:52-9. [PMID: 25868932 DOI: 10.1016/j.schres.2015.03.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/13/2015] [Accepted: 03/15/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reviews conclude that childhood and adolescence sexual, physical, emotional abuse and emotional and physical neglect are all risk factors for psychosis. However, studies suggest only some adversities are associated with psychosis. Dose-response effects of several adversities on risk of psychosis have not been consistently found. The current study aimed to explore adversity specificity and dose-response effects of adversities on risk of psychosis. METHOD Participants were 101 persons with first-episode psychosis (FEP) diagnosed with ICD-10 F20 - F29 (except F21) and 101 non-clinical control persons matched by gender, age and parents' socio-economic status. Assessment included the Childhood Trauma Questionnaire and parts of the Childhood Experience of Care and Abuse Questionnaire. RESULTS Eighty-nine percent of the FEP group reported one or more adversities compared to 37% of the control group. Childhood and adolescent sexual, physical, emotional abuse, and physical and emotional neglect, separation and institutionalization were about four to 17 times higher for the FEP group (all p<0.01). The risk of psychosis increased two and a half times for each additional adversity. All associations between specific adversities and psychosis decreased when they were adjusted for other adversities. CONCLUSION Our findings suggest that there is a large shared effect of adversities on the risk of psychosis. Contrary to the call for further research into specific adversities, we suggest a search for mechanisms in the shared effects of traumatization. Clinical implications are thorough assessment of adversities and their possible effects.
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Affiliation(s)
- Anne Marie Trauelsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
| | - Sarah Bendall
- Centre for Youth Mental Health,The University of Melbourne, Australia; Orygen: The National Centre of Excellence in Youth Mental Health, Australia
| | - Jens Einar Jansen
- Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | | | - Marlene Buch Pedersen
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | | | - Ulrik H Haahr
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Abstract
The notion that psychosis may exist on a continuum with normal experience has been proposed in multiple forms throughout the history of psychiatry. However, in recent years there has been an exponential increase in efforts aimed at elucidating what has been termed the 'psychosis continuum'. The present review seeks to summarize some of the more basic characteristics of this continuum and to present some of the recent findings that provide support for its validity. While there is still considerable work to be done, the emerging data holds considerable promise for advancing our understanding of both risk and resilience to psychiatric disorders characterized by psychosis.
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Affiliation(s)
- Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Katherine H. Karlsgodt
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
- Department of Psychiatry, Hofstra NorthShore LIJ School of Medicine, Hempstead NY
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Seffer D, Rippberger H, Schwarting RKW, Wöhr M. Pro-social 50-kHz ultrasonic communication in rats: post-weaning but not post-adolescent social isolation leads to social impairments-phenotypic rescue by re-socialization. Front Behav Neurosci 2015; 9:102. [PMID: 25983681 PMCID: PMC4416445 DOI: 10.3389/fnbeh.2015.00102] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/07/2015] [Indexed: 01/20/2023] Open
Abstract
Rats are highly social animals and social play during adolescence has an important role for social development, hence post-weaning social isolation is widely used to study the adverse effects of juvenile social deprivation and to induce behavioral phenotypes relevant to neuropsychiatric disorders, like schizophrenia. Communication is an important component of the rat's social behavior repertoire, with ultrasonic vocalizations (USV) serving as situation-dependent affective signals. High-frequency 50-kHz USV occur in appetitive situations and induce approach behavior, supporting the notion that they serve as social contact calls; however, post-weaning isolation effects on the behavioral changes displayed by the receiver in response to USV have yet to be studied. We therefore investigated the impact of post-weaning isolation on socio-affective information processing as assessed by means of our established 50-kHz USV radial maze playback paradigm. We showed that post-weaning social isolation specifically affected the behavioral response to playback of pro-social 50-kHz but not alarm 22-kHz USV. While group-housed rats showed the expected preference, i.e., approach, toward 50-kHz USV, the response was even stronger in short-term isolated rats (i.e., 1 day), possibly due to a higher level of social motivation. In contrast, no approach was observed in long-term isolated rats (i.e., 4 weeks). Importantly, deficits in approach were reversed by peer-mediated re-socialization and could not be observed after post-adolescent social isolation, indicating a critical period for social development during adolescence. Together, these results highlight the importance of social experience for affiliative behavior, suggesting a critical involvement of play behavior on socio-affective information processing in rats.
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Affiliation(s)
- Dominik Seffer
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg Marburg, Germany
| | - Henrike Rippberger
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg Marburg, Germany
| | - Rainer K W Schwarting
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg Marburg, Germany
| | - Markus Wöhr
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg Marburg, Germany
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DeRosse P, Ikuta T, Peters BD, Karlsgodt KH, Szeszko PR, Malhotra AK. Adding insult to injury: childhood and adolescent risk factors for psychosis predict lower fractional anisotropy in the superior longitudinal fasciculus in healthy adults. Psychiatry Res 2014; 224:296-302. [PMID: 25277095 PMCID: PMC4253644 DOI: 10.1016/j.pscychresns.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/03/2014] [Accepted: 09/01/2014] [Indexed: 12/21/2022]
Abstract
Although epidemiological studies provide strong support for demographic and environmental risk factors in psychotic disorders, few data examine how these risk factors relate to the putative aberrant neurodevelopment associated with illness. The present study examined how the accumulation of risk factors including low IQ, low parental socioeconomic status (SES), history of adolescent cannabis use and childhood trauma, and high levels of subclinical psychotic-like experiences (PLEs) contributed to aberrant neurodevelopmental outcomes in 112 otherwise healthy adults recruited from the community. Participants were studied with diffusion tensor imaging (DTI), and voxel-wise statistical analysis of fractional anisotropy (FA) using tract-based spatial statistics (TBSS) was used to examine the relation between cumulative risk (CR) for psychosis and white matter (WM) integrity across the whole brain. Analyses revealed that higher CR was significantly associated with lower FA in a cluster in the left superior longitudinal fasciculus (SLF). These results suggest that risk factors previously associated with psychotic disorders are associated with WM integrity even in otherwise healthy adults and may provide insight into how previously identified risk factors contribute to the structural brain abnormalities associated with psychotic illness. Prospective longitudinal studies examining the effect of risk factors on the developmental trajectory of brain WM are warranted.
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Affiliation(s)
- Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA.
| | - Toshikazu Ikuta
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Bart D. Peters
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Katherine H. Karlsgodt
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Philip R. Szeszko
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA,Hofstra North Shore – LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA
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POSITIVE AND NEGATIVE SUBCLINICAL SYMPTOMS AND MCCB PERFORMANCE IN NON-PSYCHIATRIC CONTROLS. SCHIZOPHRENIA RESEARCH-COGNITION 2014; 1:175-179. [PMID: 25530948 PMCID: PMC4266935 DOI: 10.1016/j.scog.2014.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Considerable data support the phenomenological and temporal continuity between subclinical psychosis and psychotic disorders. In recent years, neurocognitive deficits have increasingly been recognized as a core feature of psychotic illness but there are few data seeking to elucidate the relationship between subclinical psychosis and neurocogntive deficits in non-clinical samples. The goal of the present study was to examine the relationship between subclinical positive and negative symptoms, as measured by the Community Assessment of Psychic Experiences (CAPE) and performance on the MATRICS Consensus Cognitive Battery (MCCB) in a large (n = 303) and demographically diverse non-clinical sample. We found that compared to participants with low levels of subclinical positive symptoms, participants with high levels of subclinical positive symptoms performed significantly better in the domains of working memory (p < .001), verbal learning (p = .007) and visual learning (p = .014). Although comparison of participants with high and low levels of subclinical negative symptoms revealed no differences in MCCB performance, we found that individuals with high levels of subclinical negative symptoms performed significantly better on a measure of estimated IQ (WRAT-3 Reading subtest; p = .02) than those with low levels of subclinical negative symptoms. These results are at odds with prior reports that have generally shown a negative relationship between neurocognitive functioning and severity of subclinical psychotic symptoms, and suggest some potential discontinuities between clinically significant psychotic symptoms and sub-syndromal manifestations of psychosis.
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