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Huque ZM, Korenic SA, Ered A, Olino TM, Anglin DM, Ellman LM. Mechanisms mediating ethnoracial discrimination and suspiciousness in Asian, Black, and Hispanic United States college students. Schizophr Res 2024; 271:59-67. [PMID: 39013345 PMCID: PMC11384233 DOI: 10.1016/j.schres.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 07/05/2024] [Accepted: 07/07/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Despite the robust relationship between ethnoracial discrimination and positive psychotic-like experiences (PLEs) like subclinical suspiciousness in adulthood, the underlying mechanisms remain underexamined. Investigating the mechanisms previously implicated in trauma and positive PLEs - including negative-self schemas, negative-other schemas, perceived stress, dissociative experiences, and external locus of control - may inform whether ethnoracial discrimination has similar or distinct effects from other social stressors. METHOD We examined the indirect effects of experiences of discrimination (EOD) to suspicious PLEs and total positive PLEs through negative-self schemas, negative-other schemas, perceived stress, dissociative experiences, and external locus of control in Asian (nAsian = 268), Black (nBlack = 301), and Hispanic (nHispanic = 129) United States college students. RESULTS Among Asian participants, results indicated a significant indirect effect of EOD to suspicious PLEs and EOD to positive PLEs via perceived stress, and EOD to positive PLEs via negative-self schemas. Among Hispanic participants, results indicated a significant indirect effect of EOD to suspicious PLEs and EOD to positive PLEs via dissociative experiences. No mechanisms appeared significant in Black participants nor were any significant direct effects observed across models, despite them reporting significantly greater experiences of ethnoracial discrimination. CONCLUSIONS Our findings suggest some shared but potentially distinct mechanisms contribute to increased suspicious PLEs and positive PLEs in Asian, Black, and Hispanic college students, with results differing by group, compared to the mechanisms underlying trauma and positive PLEs, with implications for the treatment of PLEs in college students exposed to ethnoracial discrimination.
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Affiliation(s)
- Zeeshan M Huque
- Department of Psychology and Neuroscience, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
| | - Stephanie A Korenic
- Department of Psychology and Neuroscience, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
| | - Arielle Ered
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | - Thomas M Olino
- Department of Psychology and Neuroscience, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
| | - Deidre M Anglin
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031, USA; The Graduate Center, City University of New York, 365 5th Avenue, New York, NY 10016, USA.
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
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2
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Subica AM, Soakai L, Tukumoeatu A, Johnson T, Aitaoto N. Trauma and mental health in Pacific Islanders. Int J Soc Psychiatry 2024; 70:861-873. [PMID: 38491441 PMCID: PMC11323437 DOI: 10.1177/00207640241236109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND Little is known about trauma and its mental health impact on Native Hawaiians/Pacific Islanders (NH/PI), an understudied Indigenous-colonized population that endures severe mental health disparities. AIMS This novel investigation assessed trauma prevalence and its mental health and substance use correlates in NH/PIs in the U.S. METHOD Using community-based participatory research methods, survey data on NH/PI trauma, depression, anxiety, substance use, and treatment need were collected from 306 NH/PI adults using online, telephone, and in-person methods. Descriptive statistics and adjusted regression models were employed. RESULTS Sixty-nine percent of participants experienced lifetime trauma, reporting mean exposure to 2.5 different trauma types. Childhood physical and sexual abuse, and lifetime forced sexual assault rates were 34%, 25%, and 27%, respectively, exceeding general population rates. Women and men reported equivalent total mean exposure to different trauma types, as well as equal prevalence for every trauma type examined (e.g. sexual abuse/assault). Confirming hypotheses, after controlling for key demographic and mental health risk factors, increased exposure to multiple trauma types uniquely associated with greater depression, anxiety, alcohol symptomology, and greater likelihood for needing treatment and using illicit substances. CONCLUSIONS Trauma is prevalent in NH/PI populations and significantly impacts NH/PI mental health; serving as an important but overlooked contributor to NH/PI mental health disparities. Current findings fill critical gaps in our knowledge of NH/PI trauma and mental health while revealing the importance of screening and treating NH/PIs for trauma exposure to alleviate existing mental health disparities.
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Affiliation(s)
- Andrew M Subica
- School of Medicine, University of California, Riverside, USA
| | - Lolofi Soakai
- Motivating Action Leadership Opportunity, Pomona, CA, USA
| | - Amen Tukumoeatu
- Empowering Pacific Islander Communities, Inc., Portland, OR, USA
| | - Taffy Johnson
- United Territories of Pacific Islanders Alliance, Kent, WA, USA
| | - Nia Aitaoto
- United Territories of Pacific Islanders Alliance, Kent, WA, USA
- Pacific Islander Center of Primary Care Excellence, San Leandro, CA, USA
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Cortes Hidalgo AP, Hammerton G, Heron J, Bolhuis K, Madley-Dowd P, Tiemeier H, van IJzendoorn MH, Zammit S, Jones HJ. Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators. Schizophr Bull 2024; 50:903-912. [PMID: 38437586 PMCID: PMC11283191 DOI: 10.1093/schbul/sbae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND AND HYPOTHESIS Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. STUDY DESIGN We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. STUDY RESULTS In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. CONCLUSIONS Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.
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Affiliation(s)
- Andrea P Cortes Hidalgo
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Gemma Hammerton
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Paul Madley-Dowd
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Social and Behavioural Science, Harvard TH Chan School of Public Health, Boston, USA
| | - Marinus H van IJzendoorn
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, London, UK
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Stanley Zammit
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Hannah J Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
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de Freitas MBL, Luna LP, Beatriz M, Pinto RK, Alves CHL, Bittencourt L, Nardi AE, Oertel V, Veras AB, de Lucena DF, Alves GS. Resting-state fMRI is associated with trauma experiences, mood and psychosis in Afro-descendants with bipolar disorder and schizophrenia. Psychiatry Res Neuroimaging 2024; 340:111766. [PMID: 38408419 DOI: 10.1016/j.pscychresns.2023.111766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Bipolar disorder (BD) and schizophrenia (SCZ) may exhibit functional abnormalities in several brain areas, including the medial temporal and prefrontal cortex and hippocampus; however, a less explored topic is how brain connectivity is linked to premorbid trauma experiences and clinical features in non-Caucasian samples of SCZ and BD. METHODS Sixty-two individuals with SCZ (n = 20), BD (n = 21), and healthy controls (HC, n = 21) from indigenous and African ethnicity were submitted to clinical screening (Di-PAD), traumata experiences (ETISR-SF), cognitive and functional MRI assessment. The item psychosis/hallucinations in SCZ patients showed a negative correlation with the global efficiency (GE) in the right dorsal attention network. The items mania, irritable mood, and racing thoughts in the Di-PAD scale had a significant negative correlation with the GE in the parietal right default mode network. CONCLUSIONS Differences in the activation of specific networks were associated with earlier disease onset, history of physical abuse, and more severe psychotic and mood symptoms in SCZ and BD subjects of indigenous and black ethnicity. Findings provide further evidence on SZ and BD's brain connectivity disturbances, and their clinical significance, in non-Caucasian samples.
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Affiliation(s)
| | - Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Márcia Beatriz
- Neuroradiology Service, São Domingos Hospital, São Luís, Brazil; Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | | | - Candida H Lopes Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | - Lays Bittencourt
- Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Antônio E Nardi
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viola Oertel
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Frankfurt Goethe University, Germany
| | - André B Veras
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Sousa Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil; Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil; Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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5
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Xu B, Chen C, Wang D. Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation. Psychol Res Behav Manag 2024; 17:799-811. [PMID: 38434958 PMCID: PMC10908336 DOI: 10.2147/prbm.s451889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. Methods A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Results Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Conclusion Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.
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Affiliation(s)
- Bingna Xu
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Dongfang Wang
- School of Psychology, South China Normal University, Guangzhou, People’s Republic of China
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People’s Republic of China
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Weyhaupt M, Hardcastle S, Jesse N, Almeida M, Ward HB. Diagnosis and Management of Perimenstrual Cycloid Motility Psychosis. Harv Rev Psychiatry 2024; 32:33-39. [PMID: 38181101 DOI: 10.1097/hrp.0000000000000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Affiliation(s)
- Michelle Weyhaupt
- From Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN (Drs. Weyhaupt and Ward); Vanderbilt University School of Medicine (Ms. Hardcastle); Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN (Dr. Jesse); Harvard Medical School and Cambridge Health Alliance, Cambridge, MA (Dr. Almeida)
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7
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Cowan HR, Williams TF, Schiffman J, Ellman LM, Mittal VA. Mapping Psychosis Risk States onto the Hierarchical Taxonomy of Psychopathology Using Hierarchical Symptom Dimensions. Clin Psychol Sci 2024; 12:3-21. [PMID: 38572185 PMCID: PMC10989734 DOI: 10.1177/21677026221146178] [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: 04/05/2024]
Abstract
Clinical high risk for psychosis (CHR) is a transdiagnostic risk state. However, it is unclear how risk states such as CHR fit within broad transdiagnostic models such as the Hierarchical Taxonomy of Psychopathology (HiTOP). In this study, a hierarchical dimensional symptom structure was defined by unfolding factor analysis of self-report data from 3,460 young adults (mage=20.3). A subsample (n=436) completed clinical interviews, 85 of whom met CHR criteria. Regression models examined relationships between symptom dimensions, CHR status, and clinician-rated symptoms. CHR status was best explained by a reality distortion dimension, with contributions from internalizing dimensions. Positive and negative attenuated psychotic symptoms were best explained by multiple psychotic and nonpsychotic symptom dimensions including reality distortion, distress, fear, detachment, and mania. Attenuated psychotic symptoms are a complex presenting problem warranting comprehensive assessment. HiTOP can provide both diagnostic precision and broad transdiagnostic coverage, making it a valuable resource for use with at-risk individuals.
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Affiliation(s)
- Henry R. Cowan
- Psychology, Northwestern University, Evanston, IL
- Psychiatry, The Ohio State University, Columbus, OH
| | | | | | - Lauren M. Ellman
- Psychology and Neuroscience, Temple University, Philadelphia, PA
| | - Vijay A. Mittal
- Psychology, Northwestern University, Evanston, IL
- Psychiatry and Institute for Policy Research, Northwestern University, Evanston, IL
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8
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Rammou A, Berry C, Fowler D, Hayward M. What's the impact of voice-hearing experiences on the social relating of young people: A comparison between help-seeking young people who did and did not hear voices. PLoS One 2023; 18:e0290641. [PMID: 37751433 PMCID: PMC10522017 DOI: 10.1371/journal.pone.0290641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/12/2023] [Indexed: 09/28/2023] Open
Abstract
Limited research has explored the specific impact of voice-hearing experiences upon the social relating of adolescents. This study examined the associations of voice-hearing in youth with social relating, and putative explanatory factors. An observational, cross-sectional design using a clinical comparison group was employed to examine historical and concurrent associations with voice-hearing. Thirty-four young people (age 14-18 years) with voice-hearing experiences and 34 young people who did not hear voices were recruited from NHS mental health services. Participants completed measures about social relating and potential explanatory factors. Analyses of covariance were used to examine between-group differences. Voice-hearers scored higher on negative schematic beliefs (self-beliefs, partial η2 = .163, p = .001; other-beliefs, partial η2 = .152, p =. 002) and depressive and anxiety symptoms (partial η2 = .23 and partial η2 = .24, p-s <. 001 respectively). The two groups did not differ significantly on childhood trauma levels (partial η2 = .02, p = .273), however, the voice-hearing group scored lower on premorbid adjustment (partial η2 = .19, p < .001). Hearing voices in help-seeking youth could be an indicator for social relating issues and holding negative schematic beliefs, and may be an indicator for of increased psychopathological complexity. Although poorer premorbid adjustment might indicate an early vulnerability to social relating difficulties, voice-hearing might be an aggravating factor and one that requires treatment.
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Affiliation(s)
- Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
| | - Clio Berry
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
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Șoflău R, Szentágotai-Tătar A, Oltean LE. Childhood Adversity, Resilience, and Paranoia During the COVID-19 Outbreak. The Mediating Role of Irrational Beliefs and Affective Disturbance. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023:1-16. [PMID: 37360924 PMCID: PMC10221745 DOI: 10.1007/s10942-023-00511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Childhood adversity (CA) and resilience may impact on paranoia, but mechanisms underlying these associations are largely unknown. In this study, we investigated two potential candidates: irrational beliefs and affective disturbance. Moreover, we investigated the potential moderating role of COVID-19 perceived stress in these associations. A community sample (N = 419, m age = 27.32 years, SD = 8.98; 88.10% females) completed self-report measures. Results indicated that paranoia was significantly associated with CA and resilience (p < .05), and both irrational beliefs and affective disturbance (i.e., depressive and anxiety symptoms) mediated the associations between CA and paranoia. Moreover, depressive and anxiety symptoms partially explained the mediating role of irrational beliefs. These predictive models explained up to 23.52% of variance in paranoia (F(3,415) = 42.536, p < .001). Findings on resilience and paranoia replicated these results, and COVID-19 perceived stress moderated the association between resilience and ideas of persecution. Overall, these findings underscore the importance of irrational beliefs, depressive and anxiety symptoms in high CA or low resilience individuals experiencing paranoia. Supplementary Information The online version contains supplementary material available at 10.1007/s10942-023-00511-4.
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Affiliation(s)
- Radu Șoflău
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentágotai-Tătar
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Lia-Ecaterina Oltean
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
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Dudley R, Turkington D, Coulthard N, Pyle M, Gumley A, Schwannauer M, Kingdon D, Morrison AP. Childhood Trauma in Clozapine-Resistant Schizophrenia: Prevalence, and Relationship With Symptoms. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad030. [PMID: 39145330 PMCID: PMC11207680 DOI: 10.1093/schizbullopen/sgad030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis The role of early adversity and trauma is increasingly recognized in psychosis but treatments for trauma and its consequences are lacking. Psychological treatments need to understand the prevalence of these experiences, the relationship with specific symptoms and identify potentially tractable processes that may be targeted in therapy. It was hypothesized that greater adversity, and specifically abuse rather than neglect, would be associated with positive symptoms and specifically hallucinations. In addition, negative beliefs would mediate the relationship with positive symptoms. Study Design 292 Patients with treatment resistant psychosis completed measures of early adversity as well as current symptoms of psychosis. Study Results Early adversity in the form of abuse and neglect were common in one-third of the sample. Adversity was associated with higher levels of psychotic symptoms generally, and more so with positive rather than negative symptoms. Abuse rather than neglect was associated with positive but not with negative symptoms. Abuse rather than neglect was associated with hallucinations but not delusions. Abuse and neglect were related to negative beliefs about the self and negative beliefs about others. Mediation demonstrated a general relationship with adversity, negative-self, and other views and overall psychotic symptoms but not in relation to the specific experience of abuse and hallucinations. Females were more likely to be abused, but not neglected, than males. Conclusions Whilst most relationships were modest, they supported previous work indicating that adversity contributes to people with psychosis experiencing distressing symptoms especially hallucinations. Treatments need to address and target adversity.
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Affiliation(s)
- Robert Dudley
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
- Department of Psychology, University of York, York, YO10 5DDUK
| | - Douglas Turkington
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Naomi Coulthard
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Melissa Pyle
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK
| | - Andrew Gumley
- School of Health & Wellbeing, University of, Glasgow Clarice Pears Building, 90 Byres Road, Glasgow G12 8TBUK
| | - Matthias Schwannauer
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - David Kingdon
- University Department of Psychiatry, University of Southampton, Academic Centre, CollegeKeep 4-12 Terminus Terrace Southampton SO14 3DT, UK
| | - Anthony P Morrison
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK
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11
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Creatura GM, Ered A, Murty VP, Ellman LM. The relationship between sleep, dissociation and psychotic-like experiences. Early Interv Psychiatry 2022; 16:1353-1358. [PMID: 35333007 DOI: 10.1111/eip.13284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/02/2022] [Accepted: 03/13/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sleep disturbances have frequently been associated with the full spectrum of psychosis, from psychotic-like experiences (PLEs) to individuals who meet diagnostic criteria for schizophrenia. Similarly, dissociative experiences have been linked to both sleep disturbances and PLEs. AIM The aim of this study was to examine the role of dissociation in the relationship between sleep quality and PLEs. METHODS PLEs, dissociative symptoms, and sleep quality were examined in 1677 young adults using self-report measures. A mediation analysis was performed to examine whether dissociative experiences account for some of the relationship between sleep quality and PLEs. RESULTS Dissociative symptoms significantly mediated the relationship between sleep quality and PLEs, with both age and gender used as covariates. CONCLUSION These findings suggest that dissociation may be a key contributor to the relationship between disrupted sleep and PLEs, which could have treatment and identification implications.
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Affiliation(s)
- Gina M Creatura
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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12
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Trovão LDO, Alves GS, Carrilho CG, Ricci TG, Bittencourt L, Alves C, Brito NC, Nardi AE, Malaspina D, Veras AB. Early trauma and schizophrenia onset: preliminary results of an outpatient cohort in Brazil. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 44:e20200024. [PMID: 33872478 PMCID: PMC10039718 DOI: 10.47626/2237-6089-2020-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/12/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To assess the prevalence of early trauma in individuals with onset of schizophrenia (SZ) at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively) and explore relationships between the onset of disease and clinical variables including traumatic events and psychotic and mood symptoms. METHODS Subjects with SZ (n = 71) and EOP and AOP were compared for history of psychological trauma, sexual abuse, and physical punishment using the Early Trauma Inventory Self Report - Short Form (ETISR-SF). They were also compared for history of comorbidities and affective disorders using the Diagnostic Interview for Psychosis and Affective Disorders, the Positive and Negative Syndrome Scale, the Liebowitz Social Anxiety Scale, and the Calgary Depression Scale for Schizophrenia. Coefficients were calculated for correlations between scale results and disease duration. RESULTS Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as were social anxiety symptoms and early trauma (r = 0.319, p < 0.01). Total ETISR-SF scores and the physical abuse item were significantly higher in EOP than in AOP. In the hierarchical regression, PANSS scores were best predicted by a model including the duration of disease and age of first psychotic episode (R = 0.303). CONCLUSIONS Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.
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Affiliation(s)
- Leandro de Oliveira Trovão
- Grupo de pesquisa em Psiquiatria Translacional, Hospital Nina Rodrigues, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Gilberto Sousa Alves
- Grupo de pesquisa em Psiquiatria Translacional, Hospital Nina Rodrigues, Universidade Federal do Maranhão, São Luís, MA, Brazil. Programa de Pós-graduação em Psiquiatria e Saúde Mental (PROPSAM), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Carolina Gomes Carrilho
- Grupo de Pesquisa Translacional em Saúde Mental (GPTranSMe), Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Thaysse Gomes Ricci
- Grupo de Pesquisa Translacional em Saúde Mental (GPTranSMe), Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Lays Bittencourt
- Grupo de pesquisa em Psiquiatria Translacional, Hospital Nina Rodrigues, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Cândida Alves
- Laboratório de Neurociências, Universidade Ceuma, São Luís, MA, Brazil
| | - Natália Costa Brito
- Grupo de pesquisa em Psiquiatria Translacional, Hospital Nina Rodrigues, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Antonio Egídio Nardi
- Laboratório de Pânico e Respiração (LabPR-UFRJ), Instituto de Psiquiatria (IPUB), UFRJ, Rio de Janeiro, RJ, Brazil
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine, Mt. Sinai Medical Center, New York, NY, USA
| | - André Barciela Veras
- Grupo de Pesquisa Translacional em Saúde Mental (GPTranSMe), Universidade Católica Dom Bosco, Campo Grande, MS, Brazil. Laboratório de Pânico e Respiração (LabPR-UFRJ), Instituto de Psiquiatria (IPUB), UFRJ, Rio de Janeiro, RJ, Brazil. Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine, Mt. Sinai Medical Center, New York, NY, USA
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13
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Li B, Hu T, Tang W. The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic-like experiences. Early Interv Psychiatry 2022; 16:1217-1229. [PMID: 35192219 DOI: 10.1111/eip.13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/05/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
AIM This study investigated the influence of childhood adversity, such as peer bullying and socioeconomic status, on the suicidal behaviour of left-behind Chinese adolescents to determine whether psychotic-like experiences (PLEs) mediated the associations between these childhood adversities and suicidality; suicidal ideation (serious thoughts about taking one's own life), suicide plans, and suicide attempts. METHODS A representative group of rural adolescents (n = 3346) was recruited from 16 rural high schools in China. Suicidality was assessed using the suicide module from the Mini International Neuropsychiatric Interview Kid. Participants also completed questionnaires on bullying, socioeconomic status, left-behind characteristics, and PLEs. Structural equation modelling was then employed to explore the relationships between these variables. RESULTS Peer bullying, poverty, and left-behind status were all found to significantly increase adolescent suicide risk, the relationships between which were mediated by PLEs. Peer bullying was found to play the most significant role in the PLEs and suicidality, with the risk of suicide increasing with the length of time a child had been left behind. CONCLUSION Adverse life events can lead to a high risk of PLEs, which in turn can increase the risk of suicide. These results could assist in identifying individuals at risk of suicidality and the design of appropriate interventions. The results also highlighted the role PLEs play in suicidality and highlighted the need for further research in this area.
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Affiliation(s)
- Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
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14
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Muddle S, Jones B, Taylor G, Jacobsen P. A systematic review and meta-analysis of the association between emotional stress reactivity and psychosis. Early Interv Psychiatry 2022; 16:958-978. [PMID: 34904353 DOI: 10.1111/eip.13247] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/25/2021] [Accepted: 11/07/2021] [Indexed: 01/03/2023]
Abstract
AIM Emotional stress reactivity may be a mediating factor in the association between trauma and psychosis. This review aimed to (i) identify, summarise and critically evaluate the link between emotional stress reactivity and psychotic experiences (ii) examine evidence for a 'dose-response' relationship between stress reactivity and psychosis in the wider psychosis phenotype (i.e., sub-clinical symptoms). METHODS Electronic database searches (PsychINFO, MEDLINE, EMBASE) were conducted for studies which investigated the link between stress reactivity and psychosis, psychotic symptoms, or a vulnerability to developing psychosis (wider phenotype). Cross-sectional, experimental and experience sampling method study designs were eligible for inclusion. RESULTS Fourty five eligible articles were identified (N participants = 8830). Narrative synthesis showed that increased emotional stress reactivity was associated with psychosis and subclinical psychotic experiences across all study designs, however, findings were inconsistent across studies. The preliminary meta-analysis (k = 4, n = 383) showed increases in emotional stress reactivity was associated with higher negative affect in response to event-related stress, in those with psychosis compared to controls (mean difference in beta coefficients = 0.05, 95% CI 0.02-0.08, p = .004). However, this difference was small with a considerable degree of heterogeneity (p = .001, I2 = 81%) so results should be interpreted with caution. CONCLUSIONS Overall, the evidence suggests that there is a link between emotional stress reactivity and psychosis in those with psychosis, those at high risk of developing psychosis and in relation to subclinical psychotic-like experiences in the general population.
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Affiliation(s)
- Sarah Muddle
- Department of Psychology, University of Bath, Bath, UK
| | - Bradley Jones
- Department of Psychology, University of Bath, Bath, UK
| | - Gemma Taylor
- Department of Psychology, University of Bath, Bath, UK
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15
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Liu J, Shahwan S, Abdin E, Vaingankar JA, Basu S, Tang C, Verma S, Subramaniam M. Adverse childhood experiences and positive psychotic symptoms: A nationally representative study in Singapore. CHILD ABUSE & NEGLECT 2022; 131:105778. [PMID: 35820323 DOI: 10.1016/j.chiabu.2022.105778] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/21/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Epidemiological studies show that adverse childhood experiences (ACE) are associated with positive psychotic symptoms in Western populations; however, there is a lack of population-based data in multi-ethnic, Asian societies. OBJECTIVE We investigated the associations between ACE (type and dosage) and positive psychotic symptoms in a nationally representative study in Singapore. PARTICIPANTS AND SETTING A total of 4441 adult Singapore residents were recruited via door-to-door surveys; they were assessed for ACE and positive psychotic symptoms (i.e., hallucinations, delusions, thought insertion, thought control, and telepathic powers) on structured interviews. METHODS Lifetime experiences of positive psychotic symptoms were regressed on (1) the experience of any ACE; (2) cumulative ACE; and (3) the experience of either no ACE, interpersonal victimization only, dysfunctional home environments only, neglect only or multiple exposures to ACE in weighted and adjusted regression models. RESULTS 5.2 % of the sample experienced positive psychotic symptoms during their lifetime. Individuals exposed to dysfunctional home environments (OR = 2.84, 95 % CI 1.26 to 6.37) and multiple adverse childhood experiences (OR = 3.31, 95 % CI 2.18 to 5.01) were at an elevated risk of experiencing positive psychotic symptoms. The exposure to three or more ACE was associated with a near five-fold higher risk of experiencing positive psychotic symptoms (OR = 4.51, 95 % CI 2.89 to 7.05). CONCLUSIONS Individuals exposed to dysfunctional home environments or multiple adverse childhood experiences are at an elevated risk of experiencing positive psychotic symptoms. Given the intrafamilial nature of these childhood adversities, dual-generation approaches and family-centered interventions are key.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore.
| | | | | | | | - Sutapa Basu
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
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16
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Toutountzidis D, Gale TM, Irvine K, Sharma S, Laws KR. Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis. PLoS One 2022; 17:e0270494. [PMID: 35767584 PMCID: PMC9242513 DOI: 10.1371/journal.pone.0270494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/10/2022] [Indexed: 01/14/2023] Open
Abstract
The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.
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Affiliation(s)
| | - Tim M. Gale
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Research and Development Department, Hertfordshire Partnership NHS Foundation Trust, Hatfield, United Kingdom
| | - Karen Irvine
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Shivani Sharma
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith R. Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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17
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Houran J, Laythe B. Case Study of Recognition Patterns in Haunted People Syndrome. Front Psychol 2022; 13:879163. [PMID: 35756234 PMCID: PMC9216229 DOI: 10.3389/fpsyg.2022.879163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Haunted People Syndrome (HP-S) denotes individuals who recurrently report various “supernatural” encounters in everyday settings ostensibly due to heightened somatic-sensory sensitivities to dis-ease states (e.g., marked but sub-clinical levels of distress), which are contextualized by paranormal beliefs and reinforced by perceptual contagion effects. This view helps to explain why these anomalous experiences often appear to be idioms of stress or trauma. We tested the validity and practical utility of the HP-S concept in an empirical study of an active and reportedly intense ghostly episode that was a clinical referral. The case centered on the life story of the primary percipient, a retired female healthcare worker. Secondary percipients included her husband and adult daughter, all of whom reported an array of benign and threatening anomalies (psychological and physical in nature) across five successive residences. Guided by prior research, we administered the family online measures of transliminality, sensory-processing sensitivity, paranormal belief, locus of control, desirability for control, and a standardized checklist of haunt-type phenomena. The primary percipient also completed a measure of adverse childhood events and supplied an event diary of her anomalous experiences. We found reasonably consistent support for HP-S from a set of quantitative observations that compared five proposed syndrome features against the family members’ psychometric profiles and the structure and contents of their anomalous experiences. Specifically, the reported anomalies both correlated with the family’s scores on transliminality and paranormal belief, as well as elicited attributions and reaction patterns aligned with threat (agency) detection. There was also some evidence of perceptual congruency among the family members’ anomalous experiences. Putative psi cannot be ruled out, but we conclude that the family’s ordeal fundamentally involved the symptoms and manifestations of thin (or “permeable”) mental boundary functioning in the face of unfavorable circumstances or overstimulating environments and subsequently acerbated by poor emotion regulation, histrionic and catastrophizing reactions, and active confirmation biases.
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Affiliation(s)
- James Houran
- Integrated Knowledge Systems, Dallas, TX, United States.,Instituto Politécnico de Gestão e Tecnologia, Porto, Portugal
| | - Brian Laythe
- Institute for the Study of Religious and Anomalous Experience, Charlestown, IN, United States
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18
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Monsonet M, Rockwood NJ, Kwapil TR, Barrantes-Vidal N. Psychological Pathways to Paranoia and Psychotic-Like Experiences in Daily-Life: The Mediating Role of Distinct Affective Disturbances. Schizophr Bull 2022; 48:1053-1065. [PMID: 35759215 PMCID: PMC9434429 DOI: 10.1093/schbul/sbac071] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND HYPOTHESIS Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype. STUDY DESIGN Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions. STUDY RESULTS Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found. CONCLUSIONS This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- To whom correspondence should be addressed; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain; tel: 34-93-581-38-64, fax: 34-93-581-21-25, e-mail:
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19
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Mitchell J, Meehan T. How art-as-therapy supports participants with a diagnosis of schizophrenia: A phenomenological lifeworld investigation. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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20
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Stramecki F, Misiak B, Gawęda Ł, Prochwicz K, Kłosowska J, Samochowiec J, Samochowiec A, Pawlak E, Szmida E, Skiba P, Cechnicki A, Frydecka D. The Moderating Role of the FKBP5 Gene Polymorphisms in the Relationship between Attachment Style, Perceived Stress and Psychotic-like Experiences in Non-Clinical Young Adults. J Clin Med 2022; 11:jcm11061614. [PMID: 35329940 PMCID: PMC8953491 DOI: 10.3390/jcm11061614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Numerous studies have reported that stressful life experiences increase the risk of psychosis and psychotic-like experiences (PLEs). Common variations of the FKBP5 gene have been reported to impact the risk of psychosis by moderating the effects of environmental exposures. Moreover, anxious and avoidant attachment styles have been shown to increase both the level of perceived stress and the risk for psychosis development. In the present cross-sectional study, we aimed to investigate whether variants of the FKBP5 gene moderate the effects of attachment styles and the level of perceived stress on the development of PLEs. A total of 535 non-clinical undergraduates were genotyped for six FKBP5 single nucleotide polymorphisms (SNPs) (rs3800373, rs9470080, rs4713902, rs737054, rs1360780 and rs9296158). The Psychosis Attachment Measure (PAM), the Perceived Stress Scale-10 (PSS-10) and the Prodromal Questionnaire 16 (PQ-16) were administered to assess attachment styles, the level of perceived stress and PLEs, respectively. Anxious attachment style, lower levels of perceived self-efficacy and higher levels of perceived helplessness were associated with a significantly higher number of PLEs. The main effects of attachment style on the severity of PLEs were significant in models testing for the associations with perceived self-efficacy and three FKBP5 SNPs (rs1360780, rs9296158 and rs9470080). The main effect of rs38003733 on the number of PLEs was observed, with GG homozygotes reporting a significantly higher number of PLEs in comparison to T allele carriers. In individuals with dominant anxious attachment style, there was a significant effect of the interaction between the FKBP5 rs4713902 SNP and self-efficacy on the severity of PLEs. Among rs4713902 TT homozygotes, a low level of perceived self-efficacy was associated with higher severity of PLEs. In subjects with non-dominant anxious attachment, a low level of perceived self-efficacy was associated with a higher number of PLEs, regardless of the genotype. Our results indicate that the FKBP5 gene might moderate the relationship between attachment, perceived stress and PLEs.
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Affiliation(s)
- Filip Stramecki
- Department of Psychiatry, Wroclaw Medical University, Pasteur Street 10, 50-367 Wroclaw, Poland;
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Pasteur Street 10, 50-367 Wroclaw, Poland;
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Jaracza Street 1, 00-378 Warsaw, Poland;
| | - Katarzyna Prochwicz
- Institute of Psychology, Jagiellonian University, Ingardena 6 Street, 30-060 Krakow, Poland; (K.P.); (J.K.)
| | - Joanna Kłosowska
- Institute of Psychology, Jagiellonian University, Ingardena 6 Street, 30-060 Krakow, Poland; (K.P.); (J.K.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland;
| | - Agnieszka Samochowiec
- Institute of Psychology, Department of Clinical Psychology, University of Szczecin, 71-017 Szczecin, Poland;
| | - Edyta Pawlak
- Department of Experimental Therapy, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla Street 12, 53-114 Wroclaw, Poland;
| | - Elżbieta Szmida
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (E.S.); (P.S.)
| | - Paweł Skiba
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (E.S.); (P.S.)
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Medical College Jagiellonian University, Sikorskiego Place 2, 31-115 Krakow, Poland;
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Pasteur Street 10, 50-367 Wroclaw, Poland;
- Correspondence:
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21
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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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22
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Tseng HH, Chiu CD, Chen KC, Lee IH, Chen PS, Yang YK. Absence of negative associations of insular and medial frontal gray matter volume with dissociative symptoms in schizophrenia. J Psychiatr Res 2021; 138:485-491. [PMID: 33965737 DOI: 10.1016/j.jpsychires.2021.04.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dissociative symptoms have been constantly found in schizophrenia (SCZ). Traumatic experience seems to relate to dissociative symptoms and brain volume alterations in SCZ. The current study aimed to clarify the inter-relations of dissociative symptoms, traumatic experience, and brain volume in SCZ. METHODS We employed voxel-based morphometry to compare the distributions of gray matter volumes (GMV) in 37 SCZ patients and 26 healthy volunteers (HV). All participants underwent T1-weighted images on a 1.5 T MRI system. Traumatic experience was examined by the Brief Betrayal Trauma Survey. Pathological and non-pathological dissociation were measured by the Dissociative Symptoms Scale and the Dissociative Experiences Scale, respectively. RESULTS A GMV reduction was found in SCZ patients in the right thalamus. Importantly, a significant group by pathological dissociation interaction was observed in the medial frontal cortex (MFC), bilateral anterior insular area, and precuneus. A negative correlation between MFC/insular GMV and pathological dissociation was observed in HV; higher non-pathological dissociation and smaller volume in MFC/insula were associated with pathological dissociation. In contrast, higher traumatic experience, higher non-pathological dissociation, and larger volume in MFC/insula were associated with pathological dissociation in SCZ. CONCLUSION The negative association between MFC/insula GMV and pathological dissociation in HV was not observed in SCZ patients. The absent negative association in SCZ suggests a unique neural underpinning in SCZ with dissociative pathology, in which medial frontal and temporal regions play crucial roles.
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Affiliation(s)
- Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chui-De Chiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
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Rodriguez V, Aas M, Vorontsova N, Trotta G, Gadelrab R, Rooprai NK, Alameda L. Exploring the Interplay Between Adversity, Neurocognition, Social Cognition, and Functional Outcome in People With Psychosis: A Narrative Review. Front Psychiatry 2021; 12:596949. [PMID: 33762975 PMCID: PMC7982734 DOI: 10.3389/fpsyt.2021.596949] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
History of adversity is associated with subsequent psychosis, and with a spectrum of cognitive alterations in individuals with psychosis. These cognitive features go from neurocognitive aspects as working memory and attention, to complex social cognitive processes as theory of mind and emotional perception. Difficulties in these domains impact patients' social and occupational functioning, which has been shown to be more impaired in those previously exposed to childhood trauma. However, the interplay between adversity, neurocognition, and functioning is yet poorly understood. This narrative review aims to explore the evidence on whether deficits in neurocognitive and social cognitive domains may act as possible putative mechanism linking adversity with functioning in people with psychosis. We show available evidence supporting the link between adversity and poorer functioning in psychosis, especially in chronic stages; and replicated evidence suggesting associations of social cognition and, to a lesser extent, neurocognition with impairment in functioning in patients; although there is still an important gap in the literature testing particularly deficits in social cognition as mediator of the link between adversity and functional decline in psychosis. Targeting interventions focusing on neurocognition and social cognition in individuals with adversity and psychosis seems important, given the severe deterioration of these patients in these domains, although more research is needed to test whether such treatments can specifically improve functioning in individuals with psychosis and adversity. Literature aiming to understand the determinants of functional outcome should consider the pervasive impact of childhood adversity, and its related effects on cognition.
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Affiliation(s)
- Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NORMENT Centre for Psychosis Research, Oslo University Hospital, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Natasha Vorontsova
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Romayne Gadelrab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Navneet Kaur Rooprai
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
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24
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Pionke-Ubych R, Frydecka D, Cechnicki A, Nelson B, Gawęda Ł. The Indirect Effect of Trauma via Cognitive Biases and Self-Disturbances on Psychotic-Like Experiences. Front Psychiatry 2021; 12:611069. [PMID: 33854448 PMCID: PMC8039125 DOI: 10.3389/fpsyt.2021.611069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/08/2021] [Indexed: 12/29/2022] Open
Abstract
Although self-disturbances (SD) are considered to be a core psychopathological feature of schizophrenia spectrum disorders, there is still insufficient empirical data on the mechanisms underlying these anomalous self-experiences. The aim of the present study was to test a hypothesized model in which cognitive biases and exposure to traumatic life events are related to the frequency of SD which, in turn, contribute to the frequency of psychotic-like experiences (PLEs). Our sample consisted of 193 Polish young adults from the general population (111 females; 18-35 years of age, M = 25.36, SD = 4.69) who experience frequent PLEs. Participants were interviewed for PLEs, SD and social functioning as well as completed self-reported questionnaires and behavioral tasks that measure cognitive biases (e.g., safety behaviors, attention to threat, external attribution, jumping to conclusion, source monitoring, overperceptualization). The model was tested using path analysis with structural equation modeling. All of the hypothesized relationships were statistically significant and our model fit the data well [χ2(23) = 31.201; p = 0.118; RMSEA = 0.043 (90% CI = 0.00-0.078), CFI = 0.985, SRMR = 0.041, TLI = 0.976]. The results revealed a significant indirect effect of traumatic life events on PLEs through SD and self-reported cognitive biases. However, performance-based cognitive biases measured with three behavioral tasks were unrelated to SD and PLEs. The frequency of SD explained a substantial part (43.1%) of the variance in PLEs. Further studies with longitudinal designs and clinical samples are required to verify the predictive value of the model.
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Affiliation(s)
- Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, 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
| | - 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, Warsaw, Poland.,Medical University of Warsaw, Warsaw, Poland
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25
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Gawęda Ł, Pionke R, Hartmann J, Nelson B, Cechnicki A, Frydecka D. Toward a Complex Network of Risks for Psychosis: Combining Trauma, Cognitive Biases, Depression, and Psychotic-like Experiences on a Large Sample of Young Adults. Schizophr Bull 2020; 47:395-404. [PMID: 33728467 PMCID: PMC7965064 DOI: 10.1093/schbul/sbaa125] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although the linkage between traumatic life events and psychotic-like experiences (PLEs) is well established, the knowledge of potential mechanisms of this relationship is scarce. The aim of the present study was to better understand the structure of connections between traumatic life events and PLEs by considering at the same time the role of cognitive biases and depressive symptoms in the population of young adults (18-35 years of age, M = 26.52, SD = 4.74, n = 6772). Our study was conducted within a framework of network analysis. PLEs were measured with the Prodromal Questionnaire (PQ-16), cognitive biases were measured with nine items from the Davos Assessment of Cognitive Biases Scale-18 (DACOBS-18), depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale (CESD-R) and exposure to traumatic life events was measured with a combination of Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and Traumatic Experience Checklist (TEC). The results present a network of all nodes being interconnected within and between domains, with no isolated factors. Exposures to sexual trauma were the most central node in the network. Pathways were identified from trauma to PLEs via cognitive biases and depressive symptoms. However, the shortest pathway between the most central traumatic life event and PLEs was through other traumatic life events, without cognitive biases or depressive symptoms along the way. Our findings suggest the importance of environmental adversities as well as dysfunctional information processing and depression in the network of psychosis risks.
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Affiliation(s)
- Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,To whom correspondence should be addressed; Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378 Warsaw, Poland; tel: +48 (22) 583-13-80, fax: +48 (22) 583-13-81, e-mail:
| | - Renata Pionke
- Psychopathology and Early Interventions Lab, II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Jessica Hartmann
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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26
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Alameda L, Rodriguez V, Carr E, Aas M, Trotta G, Marino P, Vorontsova N, Herane-Vives A, Gadelrab R, Spinazzola E, Di Forti M, Morgan C, Murray RM. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychol Med 2020; 50:1966-1976. [PMID: 32744193 DOI: 10.1017/s0033291720002421] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as 'fair'. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.
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Affiliation(s)
- Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008Lausanne, Switzerland
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Spain
- Instituto de Investigacion Sanitaria de Sevilla, IBiS, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Marino
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Natasha Vorontsova
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrés Herane-Vives
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departamento de Clínicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Romayne Gadelrab
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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27
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Adverse childhood experiences and psychotic-like experiences are associated above and beyond shared correlates: Findings from the adolescent brain cognitive development study. Schizophr Res 2020; 222:235-242. [PMID: 32522466 PMCID: PMC7572890 DOI: 10.1016/j.schres.2020.05.045] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/17/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with increased risk for psychotic-like experiences (PLEs). However, ACEs and PLEs are also both associated with several shared factors (e.g., internalizing symptoms, suicidality). Few studies have explicitly examined whether the association between ACEs and PLEs remains over and above shared correlates. To address this question, using 10,800 9-11-year-olds, we examined whether ACEs and school-aged PLEs were associated when accounting for shared correlates, and whether there was evidence of mediation in associations between PLEs, ACEs, and these shared factors. Greater number of ACEs were associated with greater PLEs, including several specific ACEs (e.g., bullying). Importantly, ACEs and PLEs were related even when accounting for shared correlates. Further, PLEs partially mediated the relationships between ACEs and both internalizing symptoms and suicidality, including suicidal behavior. The current study helps clarify the nature of the associations between PLEs and ACE and has important clinical implications for addressing PLEs.
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28
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Catone G, Gritti A, Russo K, Santangelo P, Iuliano R, Bravaccio C, Pisano S. Details of the Contents of Paranoid Thoughts in Help-Seeking Adolescents with Psychotic-Like Experiences and Continuity with Bullying and Victimization: A Pilot Study. Behav Sci (Basel) 2020; 10:bs10080122. [PMID: 32751057 PMCID: PMC7463852 DOI: 10.3390/bs10080122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Psychosis recognizes an interaction between biological and social environmental factors. Adversities are now recognized to be consistently associated with psychotic-like experiences (PLEs). The purpose of this study was to describe the contents of paranoid symptoms and to focus on their relationship with bullying and victimization in help-seeking adolescents. Methods: Help-seeking adolescents who screened positive for PLEs participated in the study. They performed a battery self-report questionnaire for data collection (paranoia: the Specific Psychotic Experiences Questionnaire (SPEQ); the content of paranoid thoughts: the Details of Threat (DoT); bullying victimization: the Multidimensional Peer Victimization Scale (MPVS); depression: the Children's Depression Inventory (CDI); and anxiety: the Multidimensional Anxiety Scale (MASC)). Results: The participants were 50 adolescents (52% female; mean age: 170 months). The contents of their paranoid symptoms were related to victimization and, in particular, the certainty of threats was correlated with physical (0.394, p < 0.01) and verbal bullying (0.394, p < 0.01), respectively. The powerfulness of the threats correlated with verbal victimization (0.295, p < 0.05). The imminence of the threats was linked to verbal (0.399, p < 0.01) victimization. Hours under threat correlated with verbal (0.415, p < 0.01) victimization. The sureness of the threat had a moderate correlation with physical (0.359, p < 0.05) and verbal (0.443, p < 0.01) victimization, respectively. The awfulness of the threat was linked to social manipulation (0.325, p < 0.05). Conclusions: We described the content of the persecutory symptoms. The powerfulness, imminence, sureness, and awfulness of threats correlated with the level of physical, verbal and social manipulation victimization. Teachers and family must actively monitor early signs of bullying victimization, and school psychologists should promote preventive and therapeutic intervention. From a social psychiatry perspective, the prevention of bullying victimization is necessary.
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Affiliation(s)
- Gennaro Catone
- Department of Educational, Psychological and Communication Sciences, Suor Orsola Benincasa University, 80132 Naples, Italy; (A.G.); (K.R.)
- Correspondence:
| | - Antonella Gritti
- Department of Educational, Psychological and Communication Sciences, Suor Orsola Benincasa University, 80132 Naples, Italy; (A.G.); (K.R.)
| | - Katia Russo
- Department of Educational, Psychological and Communication Sciences, Suor Orsola Benincasa University, 80132 Naples, Italy; (A.G.); (K.R.)
| | - Pia Santangelo
- Department of Neuroscience and Rehabilitation, AORN Santobono-Pausilipon, 80129 Naples, Italy; (P.S.); (S.P.)
| | | | - Carmela Bravaccio
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, 80131 Naples, Italy;
| | - Simone Pisano
- Department of Neuroscience and Rehabilitation, AORN Santobono-Pausilipon, 80129 Naples, Italy; (P.S.); (S.P.)
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, 80131 Naples, Italy;
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Fernández-León S, Rodríguez-Testal JF, Gutiérrez-López ML, Senín-Calderón C. Interpersonal Violence and Psychotic-Like Experiences: The Mediation of Ideas of Reference, Childhood Memories, and Dissociation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4587. [PMID: 32630582 PMCID: PMC7345491 DOI: 10.3390/ijerph17124587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022]
Abstract
Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, and threat; Early Life Experiences Scale (ELES)), ideas of reference (IR), and dissociative symptoms (absorption and depersonalization), and whether the patient/nonpatient condition moderated this effect. The sample was made of 401 participants (including 43 patients with psychotic disorders) aged 18 to 71 years (Mage = 30.43; SD = 11.19). Analysis of a serial multiple mediator model revealed that IR, ELES, absorption, and depersonalization fully mediated the effect of IV on AS, explaining 39% of the variance, regardless of the patient/nonpatient condition. The indirect paths, which place IR and dissociation (especially absorption, the variable to which the IR and ELES lead) in a primordial position for being related to AS, are discussed. This continuum model could be useful for understanding processes related to the onset of psychosis unmoderated by the patient/nonpatient condition.
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Affiliation(s)
- Sandra Fernández-León
- Clinical Mental Health Management Unit, Hospital Juan Ramón Jiménez, 21005 Huelva, Spain;
| | - Juan F. Rodríguez-Testal
- Personality, Evaluation and Psychological Treatment Department, University of Seville, 41018 Seville, Spain
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Frydecka D, Misiak B, Kotowicz K, Pionke R, Krężołek M, Cechnicki A, Gawęda Ł. The interplay between childhood trauma, cognitive biases, and cannabis use on the risk of psychosis in nonclinical young adults in Poland. Eur Psychiatry 2020; 63:e35. [PMID: 32200775 PMCID: PMC7355126 DOI: 10.1192/j.eurpsy.2020.31] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background. Childhood traumatic events are risk factors for psychotic-like experiences (PLEs). However, the mechanisms explaining how trauma may contribute to the development of PLEs are not fully understood. In our study, we investigated whether cannabis use and cognitive biases mediate the relationship between early trauma and PLEs. Methods. A total sample of 6,772 young adults (age 26.6 ± 4.7, 2,181 male and 3,433 female) was recruited from the general population to participate in an online survey. We excluded 1,158 individuals due to a self-reported lifetime diagnosis of any mental disorder. The online survey included selected items from the following questionnaires: Traumatic Experience Checklist (TEC, 3 items), Childhood Experience of Care and Abuse Questionnaire (CECA.Q, 3 items), Cannabis Problems Questionnaire (CPQ, 10 items), Davos Assessment of Cognitive Biases Scale (DACOBS-18, 9 items), and Prodromal Questionnaire-16 (PQ-16). Mediation analyses were performed with respect to different categories of traumatic experiences (emotional, physical and sexual abuse as well as emotional neglect). Results. Our results showed significant associations of any time of childhood trauma with higher scores of cannabis use (CPQ), cognitive biases (DACOBS), and PLEs (PQ-16) (p < 0.001). We found a direct effect of childhood trauma on PLEs as well as significant indirect effect mediated through cannabis use and cognitive biases. All models tested for the effects of specific childhood adversities revealed similar results. The percentage of variance in PQ-16 scores explained by serial mediation models varied between 32.8 and 34.2% depending on childhood trauma category. Conclusion. Cannabis use and cognitive biases play an important mediating role in the relationship between childhood traumatic events and the development of PLEs in a nonclinical young adult population.
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Affiliation(s)
- Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
| | - Kamila Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Renata Pionke
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Martyna Krężołek
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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31
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Mętel D, Arciszewska A, Daren A, Pionke R, Cechnicki A, Frydecka D, Gawęda Ł. Mediating role of cognitive biases, resilience and depressive symptoms in the relationship between childhood trauma and psychotic-like experiences in young adults. Early Interv Psychiatry 2020; 14:87-96. [PMID: 31099186 DOI: 10.1111/eip.12829] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/28/2019] [Accepted: 04/14/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The present study aimed to test a hypothetical model where causally linked and ordered cognitive biases, resilience and depressive symptoms serve as mediators of the relationship between early traumatic life events and psychotic-like experiences (PLEs) in the general population of young adults. METHODS Two thousand six hundred and fourteen people (1673 females) took part in the online survey. Participants completed self-report questionnaires measuring exposure to early traumatic life events, PLEs, cognitive biases, resilience and depressive symptoms. Correlation and multiple mediation analyses were performed. RESULTS All three mediators turned out to be significantly correlated with early trauma, PLEs and with each other. Mediational analysis demonstrated that hypothesized model of causally linked mediators was significant (P ≤ .001) and accounted for 33% (P < .001) of the explained variance in PLEs in comparison to 11% (P ≤ .001) without mediators. CONCLUSIONS First, our results provide evidence for significant associations between early traumatic life events, cognitive biases, depressive symptoms, psychological resilience and PLEs. Second, they indicate significant indirect effects of early trauma exposure on PLEs through a path consisted of cognitive biases, psychological resilience and depressive symptoms that suggest a possible importance of interventions bolstering resilience in young people in order to minimize the severity of depressive and psychotic psychopathology.
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Affiliation(s)
- Dagmara Mętel
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | | | - Artur Daren
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | - Renata Pionke
- Psychopathology & Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Łukasz Gawęda
- Psychopathology & Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
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32
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Anglin DM, Lui F, Schneider M, Ellman LM. Changes in perceived neighborhood ethnic density among racial and ethnic minorities over time and psychotic-like experiences. Schizophr Res 2020; 216:330-338. [PMID: 31822432 PMCID: PMC7374710 DOI: 10.1016/j.schres.2019.11.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/02/2019] [Accepted: 11/22/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Research primarily conducted in Europe find high neighborhood ethnic density (i.e., proportion of own ethnic group) lessens risk of psychotic symptoms among racial and ethnic minorities; however, most studies measure ethnic density through crude demarcations in geographic data only at illness onset which may miss meaningful variation from the perspective of residents. The present study is the first in the U.S. to examine whether changes in perceived ethnic density from childhood are associated with psychotic-like experiences (PLE). METHODS A Northeastern U.S. urban undergraduate sample of 1330 racial and ethnic minorities completed a self-report inventory of PLE, the Prodromal Questionnaire, and indicated their racial and ethnic neighborhood composition before and after age 12. One way analyses of covariance (ANCOVA) adjusted for age, family poverty, racial and ethnic group, immigrant status, and lifetime cannabis use, compared PLE across ethnic density categories and change. RESULTS Racial and ethnic minorities who grew up in a neighborhood (before age 12) predominantly inhabited by a different group of color (e.g., being Black in a predominantly Asian neighborhood) endorsed significantly more PLE than those who grew up in racially concordant, mixed, or predominantly White neighborhoods. In addition, those reporting a change in perceived neighborhood ethnic density after age 12 endorsed significantly more PLE than those reporting no change. CONCLUSION Racial dynamics among people of color in urban neighborhood U.S. contexts may create psychological challenges in the social environment. The developmental timing of demographic changes in neighborhoods may influence stress processes that enhance risk for PLE.
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Affiliation(s)
- Deidre M. Anglin
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031,The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016
| | - Florence Lui
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031,The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016
| | - Matthew Schneider
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031,The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016
| | - Lauren M. Ellman
- Department of Psychology, Temple University, 1801 N. Broad Street, Philadelphia, PA 19122
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Abstract
Childhood trauma has been shown to have detrimental consequences on mental health. It is unknown what impact childhood trauma may have on the early trajectory of serious mental illness (SMI). The purpose of this article is to estimate the baseline prevalence, perceived impact, and duration of trauma that occurred before the age of 18 years in youth at risk for SMI using a transdiagnostic approach. This study included 243 youths, ages 12 to 25 years (42 healthy controls, 43 non-help-seeking individuals [stage 0], 52 help-seeking youth experiencing distress and possibly mild symptoms of anxiety or depression [stage1a], and 108 youth demonstrating attenuated symptoms of an SMI such as bipolar disorder or psychosis [stage 1b]). Participants completed an adapted version of the Childhood Trauma and Abuse scale. There were high frequencies of reported trauma across all stages. Symptomatic individuals experienced more trauma and bullying. Stage 1b individuals reported more physical abuse. Stage 1b also indicated psychological bullying to have a longer duration and impact on their lives. Future work should aim to clarify the complex interrelations between trauma and risk of SMI.
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Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
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Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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Ered A, Ellman LM. Specificity of Childhood Trauma Type and Attenuated Positive Symptoms in a Non-Clinical Sample. J Clin Med 2019; 8:jcm8101537. [PMID: 31557792 PMCID: PMC6832238 DOI: 10.3390/jcm8101537] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/15/2019] [Accepted: 09/19/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Childhood traumatic experiences have been consistently associated with psychosis risk; however, the specificity of childhood trauma type to interview-based attenuated positive psychotic symptoms has not been adequately explored. Further, previous studies examining specificity of trauma to specific positive symptoms have not accounted for co-occurring trauma types, despite evidence of multiple victimization. METHODS We examined the relationship between childhood trauma (Childhood Trauma Questionnaire) with type of attenuated positive symptom, as measured by the Structured Interview for Psychosis-risk Syndromes (SIPS) among a non-clinical, young adult sample (n = 130). Linear regressions were conducted to predict each attenuated positive symptom, with all trauma types entered into the model to control for co-occurring traumas. RESULTS Results indicated that childhood sexual abuse was significantly associated with disorganized communication and childhood emotional neglect was significantly associated with increased suspiciousness/persecutory ideas, above and beyond the effect of other co-occurring traumas. These relationships were significant even after removing individuals at clinical high-risk (CHR) for psychosis (n = 14). CONCLUSIONS Our results suggest that there are differential influences of trauma type on specific positive symptom domains, even in a non-clinical sample. Our results also confirm the importance of controlling for co-occurring trauma types, as results differ when not controlling for multiple traumas.
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Affiliation(s)
- Arielle Ered
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
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León-Palacios MDG, Garrido-Fernández M, Senín-Calderón C, Perona-Garcelán S, Rodríguez-Testal JF. Aberrant salience and fatigue as mediators between early life experiences and ideas of reference. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2019. [DOI: 10.1080/17522439.2019.1650816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | - Miguel Garrido-Fernández
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain
| | | | - Salvador Perona-Garcelán
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain
- Virgen del Rocío Outpatient Mental Hospital, University Hospital Virgen del Rocío, Seville, Spain
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Comparing the Role of Aberrant Salience and Dissociation in the Relation between Cumulative Traumatic Life Events and Psychotic-Like Experiences in a Multi-Ethnic Sample. J Clin Med 2019; 8:jcm8081223. [PMID: 31443188 PMCID: PMC6722767 DOI: 10.3390/jcm8081223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 12/16/2022] Open
Abstract
Exposure to traumatic life events (TLE) is a risk factor for psychosis. Yet, a dearth of studies examines factors linking TLE to psychosis, while considering differences in TLE frequency. This study investigated dissociation and aberrant salience as mediators and moderators of the relation between three TLE groups (none, 1–3 TLE and 4+ TLE) and psychotic-like experiences (PLE) in a multi-ethnic sample of 816 emerging adults. The participants completed self-report inventories of PLE (Prodromal Questionnaire), TLE (Life Events Checklist), dissociative experiences (Dissociative Symptoms Scale), and aberrant salience (Aberrant Salience Inventory). As expected, groups with higher TLE frequency endorsed higher PLE. Parallel mediation models indicated that, while aberrant salience mediated the relation between both levels of cumulative traumatic experiences (1–3 TLE and 4+ TLE) and PLE, dissociation only mediated the relation between exposure to at least four different traumatic experiences and PLE. The moderation results showed that risk of PLE was highest among individuals with 1–3 TLE who endorsed dissociation. Our results suggest that, while aberrant salience processing explains why TLE may relate to higher psychosis risk, dissociation’s role in this relation is dependent on the number of different TLE exposures.
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Resilience and cognitive biases mediate the relationship between early exposure to traumatic life events and depressive symptoms in young adults. J Affect Disord 2019; 254:26-33. [PMID: 31082628 DOI: 10.1016/j.jad.2019.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/18/2019] [Accepted: 05/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early trauma is an important risk factor for depression. However, little is known about the mechanisms of how traumatic life events shape the risk of depression. The present study focused on the mediating role of cognitive biases and mental resilience between early trauma and depressive symptoms in young men and women. METHODS 2218 non-clinical young adults completed an online Computer Assisted Web Interview (CAWI). It comprised selected items from several questionnaires including: a short version of the Center for Epidemiological Studies-Depression (CES-D, five items) questionnaire, the Traumatic Experience Checklist (TEC, three items) and the Childhood Experience of Care and Abuse Questionnaire (CECA.Q, three items), a short version (nine items) of Davos Assessment of Cognitive Biases Scale (DACOBS-18), the abridged version of the Connor-Davidson Resilience Scale (CD-RISC-10). Parallel mediation analyses were performed. The role of gender was considered. RESULTS A significant standardized indirect effect of childhood trauma on depressive symptoms through cognitive biases and resilience was found in the total sample. A standardized direct effect of childhood traumatic life events on depressive symptoms remained also significant, meaning that mediation is complementary. An analysis by gender showed similar results for women and men. LIMITATIONS Sample was limited to non-clinical young adults. The questionnaires were shortened, and items were selected arbitrarily due to the nature of the study (online screening). The data may include biases resulting from the use of self-report scales. CONCLUSIONS Cognitive biases and resilience are important, but not exclusive, mechanisms of the relationship between early trauma and depressive symptoms.
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