1
|
Hu H, Chen C, Xu B, Wang D. Moderating and mediating effects of resilience between childhood trauma and psychotic-like experiences among college students. BMC Psychiatry 2024; 24:273. [PMID: 38609907 PMCID: PMC11010362 DOI: 10.1186/s12888-024-05719-x] [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: 07/19/2023] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Extensive literature revealed that childhood trauma serves as a significant risk factor for developing psychotic-like experiences (PLEs) among the general population. Resilience has been regarded as a protective factor against PLEs. However, it remains unclear what role resilience plays in the relationship between childhood trauma and PLEs. METHODS A total of 4302 college students completed the web-based survey in January 2021. Participants completed self-report measures of sample characteristics variables, childhood trauma, and PLEs. Moderation and mediation analyses were adopted to examine the associations linking childhood trauma, resilience, and PLEs. RESULTS PLEs were positively associated with childhood trauma while negatively associated with resilience. Resilience played a partially mediating role in the relationship between childhood trauma and PLEs. Additionally, resilience moderated the association of childhood trauma with PLEs. CONCLUSIONS These findings indicated that resilience plays a crucial role in mediating the relationship between childhood trauma and PLEs, suggesting the potential clinical implication of enhancing resilience for the prevention and intervention of PLEs among college students.
Collapse
Affiliation(s)
- Heqiong Hu
- School of New Media Technology, Hunan Mass Media Vocational and Technical College, Changsha, China
- Hunan Academy of Education Sciences, Changsha, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Bingna Xu
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, 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, China.
| |
Collapse
|
2
|
Thomas M, Rakesh D, Whittle S, Sheridan M, Upthegrove R, Cropley V. The neural, stress hormone and inflammatory correlates of childhood deprivation and threat in psychosis: A systematic review. Psychoneuroendocrinology 2023; 157:106371. [PMID: 37651860 DOI: 10.1016/j.psyneuen.2023.106371] [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: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
Childhood adversity increases the risk of developing psychosis, but the biological mechanisms involved are unknown. Disaggregating early adverse experiences into core dimensions of deprivation and threat may help to elucidate these mechanisms. We therefore systematically searched the literature investigating associations between deprivation and threat, and neural, immune and stress hormone systems in individuals on the psychosis spectrum. Our search yielded 74 articles, from which we extracted and synthesized relevant findings. While study designs were heterogeneous and findings inconsistent, some trends emerged. In psychosis, deprivation tended to correlate with lower global cortical volume, and some evidence supported threat-related variation in prefrontal cortex morphology. Greater threat exposure was also associated with higher C-reactive protein, and higher and lower cortisol measures. When examined, associations in controls were less evident. Overall, findings indicate that deprivation and threat may associate with partially distinct biological mechanisms in the psychosis spectrum, and that associations may be stronger than in controls. Dimensional approaches may help disentangle the biological correlates of childhood adversity in psychosis, but more studies are needed.
Collapse
Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia.
| | - Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia; Neuroimaging Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| | - Margaret Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, United States
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, United Kingdom; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| |
Collapse
|
3
|
Zahra Rami F, Kim WS, Shen J, Tsogt U, Odkhuu S, Cheraghi S, Kang C, Chung YC. Differential effects of parental socioeconomic status on cortical thickness in patients with schizophrenia spectrum disorders and healthy controls. Neurosci Lett 2023; 804:137239. [PMID: 37031942 DOI: 10.1016/j.neulet.2023.137239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/06/2023] [Accepted: 04/06/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES Widespread changes in cortical thickness (CT) have been repeatedly reported in schizophrenia (SZ). The nature of the pathophysiologic process underlying such changes remains to be elucidated. The aims of the present study were to measure the CT; evaluate parent socioeconomic status (pSES), childhood trauma (ChT) and premorbid adjustment (PA) in patients with schizophrenia spectrum disorders (SSDs); and investigate group differences in CT (i.e., SSD vs. healthy controls (HCs)), pSES, PA, and/or ChT, as well as the interactions among these factors. METHODS 164 patients with SSD and 245 age-, sex- and education-matched healthy controls have participated. The pSES, ChT and PA were evaluated using Korean version of Polyenvironmental Risk Score, Early Trauma Inventory Self Report-Short Form and Premorbid Adjustment Scale, respectively. Vertex-wise measure of CT was estimated using the FreeSurfer. To investigate the main effects and interactions, multilevel regression was employed. RESULTS We found widespread cortical thinning in patients with SSDs compared to HCs. The cortical thinning was associated with ChT, symptom severity and chlorpromazine equivalent dose and duration of illness in patients. In multilevel regression, main effects of group and pSES and interaction between group and pSES were found whereas a significant interaction between ChT and CPZ equivalent was found in patients. CONCLUSION Our findings indicate that compared to HCs, patients with SSDs have cortical structural abnormalities, and that group and pSES interaction determines CT. Further studies are needed to explore the effects of psychosocial factors on brain structural and functional abnormalities in SZ.
Collapse
Affiliation(s)
- Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Woo-Sung Kim
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jie Shen
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Uyanga Tsogt
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Soyolsaikhan Odkhuu
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sahar Cheraghi
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Chaeyeong Kang
- Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
| |
Collapse
|
4
|
Traumatic stress load and stressor reactivity score associated with accelerated gray matter maturation in youths indexed by normative models. Mol Psychiatry 2023; 28:1137-1145. [PMID: 36575305 DOI: 10.1038/s41380-022-01908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022]
Abstract
Understanding how traumatic stress affects typical brain development during adolescence is critical to elucidate underlying mechanisms related to both maladaptive functioning and resilience after traumatic exposures. The current study aimed to map deviations from normative ranges of brain gray matter for youths with traumatic exposures. For each cortical and subcortical gray matter region, normative percentiles of variations were established using structural MRI from typically developing youths without any traumatic exposure (n = 245; age range = 8-23) from the Philadelphia Neurodevelopmental Cohort (PNC). The remaining PNC participants with neuroimaging data (n = 1129) were classified as either within the normative range (5-95%), delayed (>95%) or accelerated (<5%) maturational ranges for each region using the normative model. An averaged quantile regression index was calculated across all regions. Mediation models revealed that high traumatic stress load was positively associated with poorer cognitive functioning and greater psychopathology, and these associations were mediated by accelerated gray matter maturation. Furthermore, higher stressor reactivity scores, which represent a less resilient response under traumatic stress, were positively correlated with greater acceleration of gray matter maturation (r = 0.224, 95% CI = [0.17, 0.28], p < 0.001), suggesting that more accelerated maturation was linked to greater stressor response regardless of traumatic stress load. We conclude that traumatic stress is a source of deviation from normative brain development associated with poorer cognitive functioning and more psychopathology in the long run.
Collapse
|
5
|
Choung Y, Pak TY. More than just a bad day? Traumatic life events and self-control in old age. PLoS One 2023; 18:e0266312. [PMID: 36753499 PMCID: PMC9907851 DOI: 10.1371/journal.pone.0266312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
The behavioral economics literature suggests that exposure to traumatic events shifts preference features including risk aversion and time preference. In this study, we examined the association between traumatic life events and self-control in old age. Data were obtained from the Health and Retirement Study, which offers retrospective data on trauma exposure and early life characteristics. The results showed that experiences of serious physical attacks or assaults is associated with a 3.1% reduction in self-control, adjusted for demographic and childhood socioeconomic characteristics. The attacks or assaults were experienced approximately 30 years prior to the survey, indicating that traumatic life events exert a lasting influence on self-control. Further analyses found no difference in the association between the experience of serious physical attacks or assaults and self-control according to the timing of occurrence. Our findings are consistent with the evidence that experiences of natural disasters or armed conflicts increase impatience among survivors.
Collapse
Affiliation(s)
- Youngjoo Choung
- Department of Consumer Science, Inha University, Incheon, Republic of Korea
| | - Tae-Young Pak
- Department of Consumer Science and Convergence Program for Social Innovation, Sungkyunkwan University, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
6
|
High levels of childhood trauma associated with changes in hippocampal functional activity and connectivity in young adults during novelty salience. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01564-3. [PMID: 36738332 PMCID: PMC10359215 DOI: 10.1007/s00406-023-01564-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
Childhood trauma (CT) has been linked to increased risk for psychosis. Moreover, CT has been linked to psychosis phenotypes such as impaired cognitive and sensory functions involved in the detection of novel sensory stimuli. Our objective was to investigate if CT was associated with changes in hippocampal and superior temporal gyrus functional activation and connectivity during a novelty detection task. Fifty-eight young adults were assigned to High-CT (n = 28) and Low-CT (n = 24) groups based on their scores on the childhood trauma questionnaire (CTQ) and underwent functional Magnetic Resonance Imaging during an auditory oddball task (AOT). Relative to the Low CT group, High CT participants showed reduced functional activation in the left hippocampus during the unpredictable tone condition of the AOT. Furthermore, in the High CT group, psychophysiological interaction analysis revealed hypoconnectivity between the hippocampus and temporal and medial regions. The present study indicates both altered hippocampal activation and hippocampal-temporal-prefrontal connectivity during novelty detection in individuals that experienced CT, similarly to that reported in psychosis risk populations. Early stressful experiences and environments may alter hippocampal function during salient events, mediating the relationship between childhood trauma and psychosis risk.
Collapse
|
7
|
Begemann MJH, Schutte MJL, van Dellen E, Abramovic L, Boks MP, van Haren NEM, Mandl RCW, Vinkers CH, Bohlken MM, Sommer IEC. Childhood trauma is associated with reduced frontal gray matter volume: a large transdiagnostic structural MRI study. Psychol Med 2023; 53:741-749. [PMID: 34078485 PMCID: PMC9975993 DOI: 10.1017/s0033291721002087] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood trauma increases risk for psychopathology and cognitive impairment. Prior research mainly focused on the hippocampus and amygdala in single diagnostic categories. However, other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis. This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. METHODS We included 554 participants: 250 bipolar-I patients, 84 schizophrenia-spectrum patients and 220 healthy individuals without a psychiatric history. Participants filled in the Childhood Trauma Questionnaire. Anatomical T1 MRI scans were acquired at 3T, regional brain morphology was assessed using Freesurfer. RESULTS In the total sample, trauma-related gray matter reductions were found in the frontal lobe (β = -0.049, p = 0.008; q = 0.048), this effect was driven by the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region. No trauma-related volume reductions were observed in any other (sub)cortical lobes nor the hippocampus or amygdala, trauma-by-group (i.e. both patient groups and healthy subjects) interaction effects were absent. A categorical approach confirmed a pattern of more pronounced frontal gray matter reductions in individuals reporting multiple forms of trauma and across quartiles of cumulative trauma scores. Similar dose-response patterns were revealed within the bipolar and healthy subgroups, but did not reach significance in schizophrenia-spectrum patients. CONCLUSIONS Findings show that childhood trauma is linked to frontal gray matter reductions, independent of psychiatric morbidity. Our results indicate that childhood trauma importantly contributes to the neurobiological changes commonly observed across psychiatric disorders. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals.
Collapse
Affiliation(s)
- Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Maya J. L. Schutte
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marco P. Boks
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Neeltje E. M. van Haren
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Rene C. W. Mandl
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Christiaan H. Vinkers
- Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
| | - Marc M. Bohlken
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
8
|
Structural and Functional Deviations of the Hippocampus in Schizophrenia and Schizophrenia Animal Models. Int J Mol Sci 2022; 23:ijms23105482. [PMID: 35628292 PMCID: PMC9143100 DOI: 10.3390/ijms23105482] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia is a grave neuropsychiatric disease which frequently onsets between the end of adolescence and the beginning of adulthood. It is characterized by a variety of neuropsychiatric abnormalities which are categorized into positive, negative and cognitive symptoms. Most therapeutical strategies address the positive symptoms by antagonizing D2-dopamine-receptors (DR). However, negative and cognitive symptoms persist and highly impair the life quality of patients due to their disabling effects. Interestingly, hippocampal deviations are a hallmark of schizophrenia and can be observed in early as well as advanced phases of the disease progression. These alterations are commonly accompanied by a rise in neuronal activity. Therefore, hippocampal formation plays an important role in the manifestation of schizophrenia. Furthermore, studies with animal models revealed a link between environmental risk factors and morphological as well as electrophysiological abnormalities in the hippocampus. Here, we review recent findings on structural and functional hippocampal abnormalities in schizophrenic patients and in schizophrenia animal models, and we give an overview on current experimental approaches that especially target the hippocampus. A better understanding of hippocampal aberrations in schizophrenia might clarify their impact on the manifestation and on the outcome of this severe disease.
Collapse
|
9
|
Nogovitsyn N, Addington J, Souza R, Placsko TJ, Stowkowy J, Wang J, Goldstein BI, Bray S, Lebel C, Taylor VH, Kennedy SH, MacQueen G. Childhood trauma and amygdala nuclei volumes in youth at risk for mental illness. Psychol Med 2022; 52:1192-1199. [PMID: 32940197 DOI: 10.1017/s0033291720003177] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adults with significant childhood trauma and/or serious mental illness may exhibit persistent structural brain changes within limbic structures, including the amygdala. Little is known about the structure of the amygdala prior to the onset of SMI, despite the relatively high prevalence of trauma in at-risk youth. METHODS Data were gathered from the Canadian Psychiatric Risk and Outcome study. A total of 182 youth with a mean age of 18.3 years completed T1-weighted MRI scans along with clinical assessments that included questionnaires on symptoms of depression and anxiety. Participants also completed the Childhood Trauma and Abuse Scale. We used a novel subfield-specific amygdala segmentation workflow as a part of FreeSurfer 6.0 to examine amygdala structure. RESULTS Participants with higher trauma scores were more likely to have smaller amygdala volumes, particularly within the basal regions. Among various types of childhood trauma, sexual and physical abuse had the largest effects on amygdala subregions. Abuse-related differences in the right basal region mediated the severity of depression and anxiety symptoms, even though no participants met criteria for clinical diagnosis at the time of assessment. CONCLUSION The experience of physical or sexual abuse may leave detectable structural alterations in key regions of the amygdala, potentially mediating the risk of psychopathology in trauma-exposed youth.
Collapse
Affiliation(s)
- Nikita Nogovitsyn
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Roberto Souza
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Thea J Placsko
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jacqueline Stowkowy
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - JianLi Wang
- Work & Mental health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Signe Bray
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Valerie H Taylor
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada
- Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
10
|
Abstract
Early-life adverse events or childhood adversities (CAs) are stressors and harmful experiences severely impacting on a child's wellbeing and development. Examples of CAs include parental neglect, emotional and physical abuse and bullying. Even though the prevalence of CAs and their psychological effects in both healthy and psychiatric populations is established, only a paucity of studies have investigated the neurobiological firms associated with CAs in bipolar disorder (BD). In particular, the exact neural mechanisms and trajectories of biopsychosocial models integrating both environmental and genetic effects are still debated. Considering the potential impact of CAs on BD, including its clinical manifestations, we reviewed existing literature discussing the association between CAs and brain alterations in BD patients. Results showed that CAs are associated with volume alterations of several grey matter regions including the hippocampus, thalamus, amygdala and frontal cortex. A handful of studies suggest the presence of alterations in the corpus callosum and the pre-fronto-limbic connectivity at rest. Alterations in these regions of the brain of patients with BD are possibly due to the effect of stress produced by CAs, being hippocampus part of the hypothalamus-pituitary-adrenal axis and thalamus together with amygdala filtering sensory information and regulating emotional responses. However, results are mixed possibly due to the heterogeneity of methods and study design. Future neuroimaging studies disentangling between different types of CAs or differentiating between BD sub-types are needed in order to understand the link between CAs and BD.
Collapse
|
11
|
Murphy F, Nasa A, Cullinane D, Raajakesary K, Gazzaz A, Sooknarine V, Haines M, Roman E, Kelly L, O'Neill A, Cannon M, Roddy DW. Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis. Front Psychiatry 2022; 13:748372. [PMID: 35599780 PMCID: PMC9120425 DOI: 10.3389/fpsyt.2022.748372] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Studies of early life stress (ELS) demonstrate the long-lasting effects of acute and chronic stress on developmental trajectories. Such experiences can become biologically consolidated, creating individual vulnerability to psychological and psychiatric issues later in life. The hippocampus, amygdala, and the medial prefrontal cortex are all important limbic structures involved in the processes that undermine mental health. Hyperarousal of the sympathetic nervous system with sustained allostatic load along the Hypothalamic Pituitary Adrenal (HPA) axis and its connections has been theorized as the basis for adult psychopathology following early childhood trauma. In this review we synthesize current understandings and hypotheses concerning the neurobiological link between childhood trauma, the HPA axis, and adult psychiatric illness. We examine the mechanisms at play in the brain of the developing child and discuss how adverse environmental stimuli may become biologically incorporated into the structure and function of the adult brain via a discussion of the neurosequential model of development, sensitive periods and plasticity. The HPA connections and brain areas implicated in ELS and psychopathology are also explored. In a targeted review of HPA activation in mood and psychotic disorders, cortisol is generally elevated across mood and psychotic disorders. However, in bipolar disorder and psychosis patients with previous early life stress, blunted cortisol responses are found to awakening, psychological stressors and physiological manipulation compared to patients without previous early life stress. These attenuated responses occur in bipolar and psychosis patients on a background of increased cortisol turnover. Although cortisol measures are generally raised in depression, the evidence for a different HPA activation profile in those with early life stress is inconclusive. Further research is needed to explore the stress responses commonalities between bipolar disorder and psychosis in those patients with early life stress.
Collapse
Affiliation(s)
- Felim Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anurag Nasa
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - Kesidha Raajakesary
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Areej Gazzaz
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Vitallia Sooknarine
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Madeline Haines
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Elena Roman
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Linda Kelly
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aisling O'Neill
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Darren William Roddy
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
12
|
Juckel G, Mavrogiorgou P. [Traumatization and Schizophrenic Disorders - A Multidimensional View]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:512-522. [PMID: 34388829 DOI: 10.1055/a-1535-1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Prevalence of traumatizing of patients with schizophrenia is higher as in the normal community. Meta analyses show significant relationships between traumatic experiences in childhood and psychotic disorders. Patients with schizophrenia as well as those with posttraumatic stress disorder (PTSD) are characterized by brain morphological changes (mygdala und Hippocampus). In these two patient groups, neuroendocrinological disturbances (cortisol und α-amylase) as well as a worse clinical outcome could be additionally found. In the psychodynamic theoretical discussion, there are only few approaches concerning trauma and psychosis. Specifically here, the name of Frieda Fromm-Reichmann should be noted, who already pointed out the great meaning of child traumatization (especially physical and sexual abuse) for the later manifestation of schizophrenia. She also developed first principles of analytic psychosis therapy with the working on the deep life anxiety caused by the trauma in the here and now of the transference situation. It is assumed that schizophrenic disorders and PTSD have to be understood as trauma consequence diseases, which occur in comorbidty in a so far unknown extent.
Collapse
Affiliation(s)
- Georg Juckel
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr-Universität Bochum
| | - Paraskevi Mavrogiorgou
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr-Universität Bochum
| |
Collapse
|
13
|
Misiak B, Pruessner M, Samochowiec J, Wiśniewski M, Reginia A, Stańczykiewicz B. A meta-analysis of blood and salivary cortisol levels in first-episode psychosis and high-risk individuals. Front Neuroendocrinol 2021; 62:100930. [PMID: 34171354 DOI: 10.1016/j.yfrne.2021.100930] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 11/18/2022]
Abstract
Dysregulated cortisol responses and glucose metabolism have been reported in psychosis. We performed a random-effects meta-analysis of cortisol responses in first-episode psychosis (FEP) and psychosis risk states, taking into consideration glucose metabolism. A total of 47 studies were included. Unstimulated blood cortisol levels were significantly higher (g = 0.48, 95 %CI: 0.25-0.70, p < 0.001) in FEP, but not in psychosis risk states (g = 0.39, 95 %CI: -0.42-1.21, p = 0.342), compared to controls. Cortisol awakening response (CAR) was attenuated in FEP (g = -0.40, 95 %CI: -0.68 - -0.12, p = 0.006), but not in psychosis risk states (p = 0.433). Glucose and insulin levels were positively correlated with unstimulated blood cortisol levels in FEP. Our meta-analysis supports previous findings of elevated blood cortisol levels and attenuated CAR in FEP. Future research should focus on identifying the common denominators for alterations in stress hormones and glucose metabolism.
Collapse
Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland.
| | - Marita Pruessner
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada; Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland
| | | | - Artur Reginia
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland
| | - Bartłomiej Stańczykiewicz
- Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland
| |
Collapse
|
14
|
Rokita KI, Holleran L, Dauvermann MR, Mothersill D, Holland J, Costello L, Kane R, McKernan D, Morris DW, Kelly JP, Corvin A, Hallahan B, McDonald C, Donohoe G. Childhood trauma, brain structure and emotion recognition in patients with schizophrenia and healthy participants. Soc Cogn Affect Neurosci 2021; 15:1336-1350. [PMID: 33245126 PMCID: PMC7759212 DOI: 10.1093/scan/nsaa160] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/25/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022] Open
Abstract
Childhood trauma, and in particular physical neglect, has been repeatedly associated with lower performance on measures of social cognition (e.g. emotion recognition tasks) in both psychiatric and non-clinical populations. The neural mechanisms underpinning this association have remained unclear. Here, we investigated whether volumetric changes in three stress-sensitive regions—the amygdala, hippocampus and anterior cingulate cortex (ACC)—mediate the association between childhood trauma and emotion recognition in a healthy participant sample (N = 112) and a clinical sample of patients with schizophrenia (N = 46). Direct effects of childhood trauma, specifically physical neglect, on Emotion Recognition Task were observed in the whole sample. In healthy participants, reduced total and left ACC volumes were observed to fully mediate the association between both physical neglect and total childhood trauma score, and emotion recognition. No mediating effects of the hippocampus and amygdala volumes were observed for either group. These results suggest that reduced ACC volume may represent part of the mechanism by which early life adversity results in poorer social cognitive function. Confirmation of the causal basis of this association would highlight the importance of resilience-building interventions to mitigate the detrimental effects of childhood trauma on brain structure and function.
Collapse
Affiliation(s)
- Karolina I Rokita
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Laurena Holleran
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, MIT, Cambridge, MA 02135, USA
| | - David Mothersill
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,School of Business, National College of Ireland, Dublin, Ireland
| | - Jessica Holland
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Laura Costello
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Ruán Kane
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Declan McKernan
- Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Aiden Corvin
- Department of Psychiatry, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Gary Donohoe
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
15
|
Quidé Y, Bortolasci CC, Spolding B, Kidnapillai S, Watkeys OJ, Cohen-Woods S, Carr VJ, Berk M, Walder K, Green MJ. Systemic inflammation and grey matter volume in schizophrenia and bipolar disorder: Moderation by childhood trauma severity. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110013. [PMID: 32540496 DOI: 10.1016/j.pnpbp.2020.110013] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Elevated levels of systemic inflammation are consistently reported in both schizophrenia (SZ) and bipolar-I disorder (BD), and are associated with childhood trauma exposure. We tested whether childhood trauma exposure moderates associations between systemic inflammation and brain morphology in people with these diagnoses. METHODS Participants were 55 SZ cases, 52 BD cases and 59 healthy controls (HC) who underwent magnetic resonance imaging. Systemic inflammation was measured using a composite z-score derived from serum concentrations of interleukin 6, tumor necrosis factor alpha and C-reactive protein. Indices of grey matter volume covariation (GMC) were derived from independent component analysis. Childhood trauma was measured using the Childhood Trauma Questionnaire (CTQ Total score). RESULTS A series of moderated moderation analyses indicated that increased systemic inflammation were associated with increased GMC in the striatum and cerebellum among all participants. Severity of childhood trauma exposure moderated the relationship between systemic inflammation and GMC in one component, differently among the groups. Specifically, decreased GMC in the PCC/precuneus, parietal lobule and postcentral gyrus, and increased GMC in the left middle temporal gyrus was associated with increased systemic inflammation in HC individuals exposed to high (but not low or average) levels of trauma and in SZ cases exposed to low (but not average or high) levels of trauma, but not in BD cases. CONCLUSIONS Increased systemic inflammation is associated with grey matter changes in people with psychosis, and these relationships may be partially and differentially moderated by childhood trauma exposure according to diagnosis.
Collapse
Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Chiara C Bortolasci
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Briana Spolding
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Srisaiyini Kidnapillai
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Oliver J Watkeys
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | - Sarah Cohen-Woods
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia; Flinders Centre for Innovation in Cancer, Adelaide, SA, Australia; Órama Institute, College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Michael Berk
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia; Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Ken Walder
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia; Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| |
Collapse
|
16
|
Vila-Badia R, Butjosa A, Del Cacho N, Serra-Arumí C, Esteban-Sanjusto M, Ochoa S, Usall J. Types, prevalence and gender differences of childhood trauma in first-episode psychosis. What is the evidence that childhood trauma is related to symptoms and functional outcomes in first episode psychosis? A systematic review. Schizophr Res 2021; 228:159-179. [PMID: 33434728 DOI: 10.1016/j.schres.2020.11.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 11/24/2022]
Abstract
This paper reviews and discusses the literature on childhood trauma (CT) in people with first-episode psychosis (FEP). The aim is to update the knowledge on the prevalence and the types of CT suffered by FEP people, to compare them with other samples, to study the impact of gender, and to examine the relationship between CT and symptoms and functional outcomes. We conducted a literature search (1995-2019), to identify reported data on any topic related to CT in FEP samples. The following terms were used in the search: CT or sexual abuse or physical abuse or neglect, and first-episode psychosis. We found 493 studies, of which 68 were included in the review. FEP presented a higher prevalence of CT than controls. Women suffer more sexual abuse. The effect of CT on the severity, the prognosis and the evolution of FEP is unclear. FEP have a high prevalence of CT. Its relationship with symptoms and functional outcomes indicates its importance within treatment. This suggests the importance of creating and implementing specific interventions and personalized therapies addressed to work through their past traumatic experiences to improve their quality of live and their prognosis.
Collapse
Affiliation(s)
- Regina Vila-Badia
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain.
| | - Anna Butjosa
- Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, CIBERSAM, Barcelona, Spain
| | - Núria Del Cacho
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Clara Serra-Arumí
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Marina Esteban-Sanjusto
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| |
Collapse
|
17
|
Hou J, Schmitt S, Meller T, Falkenberg I, Chen J, Wang J, Zhao X, Shi J, Nenadić I. Cortical Complexity in People at Ultra-High-Risk for Psychosis Moderated by Childhood Trauma. Front Psychiatry 2020; 11:594466. [PMID: 33244301 PMCID: PMC7685197 DOI: 10.3389/fpsyt.2020.594466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Subjects with ultra-high risk (UHR) states for psychosis show brain structural volume changes similar to first-episode psychosis and also elevated incidence of environmental risk factors like childhood trauma. It is unclear, however, whether early neurodevelopmental trajectories are altered in UHR. We screened a total of 12,779 first-year Chinese students to enroll 36 UHR subjects (based on clinical interviews) and 59 non-UHR healthy controls for a case-control study of markers of early neurodevelopment. Subjects underwent 3T MRI scanning and clinical characterization, including the childhood trauma questionnaire (CTQ). We then used the CAT12 toolbox to analyse structural brain scans for cortical surface complexity, a spherical harmonics-based marker of early neurodevelopmental changes. While we did not find statistically significant differences between the groups, a trend level finding for reduced cortical complexity (CC) in UHR vs. non-UHR subjects emerged in the left superior temporal cortex (and adjacent insular and transverse temporal cortices), and this trend level association was significantly moderated by childhood trauma (CTQ score). Our findings indicate that UHR subjects tend to show abnormal cortical surface morphometry, in line with recent research; more importantly, however, this association seems to be considerably modulated by early environmental impacts. Hence, our results provide an indication of environmental or gene × environment interactions on early neurodevelopment leading up to elevated psychosis risk.
Collapse
Affiliation(s)
- Jiaojiao Hou
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and Marburg University Hospital, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and Marburg University Hospital, Marburg, Germany
- Center for Mind, Brain, and Behavior, Philipps-Universität Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and Marburg University Hospital, Marburg, Germany
- Center for Mind, Brain, and Behavior, Philipps-Universität Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and Marburg University Hospital, Marburg, Germany
- Center for Mind, Brain, and Behavior, Philipps-Universität Marburg, Marburg, Germany
| | - Jianxing Chen
- Tongji University School of Medicine, Shanghai, China
| | - Jiayi Wang
- Tongji University School of Medicine, Shanghai, China
| | - Xudong Zhao
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Jingyu Shi
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Division of Medical Humanities & Behavioral Sciences, Tongji University School of Medicine, Shanghai, China
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and Marburg University Hospital, Marburg, Germany
- Center for Mind, Brain, and Behavior, Philipps-Universität Marburg, Marburg, Germany
| |
Collapse
|
18
|
Calvo A, Roddy DW, Coughlan H, Kelleher I, Healy C, Harley M, Clarke M, Leemans A, Frodl T, O’Hanlon E, Cannon M. Reduced hippocampal volume in adolescents with psychotic experiences: A longitudinal population-based study. PLoS One 2020; 15:e0233670. [PMID: 32492020 PMCID: PMC7269246 DOI: 10.1371/journal.pone.0233670] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 05/04/2020] [Indexed: 11/18/2022] Open
Abstract
Aims Smaller hippocampal volumes are among the most consistently reported neuroimaging findings in schizophrenia. However, little is known about hippocampal volumes in people who report psychotic experiences. This study investigated differences in hippocampal volume between young people without formal diagnoses who report psychotic experiences (PEs) and those who do not report such experiences. This study also investigated if any differences persisted over two years. Methods A nested case-control study of 25 adolescents (mean age 13.5 years) with reported PEs and 25 matched controls (mean age 13.36 years) without PEs were drawn from a sample of 100 local schoolchildren. High-resolution T1-weighted anatomical imaging and subsequent automated cortical segmentation (Freesurfer 6.0) was undertaken to determine total hippocampal volumes. Comprehensive semi-structured clinical interviews were also performed including information on PEs, mental diagnoses and early life stress (bullying). Participants were invited for a second scan at two years. Results 19 adolescents with PEs and 19 controls completed both scans. Hippocampal volumes were bilaterally lower in the PE group compared to the controls with moderate effects sizes both at baseline [left hippocampus p = 0.024 d = 0.736, right hippocampus p = 0.018, d = 0.738] and at 2 year follow up [left hippocampus p = 0.027 d = 0.702, right = 0.048 d = 0.659] throughout. These differences survived adjustment for co-morbid mental disorders and early life stress. Conclusions Psychotic experiences are associated with total hippocampal volume loss in young people and this volume loss appears to be independent of possible confounders such as co-morbid disorders and early life stress.
Collapse
Affiliation(s)
- Ana Calvo
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Faculty of Health Sciences, Universidad Internacional de la Rioja (UNIR), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
- * E-mail: (AC); (MC)
| | - Darren W. Roddy
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Helen Coughlan
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ian Kelleher
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colm Healy
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Michelle Harley
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alexander Leemans
- Image Sciences Institute University Medical Center Utrecht, Utrecht, the Netherlands
| | - Thomas Frodl
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Department and Hospital of Psychiatry and Psychotherapy, Otto von Guericke University Mageburg, Mageburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Magdeburg, Magdeburg, Germany
| | - Erik O’Hanlon
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Mary Cannon
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- * E-mail: (AC); (MC)
| |
Collapse
|
19
|
Region-specific effects of maternal separation on oxidative stress accumulation in parvalbumin neurons of male and female rats. Behav Brain Res 2020; 388:112658. [PMID: 32339550 DOI: 10.1016/j.bbr.2020.112658] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Early life adversity in humans is linked to cognitive deficits and increased risk of mental illnesses, including depression, bipolar disorder, and schizophrenia, with evidence for different vulnerabilities in men versus women. Modeling early life adversity in rodents shows similar neuropsychological deficits that may partially be driven by sex-dependent dysfunction in parvalbumin (PV) interneurons in the prefrontal cortex (PFC), hippocampus (HPC), and basolateral amygdala (BLA). Research demonstrates that PV interneurons are particularly susceptible to oxidative stress; therefore, accumulation of oxidative damage may drive PV dysfunction following early life adversity. The goal of this study was to quantify oxidative stress accumulation in PV neurons in rats exposed to maternal separation (MS). Pups were separated from their dam and littermates for 4 h per day from postnatal day (P)2 to 20. Serial sections from the PFC, HPC, and BLA of juvenile (P20) rats of both sexes were immunohistochemically stained with antibodies against PV and 8-oxo-dG, a marker for oxidative DNA damage. PV cell counts, colocalization with 8-oxo-dG, and intensity of each signal were measured in each region to determine the effects of MS and establish whether MS-induced oxidative damage varies between sexes. A significant increase in colocalization of PV and 8-oxo-dG was found in the PFC and HPC, indicating increased oxidative stress in that cell population following MS. Region-specific sex differences were also revealed in the PFC, BLA, and HPC. These data identify oxidative stress during juvenility as a potential mechanism mediating PV dysfunction in individuals with a history of early life adversity.
Collapse
|
20
|
du Plessis S, Scheffler F, Luckhoff H, Asmal L, Kilian S, Phahladira L, Emsley R. Childhood trauma and hippocampal subfield volumes in first-episode schizophrenia and healthy controls. Schizophr Res 2020; 215:308-313. [PMID: 31653582 DOI: 10.1016/j.schres.2019.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/29/2019] [Accepted: 10/06/2019] [Indexed: 12/20/2022]
Abstract
Childhood trauma and schizophrenia are both associated with neuroanatomical abnormalities in the hippocampus, a stress-sensitive structure vulnerable to developmental insults. However, few studies have evaluated the effects of childhood trauma exposure on hippocampal morphometry in minimally treated first-episode schizophrenia patients. Here we aim to investigate the associations of childhood trauma with hippocampal subfield volumes in a cohort of antipsychotic-naive or minimally treated first-episode schizophrenia spectrum disorder patients and matched controls. 79 patients with first-episode schizophrenia spectrum disorder and 82 matched controls completed the childhood trauma questionnaire and underwent MRI assessment. Hippocampal subfields were reconstructed using FreeSurfer 6.0. We considered inter-correlations between the various subfields, by entering them as dependent variables into a multivariate analysis of co-variance (MANCOVA), modeling for interactions between diagnosis, childhood trauma total score and gender while controlling for substance use, scanner sequence and age. MANCOVA revealed a significant interaction between sex, childhood trauma total scores and diagnosis across hippocampal sub-regions (p = 0.012). Bonferroni corrected post-hoc analysis revealed a significant sex*diagnosis*childhood trauma score interaction for the hippocampal fissure (F(1,161) = 9.485,p = .002). Hippocampal fissure size showed a positive relationship with CA structures as well as whole hippocampal size in the larger sample. Findings from the present study suggest that childhood trauma exposure exerts illness-specific effects on hippocampal structures in female patients with first-episode schizophrenia, consistent with increased stress sensitivity in this group.
Collapse
Affiliation(s)
- Stéfan du Plessis
- Department of Psychiatry, Stellenbosch University, Republic of South Africa.
| | | | - Hilmar Luckhoff
- Department of Psychiatry, Stellenbosch University, Republic of South Africa
| | - Laila Asmal
- Department of Psychiatry, Stellenbosch University, Republic of South Africa
| | - Sanja Kilian
- Department of Psychiatry, Stellenbosch University, Republic of South Africa
| | | | - Robin Emsley
- Department of Psychiatry, Stellenbosch University, Republic of South Africa
| |
Collapse
|
21
|
Herzberg MP, Gunnar MR. Early life stress and brain function: Activity and connectivity associated with processing emotion and reward. Neuroimage 2019; 209:116493. [PMID: 31884055 DOI: 10.1016/j.neuroimage.2019.116493] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/10/2019] [Accepted: 12/23/2019] [Indexed: 01/01/2023] Open
Abstract
Investigating the developmental sequelae of early life stress has provided researchers the opportunity to examine adaptive responses to extreme environments. A large body of work has established mechanisms by which the stressful experiences of childhood poverty, maltreatment, and institutional care can impact the brain and the distributed stress systems of the body. These mechanisms are reviewed briefly to lay the foundation upon which the current neuroimaging literature has been built. More recently, developmental cognitive neuroscientists have identified a number of the effects of early adversity, including differential behavior and brain function. Among the most consistent of these findings are differences in the processing of emotion and reward-related information. The neural correlates of emotion processing, particularly frontolimbic functional connectivity, have been well studied in early life stress samples with results indicating accelerated maturation following early adversity. Reward processing has received less attention, but here the evidence suggests a deficit in reward sensitivity. It is as yet unknown whether the accelerated maturation of emotion-regulation circuits comes at the cost of delayed development in other systems, most notably the reward system. This review addresses the early life stress neuroimaging literature that has investigated emotion and reward processing, identifying important next steps in the study of brain function following adversity.
Collapse
Affiliation(s)
- Max P Herzberg
- Institute of Child Development, University of Minnesota, USA.
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota, USA
| |
Collapse
|
22
|
Moreno-López L, Ioannidis K, Askelund AD, Smith AJ, Schueler K, van Harmelen AL. The Resilient Emotional Brain: A Scoping Review of the Medial Prefrontal Cortex and Limbic Structure and Function in Resilient Adults With a History of Childhood Maltreatment. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:392-402. [PMID: 32115373 DOI: 10.1016/j.bpsc.2019.12.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/18/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
Childhood maltreatment (CM) is one of the strongest predictors of adult mental illness, although not all adults with CM develop psychopathology. Here, we describe the structure and function of the emotional brain regions that may contribute to resilient functioning after CM. We review studies that report medial prefrontal cortex, amygdala, and hippocampus (limbic regions) structure, function, and/or connections in resilient adults (i.e., those reporting CM without psychopathology) versus vulnerable adults (i.e., those reporting CM with psychopathology) or healthy adults (those without CM and with no psychopathology). We find that resilient adults have larger hippocampal gray and white matter volume and greater connectivity between the central executive network and the limbic regions. In addition, resilient adults have improved ability to regulate emotions through medial prefrontal cortex-limbic downregulation, lower hippocampal activation to emotional faces, and increased amygdala habituation to stress. We highlight the need for longitudinal designs that examine resilient functioning across domains and consider gender, type, timing, and nature of CM assessments and further stressors to further improve our understanding of the role of the emotional brain in resilient functioning after CM.
Collapse
Affiliation(s)
- Laura Moreno-López
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, United Kingdom
| | | | - Alicia J Smith
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Katja Schueler
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | | |
Collapse
|
23
|
Velikonja T, Velthorst E, McClure MM, Rutter S, Calabrese WR, Rosell D, Koenigsberg HW, Goodman M, New AS, Hazlett EA, Perez-Rodriguez MM. Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder. Acta Psychiatr Scand 2019; 140:50-64. [PMID: 30951190 DOI: 10.1111/acps.13032] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Literature suggests that childhood trauma increases vulnerability for schizophrenia-spectrum disorders, including schizotypal personality disorder (SPD). Yet, it remains unexplored whether childhood trauma predicts symptom load and the level of neurocognitive functioning in SPD. METHOD We included 225 individuals with SPD and 127 healthy controls. Childhood trauma was evaluated using the Childhood Trauma Questionnaire, and schizotypal traits were assessed using the Schizotypal Personality Questionnaire. Standard neurocognitive assessments covered six cognitive domains. RESULTS All types of reported childhood trauma were significantly associated with SPD, in a linear fashion. Severe sexual abuse showed the greatest magnitude of association with higher cognitive-perceptual load (e.g., ideas of reference, odd belief or magical thinking); severe emotional neglect was associated with interpersonal scores (e.g., excessive social anxiety, constricted affect) within the SPD group. SPD individuals who reported severe trauma showed worse cognitive functioning (i.e., working memory, verbal/visual learning and memory, as well as verbal fluency). CONCLUSIONS Particular severe childhood trauma types were associated with higher cognitive-perceptual and interpersonal symptoms in SPD, along with worse cognitive functioning. These findings highlight the need for clinicians to enquire about childhood trauma in SPD patients, since unaddressed early adverse experiences may carry long-term negative consequences.
Collapse
Affiliation(s)
- T Velikonja
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,Seaver Center of Research and Treatment, Icahn School of Medicine, Mount Sinai, NY, USA
| | - E Velthorst
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,Seaver Center of Research and Treatment, Icahn School of Medicine, Mount Sinai, NY, USA
| | - M M McClure
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,Fairfield University, Fairfield, CT, USA
| | - S Rutter
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA
| | - W R Calabrese
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - D Rosell
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - H W Koenigsberg
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA
| | - M Goodman
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA
| | - A S New
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA
| | - E A Hazlett
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA
| | - M M Perez-Rodriguez
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.,James J. Peters VA Medical Center, The Bronx, NY, USA.,CIBERSAM, Madrid, Spain
| |
Collapse
|
24
|
Gawęda Ł, Göritz AS, Moritz S. Mediating role of aberrant salience and self-disturbances for the relationship between childhood trauma and psychotic-like experiences in the general population. Schizophr Res 2019; 206:149-156. [PMID: 30545759 DOI: 10.1016/j.schres.2018.11.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/13/2018] [Accepted: 11/30/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The relationship between childhood trauma and the risk of psychosis is well established. However, the mechanisms of the relationship are still unknown. We investigated whether two factors involved in the risk of psychosis - self-disturbances and aberrant salience - mediate the relationship between childhood trauma and psychotic-like experiences in the general population. METHODS We tested parallel mediation models which assume that the relationship between childhood trauma (Childhood Trauma Questionnaire, the CTQ) and psychotic-like experiences (Prodromal questionnaire, PQ-16) is mediated by both self-disturbances and aberrant salience (Aberrant Salience Inventory, the ASI) in a general population sample (N = 649). Separate parallel mediation models were calculated for cumulative childhood trauma, exposure to abusive behaviors (emotional, physical and sexual abuse) and neglect (emotional and physical neglect) controlling for gender. RESULTS Childhood traumatic life events predicted psychotic-like experiences. Childhood trauma was also related to self-disturbances and aberrant salience. Self-disturbances and aberrant salience were related to psychotic-like experiences. Models of mediation for the relationship between cumulative childhood trauma and neglect and psychotic-like experiences revealed an indirect-only mediation by self-disturbances and aberrant salience. The model for childhood abuse suggested a complementary mediation and was affected by gender. CONCLUSIONS Our results provide tentative evidence that self-disturbances and aberrant salience are important factors in the translation of childhood trauma into the risk of psychosis in the general population. Causal relationships could not be inferred from this cross-sectional data. Hence, longitudinal studies on a clinical sample are warranted.
Collapse
Affiliation(s)
- Łukasz Gawęda
- II Department of Psychiatry, Medical University of Warsaw, Poland; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
| | - Anja S Göritz
- Department of Psychology, University of Freiburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| |
Collapse
|
25
|
Schalinski I, Breinlinger S, Hirt V, Teicher MH, Odenwald M, Rockstroh B. Environmental adversities and psychotic symptoms: The impact of timing of trauma, abuse, and neglect. Schizophr Res 2019; 205:4-9. [PMID: 29141785 DOI: 10.1016/j.schres.2017.10.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/20/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Trauma and adverse childhood experiences (ACE) occur more often in mental illness, including psychosis, than in the general population. Individuals with psychosis (cases) report a higher number and severity (dose) of adversities than healthy controls. While a dose-dependent increase of adversities has been related to more severe psychopathology, the role of type and timing is still insufficiently understood on the exacerbation of positive and negative psychotic symptoms. Moreover, dissociative symptoms were examined as potential mediator between adversities and severity of psychotic symptoms. METHODS Exposure to adversities were assessed by interviews in n=180 cases and n=70 controls. In cases, symptom severities were obtained for psychotic symptoms and dissociation. Conditioned random forest regression determined the importance of type and timing of ACE for positive and negative symptom severity, and mediator analyses evaluated the role of dissociative symptoms in the relationship between adversities and psychotic symptoms. RESULTS Cases experienced substantially more abuse and neglect than controls. Adversities were related in a dose-dependent manner to psychotic disorder. An array of adversities was associated with more severe positive symptoms, while the conditioned random forest regression depicted neglect at age 10 as the most important predictor. Dissociative symptoms mediated the small relation of trauma load in childhood and positive symptoms. CONCLUSION The role of trauma and ACE on psychotic symptoms can be specified by neglect during frontocortical development in the exacerbation of positive symptoms. The mediating role of dissociation is restricted to the relation of childhood trauma and positive symptoms.
Collapse
Affiliation(s)
| | - Susanne Breinlinger
- Department of Psychology, University of Konstanz, Germany; Center for Psychiatry Reichenau, Germany
| | - Vanessa Hirt
- Department of Psychology, University of Konstanz, Germany
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | | | | |
Collapse
|
26
|
Kaufman J, Torbey S. Child maltreatment and psychosis. Neurobiol Dis 2019; 131:104378. [PMID: 30685353 DOI: 10.1016/j.nbd.2019.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 12/27/2022] Open
Abstract
This paper reviews the literature on the association between experiences of child abuse and neglect and the development of psychoses. It then explores the premise that psychotic patients with a history of maltreatment may comprise a clinically and biological distinct subgroup. The review demonstrates that there is a growing consensus in the field that experiences of child maltreatment contribute to the onset of psychotic symptoms and psychotic disorders. There is also strong support for the premise that patients with psychotic disorders and histories of child maltreatment have distinct clinical characteristics and unique treatment needs, and emerging preliminary data to suggest psychotic patients with a history of maltreatment may comprise a distinct neurobiological subgroup. The mechanisms by which experiences of child maltreatment confers risk for psychotic disorders remains unknown, and the review highlights the value of incorporating translational research perspectives to advance knowledge in this area.
Collapse
Affiliation(s)
- Joan Kaufman
- Kennedy Krieger Institute, Center for Child and Family Traumatic Stress, 1741 Ashland Avenue, Baltimore, MD 21205, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - Souraya Torbey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| |
Collapse
|
27
|
Hoffmann C, Van Rheenen TE, Mancuso SG, Zalesky A, Bruggemann J, Lenroot RK, Sundram S, Weickert CS, Weickert TW, Pantelis C, Cropley V, Bousman CA. Exploring the moderating effects of dopaminergic polymorphisms and childhood adversity on brain morphology in schizophrenia-spectrum disorders. Psychiatry Res Neuroimaging 2018; 281:61-68. [PMID: 30253269 DOI: 10.1016/j.pscychresns.2018.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022]
Abstract
Genetic and environmental etiologies may contribute to schizophrenia and its associated neurobiological profile. We examined the interaction between dopaminergic polymorphisms, childhood adversity and diagnosis (schizophrenia/schizoaffective disorder) on dopamine-related brain structures. Childhood adversity histories and structural MRI data were obtained from 249 (153 schizophrenia/schizoaffective, 96 controls) participants registered in the Australian Schizophrenia Research Bank. Polymorphisms in DRD2 and COMT were genotyped and a dopaminergic risk allelic load (RAL) was calculated. Regression analysis was used to test the main and interaction effects of RAL, childhood adversity and diagnosis on volumes of dopamine-related brain structures (caudate, putamen, nucleus accumbens, dorsolateral prefrontal cortex and hippocampus). A schizophrenia/schizoaffective diagnosis showed significant main effects on bilateral hippocampus, left dorsolateral prefrontal cortex and bilateral putamen volumes. RAL showed a significant main effect on left putamen volumes. Furthermore, across the whole sample, a significant two-way interaction between dopaminergic RAL and childhood adversity was found for left putamen volumes. No brain structure volumes were predicted by a three-way interaction that included diagnosis. Our finding suggests the left putamen may be particularly sensitive to dopaminergic gene-environment interactions regardless of diagnosis. However, larger studies are needed to assess whether these interactions are more or less pronounced in those with schizophrenia/schizoaffective disorders.
Collapse
Affiliation(s)
- Cassandra Hoffmann
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Serafino G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York, USA
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Australia; Department of Electrical and Electronic Engineering, University of Melbourne, Victoria, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
28
|
Crossley NA, Alliende LM, Ossandon T, Castañeda CP, González-Valderrama A, Undurraga J, Castro M, Guinjoan S, Díaz-Zuluaga AM, Pineda-Zapata JA, López-Jaramillo C, Reyes-Madrigal F, León-Ortíz P, de la Fuente-Sandoval C, Czepielewski LS, Gama CS, Zugman A, Gadelha A, Jackowski A, Bressan R. Imaging Social and Environmental Factors as Modulators of Brain Dysfunction: Time to Focus on Developing Non-Western Societies. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:8-15. [PMID: 30396768 DOI: 10.1016/j.bpsc.2018.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 12/18/2022]
Abstract
Social and environmental factors are known risk factors and modulators of mental health disorders. We here conducted a nonsystematic review of the neuroimaging literature studying the effects of poverty, urbanicity, and community violence, highlighting the opportunities of studying non-Western developing societies such as those in Latin America. Social and environmental factors in these communities are widespread and have a large magnitude, as well as an unequal distribution, providing a good opportunity for their characterization. Studying the effect of poverty in these settings could help to explore the brain effect of economic improvements, disentangle the effect of absolute and relative poverty, and characterize the modulating impact of poverty on the underlying biology of mental health disorders. Exploring urbanicity effects in highly unequal cities could help identify the specific factors that modulate this effect as well as examine a possible dose-response effect by studying megacities. Studying brain changes in those living among violence, which is particularly high in places such as Latin America, could help to characterize the interplay between brain predisposition and exposure to violence. Furthermore, exploring the brain in an adverse environment should shed light on the mechanisms underlying resilience. We finally provide examples of two methodological approaches that could contribute to this field, namely a big cohort study in the developing world and a consortium-based meta-analytic approach, and argue about the potential translational value of this research on the development of effective social policies and successful personalized medicine in disadvantaged societies.
Collapse
Affiliation(s)
- Nicolas A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom.
| | - Luz Maria Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomas Ossandon
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Alfonso González-Valderrama
- Early Intervention Program, José Horwitz Psychiatric Institute, Santiago, Chile; School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Juan Undurraga
- Early Intervention Program, José Horwitz Psychiatric Institute, Santiago, Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Mariana Castro
- FLENI Foundation, Buenos Aires, Argentina; Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Salvador Guinjoan
- FLENI Foundation, Buenos Aires, Argentina; Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | | | - Carlos López-Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Mood Disorders Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Pablo León-Ortíz
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Leticia Sanguinetti Czepielewski
- Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clarissa S Gama
- Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andre Zugman
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Andrea Jackowski
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Rodrigo Bressan
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
29
|
Bailey T, Alvarez-Jimenez M, Garcia-Sanchez AM, Hulbert C, Barlow E, Bendall S. Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis. Schizophr Bull 2018; 44:1111-1122. [PMID: 29301025 PMCID: PMC6101549 DOI: 10.1093/schbul/sbx161] [Citation(s) in RCA: 165] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction Childhood trauma is a risk factor for the development of psychosis. Furthermore, a number of theories propose specific mechanisms by which childhood trauma may contribute to more severe positive and negative psychotic symptoms, some of which are supported empirically. The robustness of this empirical evidence is unclear due to mixed results and methodological limitations of individual studies. A systematic review and meta-analysis of the evidence for associations between childhood trauma and severity of hallucinations, delusions, and negative psychotic symptoms in clinical populations with a diagnosed psychotic disorder is needed. Method A systematic search was conducted. Reference lists of relevant review articles were hand-searched, and authors contacted for data and additional unpublished studies. Study reporting bias and quality was assessed. Results In total, 6667 studies were identified and of these 41 studies met inclusion criteria. Of these, 29 studies (4680 participants) were meta-analyzed. Among individuals with psychosis, childhood trauma was significantly correlated with severity of hallucinations (r = .199, P < .001) and delusions (r = .172, P < .001) but contrary to our hypothesis, not correlated with severity of negative symptoms (r = .049, P = .095). Severity of childhood neglect was correlated with negative symptoms (r = .142, P = .005). Conclusion The results lend support for cognitive and biological theories that traumas in childhood may lead to hallucinations and delusions within psychotic disorders and have important implications for clinical practice.
Collapse
Affiliation(s)
- Thomas Bailey
- Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Ana M Garcia-Sanchez
- Hospital Universitario de Gran Canaria Dr Negrin, Servicio Canario de Salud, Las Palmas de Gran Canaria, Spain
| | - Carol Hulbert
- Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Emma Barlow
- Clinical Services, Port Phillip Prison, Truganina, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| |
Collapse
|
30
|
Schalinski I, Teicher MH, Carolus AM, Rockstroh B. Defining the impact of childhood adversities on cognitive deficits in psychosis: An exploratory analysis. Schizophr Res 2018; 192:351-356. [PMID: 28576548 DOI: 10.1016/j.schres.2017.05.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/30/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exposure to adverse childhood experiences (ACE) and cognitive deficits are both prevalent in psychosis. While it has been repeatedly demonstrated that ACE contribute to cognitive dysfunctions, the specific nature of this contribution remains elusive. Recent evidence suggests that types of adversities during critical periods have deleterious effects on brain structures that are important for cognitive functioning. The present study sought to clarify which types of adversities experienced at which time during development aggravate cognitive deficits in psychosis. METHODS Exposure to abuse and neglect during childhood and adolescence were retrospectively assessed in N=168 adult individuals with psychotic disorder. Conditioned random forest regression was used to define the importance of type and timing of ACE for predicting domains of the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Significant importance of ACE was determined for 5 out of 7 MCCB domains. Particularly abuse at age 3 contributed to dysfunctional cognitive domains attention, learning, and working memory. Social cognition was related to neglect experienced at 11-12years, and to cumulative ACE. CONCLUSION Abuse and neglect at periods when children spend substantial time in their families affect cognitive functioning, and hence aggravate dysfunction in psychosis. Results support the neurodevelopmental perspective on psychosis and the diagnostic value of type and timing of ACE.
Collapse
Affiliation(s)
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | | | | |
Collapse
|
31
|
Coccaro EF, Cremers H, Fanning J, Nosal E, Lee R, Keedy S, Jacobson KC. Reduced frontal grey matter, life history of aggression, and underlying genetic influence. Psychiatry Res Neuroimaging 2018; 271:126-134. [PMID: 29174436 DOI: 10.1016/j.pscychresns.2017.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 11/28/2022]
Abstract
Physically healthy, adult, same-sexed twins (n = 287) from a population-based twin cohort underwent high-resolution magnetic resonance imaging (MRI) to identify fronto-limbic brain regions significantly associated with lifetime history of aggression. MRI scans used a 3D magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) sequence, for voxel-based morphometry (VBM) and history of aggressive behavior was assessed using the Life History of Aggression measure. Aggression had modest, inverse associations with grey matter volume (GMV) in medial prefrontal cortex (mPFC, b = -0.20, se = 0.05, p < 0.001) and lateral prefrontal cortex (lPFC, b = -0.23, se = 0.06, p < 0.001). These associations were not confounded by other demographic, psychiatric, or personality factors. Biometrical twin analyses revealed significant heritabilities of 0.57 for GMV in the mPFC cluster and 0.36 for GMV in the lPFC cluster. Genetic factors accounted for the majority of the phenotypic correlations between aggression and mPFC GMV (85.3%) and between aggression and lPFC GMV (63.7%). Reduced GMV of prefrontal brain regions may be a neuronal characteristic of individuals with substantial histories of aggressive behavior regardless of psychiatric diagnosis. As such, these data suggest an anatomical correlate, with a possible genetic etiology, associated with functional deficits in social-emotional information processing.
Collapse
Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Henk Cremers
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Jennifer Fanning
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Eryka Nosal
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Royce Lee
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Sarah Keedy
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Kristen C Jacobson
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| |
Collapse
|
32
|
Janiri D, Sani G, Rossi PD, Piras F, Iorio M, Banaj N, Giuseppin G, Spinazzola E, Maggiora M, Ambrosi E, Simonetti A, Spalletta G. Amygdala and hippocampus volumes are differently affected by childhood trauma in patients with bipolar disorders and healthy controls. Bipolar Disord 2017; 19:353-362. [PMID: 28699182 DOI: 10.1111/bdi.12516] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Volumetric studies on deep gray matter structures in bipolar disorder (BP) have reported contrasting results. Childhood trauma, a relevant environmental stressor for BP, could account for the variability of the results, modulating differences in the amygdala and hippocampus in patients with BP compared with healthy controls (HC). Our study aimed to test this hypothesis. METHODS We assessed 105 outpatients, diagnosed with bipolar disorder type I (BP-I) or bipolar disorder type II (BP-II) according to DSM-IV-TR criteria, and 113 HC subjects. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). High-resolution magnetic resonance imaging was performed on all subjects and volumes of the amygdala, hippocampus, nucleus accumbens, caudate, pallidum, putamen, and thalamus were measured using FreeSurfer. RESULTS Patients with BP showed a global reduction of deep gray matter volumes compared to HCs. However, childhood trauma modulated the impact of the diagnosis specifically on the amygdala and hippocampus. Childhood trauma was associated with bilateral decreased volumes in HCs and increased volumes in patients with BP. CONCLUSIONS The results suggest that childhood trauma may have a different effect in health and disease on volumes of gray matter in the amygdala and hippocampus, which are brain areas specifically involved in response to stress and emotion processing.
Collapse
Affiliation(s)
- Delfina Janiri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.,Centro Lucio Bini, Rome, Italy.,Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Pietro De Rossi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.,Centro Lucio Bini, Rome, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Rome, Italy.,Museo storico della fisica e Centro studi e ricerche Enrico Fermi, Rome, Italy
| | - Mariangela Iorio
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - Nerisa Banaj
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - Giulia Giuseppin
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A.Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Edoardo Spinazzola
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Matteo Maggiora
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Elisa Ambrosi
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alessio Simonetti
- Centro Lucio Bini, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Gianfranco Spalletta
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
33
|
Paquola C, Bennett MR, Hatton SN, Hermens DF, Groote I, Lagopoulos J. Hippocampal development in youth with a history of childhood maltreatment. J Psychiatr Res 2017; 91:149-155. [PMID: 28364595 DOI: 10.1016/j.jpsychires.2017.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
Childhood maltreatment (CM) is associated with enhanced risk of psychiatric illness and reduced subcortical grey matter in adulthood. The hippocampus and amygdala, due to their involvement in stress and emotion circuitries, have been subject to extensive investigations regarding the effect of CM. However, the complex relationship between CM, subcortical grey matter and mental illness remains poorly understood partially due to a lack of longitudinal studies. Here we used segmentation and linear mixed effect modelling to examine the impact of CM on hippocampal and amygdala development in young people with emerging mental illness. A total of 215 structural magnetic resonance imaging (MRI) scans were acquired from 123 individuals (age: 14-28 years, 79 female), 52 of whom were scanned twice or more. Hippocampal and amygdala volumes increased linearly with age, and their developmental trajectories were not moderated by symptom severity. However, exposure to CM was associated with significantly stunted right hippocampal growth. This finding bridges the gap between child and adult research in the field and provides novel evidence that CM is associated with disrupted hippocampal development in youth. Although CM was associated with worse symptom severity, we did not find evidence that CM-induced structural abnormalities directly underpin psychopathology. This study has important implications for the psychiatric treatment of individuals with CM since they are clinically and neurobiologically distinct from their peers who were not maltreated.
Collapse
Affiliation(s)
- Casey Paquola
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, NSW, Australia.
| | - Maxwell R Bennett
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Sean N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, NSW, Australia; Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Inge Groote
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, NSW, Australia; Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, QLD, Australia
| |
Collapse
|
34
|
Effects of environmental risks and polygenic loading for schizophrenia on cortical thickness. Schizophr Res 2017; 184:128-136. [PMID: 27989645 DOI: 10.1016/j.schres.2016.12.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/09/2016] [Accepted: 12/11/2016] [Indexed: 01/21/2023]
Abstract
There are established differences in cortical thickness (CT) in schizophrenia (SCZ) and bipolar (BD) patients when compared to healthy controls (HC). However, it is unknown to what extent environmental or genetic risk factors impact on CT in these populations. We have investigated the effect of Environmental Risk Scores (ERS) and Polygenic Risk Scores for SCZ (PGRS-SCZ) on CT. Structural MRI scans were acquired at 3T for patients with SCZ or BD (n=57) and controls (n=41). Cortical reconstructions were generated in FreeSurfer (v5.3). The ERS was created by determining exposure to cannabis use, childhood adverse events, migration, urbanicity and obstetric complications. The PGRS-SCZ were generated, for a subset of the sample (Patients=43, HC=32), based on the latest PGC GWAS findings. ANCOVAs were used to test the hypotheses that ERS and PGRS-SCZ relate to CT globally, and in frontal and temporal lobes. An increase in ERS was negatively associated with CT within temporal lobe for patients. A higher PGRS-SCZ was also related to global cortical thinning for patients. ERS effects remained significant when including PGRS-SCZ as a fixed effect. No relationship which survived FDR correction was found for ERS and PGRS-SCZ in controls. Environmental risk for SCZ was related to localised cortical thinning in patients with SCZ and BD, while increased PGRS-SCZ was associated with global cortical thinning. Genetic and environmental risk factors for SCZ appear therefore to have differential effects. This provides a mechanistic means by which different risk factors may contribute to the development of SCZ and BD.
Collapse
|
35
|
Asmal L, du Plessis S, Vink M, Fouche JP, Chiliza B, Emsley R. Insight and white matter fractional anisotropy in first-episode schizophrenia. Schizophr Res 2017; 183:88-94. [PMID: 27887780 DOI: 10.1016/j.schres.2016.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 12/22/2022]
Abstract
Impaired insight is a hallmark feature of schizophrenia. Structural studies implicate predominantly prefrontal, cingulate, cuneus/precuneus, and inferior temporal brain regions. The cortical midline structures (CMS) are also implicated in functional studies primarily through self-reflective processing tasks. However, few studies have explored the relationship between white matter tracts and insight in schizophrenia, and none in first-episode schizophrenia (FES). Here, we examined for fractional anisotropy (FA) differences in 89 minimally treated FES patients and 98 matched controls, and identified those FA differences associated with impaired clinical insight in patients. We found widespread FA reduction in FES patients compared to controls. Poorer insight in patients was predicted by lower FA values in a number of white matter tracts with a predilection for tracts associated with cortical midline structures (fronto-occipital, cingulate, cingulate hippocampus, uncinate, anterior corona radiata), and more severe depressive symptoms. The association between FA abnormalities and insight was most robust for the awareness of symptoms and illness awareness domains. Our study implicates a network of tracts involved in impaired insight in schizophrenia with a predilection for the CMS. This study is a first step in delineating the white matter tracts involved in insight impairment in schizophrenia prior to chronicity.
Collapse
Affiliation(s)
- Laila Asmal
- Stellenbosch University, Faculty of Medicine and Health Sciences, Psychiatry, PO Box 19063, Tygerberg, Cape Town ZA 7505, South Africa.
| | - Stefan du Plessis
- Stellenbosch University, Faculty of Medicine and Health Sciences, Psychiatry, PO Box 19063, Tygerberg, Cape Town ZA 7505, South Africa
| | - Matthijs Vink
- Departments of Developmental and Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town ZA 8001, South Africa
| | - Bonginkosi Chiliza
- Stellenbosch University, Faculty of Medicine and Health Sciences, Psychiatry, PO Box 19063, Tygerberg, Cape Town ZA 7505, South Africa
| | - Robin Emsley
- Stellenbosch University, Faculty of Medicine and Health Sciences, Psychiatry, PO Box 19063, Tygerberg, Cape Town ZA 7505, South Africa
| |
Collapse
|
36
|
Bartholomeusz CF, Cropley VL, Wannan C, Di Biase M, McGorry PD, Pantelis C. Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model. Aust N Z J Psychiatry 2017; 51:455-476. [PMID: 27733710 DOI: 10.1177/0004867416670522] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model. RESULTS In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions). CONCLUSION We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.
Collapse
Affiliation(s)
- Cali F Bartholomeusz
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Vanessa L Cropley
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Cassandra Wannan
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Maria Di Biase
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Patrick D McGorry
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christos Pantelis
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- 4 Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
| |
Collapse
|
37
|
Paquola C, Bennett MR, Hatton SN, Hermens DF, Lagopoulos J. Utility of the cumulative stress and mismatch hypotheses in understanding the neurobiological impacts of childhood abuse and recent stress in youth with emerging mental disorder. Hum Brain Mapp 2017; 38:2709-2721. [PMID: 28256777 DOI: 10.1002/hbm.23554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 11/08/2022] Open
Abstract
Childhood abuse has an enduring impact on the brain's stress system. Whether the effects of childhood abuse and adulthood stress are additive (cumulative stress hypothesis) or interactive (mismatch hypothesis) is widely disputed, however. The primary aim of this study was to test the utility of the cumulative stress and mismatch hypotheses in understanding brain and behaviour. We recruited 64 individuals (aged 14-26) from a specialised clinic for assessment and early intervention of mental health problems in young people. A T1-weighted MRI, a resting state fMRI and clinical assessment were acquired from each participant. Grey matter estimates and resting state functional connectivity (rsFC) of the hippocampus, amygdala and anterior cingulate cortex (ACC) were determined using segmentation and seed-to-voxel rsFC analyses. We explored the effects of childhood abuse and recent stress on the structure and function of the regions of interest within general linear models. Worse psychiatric symptoms were significantly related to higher levels of life time stress. Individuals with mismatched childhood and recent stress levels had reduced left hippocampal volume, reduced ACC-ventrolateral prefrontal cortex rsFC and greater ACC-hippocampus rsFC, compared to individuals with matched childhood and recent stress levels. These results show specific utility of the cumulative stress hypothesis in understanding psychiatric symptomatology and of the mismatch hypothesis in modelling hippocampal grey matter, prefrontal rsFC, and prefrontal-hippocampal rsFC. We provide novel evidence for the enduring impact of childhood abuse on stress reactivity in a clinical population, and demonstrate the distinct effects of stress in different systems. Hum Brain Mapp 38:2709-2721, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Casey Paquola
- Clinical Research Unit, Brain & Mind Centre, University of Sydney, New South Wales, 2050, Australia
| | - Maxwell R Bennett
- Clinical Research Unit, Brain & Mind Centre, University of Sydney, New South Wales, 2050, Australia
| | - Sean N Hatton
- Clinical Research Unit, Brain & Mind Centre, University of Sydney, New South Wales, 2050, Australia.,Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Daniel F Hermens
- Clinical Research Unit, Brain & Mind Centre, University of Sydney, New South Wales, 2050, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain & Mind Centre, University of Sydney, New South Wales, 2050, Australia.,Sunshine Coast Mind and Neuroscience, University of the Sunshine Coast, Queensland, 4558, Australia
| |
Collapse
|
38
|
Calem M, Bromis K, McGuire P, Morgan C, Kempton MJ. Meta-analysis of associations between childhood adversity and hippocampus and amygdala volume in non-clinical and general population samples. NEUROIMAGE-CLINICAL 2017; 14:471-479. [PMID: 28275547 PMCID: PMC5331153 DOI: 10.1016/j.nicl.2017.02.016] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 11/25/2022]
Abstract
Background Studies of psychiatric populations have reported associations between childhood adversity and volumes of stress-related brain structures. This meta-analysis investigated these associations in non-clinical samples and therefore independent of the effects of severe mental health difficulties and their treatment. Methods The MEDLINE database was searched for magnetic resonance imaging studies measuring brain structure in adults with and without childhood adversity. Fifteen eligible papers (1781 participants) reporting hippocampal volumes and/or amygdala volumes were pooled using a random effects meta-analysis. Results Those with childhood adversity had lower hippocampus volumes (hedges g = − 0.15, p = 0.010). Controlling for gender, this difference became less evident (hedges g = − 0.12, p = 0.124). This association differed depending on whether studies included participants with some psychopathology, though this may be due to differences in the type of adversity these studies examined. There was no strong evidence of any differences in amygdala volume. Discussion Childhood adversity may have only a modest impact on stress-related brain structures in those without significant mental health difficulties. Reduced hippocampal volume found in non-clinical people with childhood adversity This effect was less marked than those found in psychiatric populations. There was some evidence for confounding by gender. Further studies needed on impact of different forms of adversity on neuroanatomy.
Collapse
Affiliation(s)
- Maria Calem
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Konstantinos Bromis
- School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Craig Morgan
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Corresponding author at: Department of Psychosis Studies, PO67, Institute of Psychiatry, 16 de Crespigny Park, London SE5 8AF, UK.Department of Psychosis StudiesPO67Institute of Psychiatry16 de Crespigny ParkLondonSE5 8AFUK
| |
Collapse
|
39
|
Misiak B, Krefft M, Bielawski T, Moustafa AA, Sąsiadek MM, Frydecka D. Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neurosci Biobehav Rev 2017; 75:393-406. [PMID: 28216171 DOI: 10.1016/j.neubiorev.2017.02.015] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/09/2017] [Accepted: 02/14/2017] [Indexed: 01/05/2023]
Abstract
There is a growing body of research focused on the relationship between childhood trauma and the risk of developing psychosis. Numerous studies, including many large-scale population-based studies, controlling for possible mediating variables, provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Existing evidence supports the specificity model, showing differential associations between particular adversities and clinical symptoms, with cumulative adversity causing less favorable clinical and functional outcomes in psychotic patients. To date, several psychological and biological models have been proposed to search for underlying developmental trajectories leading to the onset of psychosis, influencing psychopathological manifestation and negative functional outcomes due to a history of childhood trauma. In this article, we provide a unified review on the relationship between childhood trauma and psychosis by integrating results of epidemiological, clinical, neuropsychological and biological studies. The question whether psychosis with a positive history of childhood trauma should be considered as a new psychotic phenotype, requiring specific therapeutic interventions, warrants further investigation.
Collapse
Affiliation(s)
- Błażej Misiak
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Maja Krefft
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, University of Western Sydney, Penrith, NSW, Australia
| | - Maria M Sąsiadek
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| |
Collapse
|
40
|
Colle R, Segawa T, Chupin M, Tran Dong MNTK, Hardy P, Falissard B, Colliot O, Ducreux D, Corruble E. Early life adversity is associated with a smaller hippocampus in male but not female depressed in-patients: a case-control study. BMC Psychiatry 2017; 17:71. [PMID: 28202012 PMCID: PMC5312536 DOI: 10.1186/s12888-017-1233-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/07/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Three studies assessed the association of early life adversity (ELA) and hippocampal volumes in depressed patients, of which one was negative and the two others did not control for several potential confounding variables. Since the association of ELA and hippocampal volumes differ in male and female healthy volunteers, we investigated the association of ELA and hippocampal volumes in depressed patients, while focusing specifically on sex and controlling for several relevant socio-demographic and clinical variables. METHODS Sixty-three depressed in-patients treated in a psychiatric setting, with a current Major Depressive Episode (MDE) and a Major Depressive Disorder (MDD) were included and assessed for ELA. Hippocampal volumes were measured with brain magnetic resonance imaging (MRI) and automatic segmentation. They were compared between patients with (n = 28) or without (n = 35) ELA. After bivariate analyses, multivariate regression analyses tested the interaction of sex and ELA on hippocampal volume and were adjusted for several potential confounding variables. The subgroups of men (n = 26) and women (n = 37) were assessed separately. RESULTS Patients with ELA had a smaller hippocampus than those without ELA (4.65 (±1.11) cm3 versus 5.25 (±1.01) cm3), bivariate: p = 0.03, multivariate: HR = 0.40, 95%CI [0.23;0.71], p = 0.002), independently from other factors. This association was found in men (4.43 (±1.22) versus 5.67 (±0.77) cm3), bivariate: p = 0.006, multivariate HR = 0.23, 95%CI [0.06;0.82], p = 0.03) but not in women. CONCLUSION ELA is associated with a smaller hippocampus in male but not female depressed in-patients. The reasons for this association should be investigated in further studies.
Collapse
Affiliation(s)
- Romain Colle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275, Le Kremlin Bicêtre, France. .,Faculté de Médecine Paris Sud, Univ. Paris-Sud, 94275, Le Kremlin Bicêtre, France. .,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin Bicêtre, France.
| | - Tomoyuki Segawa
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Marie Chupin
- INSERM U1127, F-75013 Paris, France ,CNRS, UMR 7225, 75013 Paris, France ,0000 0001 1955 3500grid.5805.8Sorbonne Universités, UPMC Univ. Paris 06, UMR S 1127, F-75013 Paris, France ,0000 0001 2175 1768grid.418189.dInstitut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France ,Inria, Aramis project-team, Centre de Recherche de Paris, Paris, France ,0000 0001 2150 9058grid.411439.aDepartments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Minh Ngoc Thien Kim Tran Dong
- CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France ,Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- INSERM, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Olivier Colliot
- INSERM U1127, F-75013 Paris, France ,CNRS, UMR 7225, 75013 Paris, France ,0000 0001 1955 3500grid.5805.8Sorbonne Universités, UPMC Univ. Paris 06, UMR S 1127, F-75013 Paris, France ,0000 0001 2175 1768grid.418189.dInstitut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France ,Inria, Aramis project-team, Centre de Recherche de Paris, Paris, France ,0000 0001 2150 9058grid.411439.aDepartments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Denis Ducreux
- CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France ,Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| |
Collapse
|
41
|
Pruessner M, Bechard-Evans L, Pira S, Joober R, Collins DL, Pruessner JC, Malla AK. Interplay of hippocampal volume and hypothalamus-pituitary-adrenal axis function as markers of stress vulnerability in men at ultra-high risk for psychosis. Psychol Med 2017; 47:471-483. [PMID: 27774914 DOI: 10.1017/s0033291716002658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Altered hypothalamus-pituitary-adrenal (HPA) axis function and reduced hippocampal volume (HV) are established correlates of stress vulnerability. We have previously shown an attenuated cortisol awakening response (CAR) and associations with HV specifically in male first-episode psychosis patients. Findings in individuals at ultra-high risk (UHR) for psychosis regarding these neurobiological markers are inconsistent, and assessment of their interplay, accounting for sex differences, could explain incongruent results. METHOD Study participants were 42 antipsychotic-naive UHR subjects (24 men) and 46 healthy community controls (23 men). Saliva samples for the assessment of CAR were collected at 0, 30 and 60 min after awakening. HV was determined from high-resolution structural magnetic resonance imaging scans using a semi-automatic segmentation protocol. RESULTS Cortisol measures and HV were not significantly different between UHR subjects and controls in total, but repeated-measures multivariate regression analyses revealed reduced cortisol levels 60 min after awakening and smaller left HV in male UHR individuals. In UHR participants only, smaller left and right HV was significantly correlated with a smaller total CAR (ρ = 0.42, p = 0.036 and ρ = 0.44, p = 0.029, respectively), corresponding to 18% and 19% of shared variance (medium effect size). CONCLUSIONS Our findings suggest that HV reduction in individuals at UHR for psychosis is specific to men and linked to reduced post-awakening cortisol concentrations. Abnormalities in the neuroendocrine circuitry modulating stress vulnerability specifically in male UHR subjects might explain increased psychosis risk and disadvantageous illness outcomes in men compared to women.
Collapse
Affiliation(s)
- M Pruessner
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - L Bechard-Evans
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - S Pira
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - R Joober
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - D L Collins
- Departments of Neurology & Neurosurgery, and Biomedical Engineering,Brain Imaging Centre,Montreal Neurological Institute,McGill University,Montréal,Québec,Canada
| | - J C Pruessner
- Departments of Psychiatry, and Psychology,McGill Centre for Studies in Aging,Douglas Mental Health University Institute,McGill University,Montréal,Québec,Canada
| | - A K Malla
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| |
Collapse
|
42
|
Understanding heterogeneity in grey matter research of adults with childhood maltreatment—A meta-analysis and review. Neurosci Biobehav Rev 2016; 69:299-312. [DOI: 10.1016/j.neubiorev.2016.08.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/18/2016] [Accepted: 08/06/2016] [Indexed: 12/20/2022]
|
43
|
Barker V, Bois C, Neilson E, Johnstone EC, Owens DGC, Whalley HC, McIntosh AM, Lawrie SM. Childhood adversity and hippocampal and amygdala volumes in a population at familial high risk of schizophrenia. Schizophr Res 2016; 175:42-47. [PMID: 27179666 DOI: 10.1016/j.schres.2016.04.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is an established link between childhood adversity (CA) and schizophrenia. Hippocampus and amygdala abnormalities pre-date onset in those at high familial risk (fHR) of schizophrenia, but it is not clear whether these alterations are associated with CA in those at elevated risk of schizophrenia. METHODS We examined hippocampal and amygdala volumes in those at fHR who had been referred to a social worker or the Children's Panel compared to those who had not. RESULTS The right hippocampus and left amygdala were significantly smaller in those that had been referred to social work and Children's Panel. CONCLUSIONS Our findings suggest that CA can influence structural changes in the brain in a cohort at fHR of schizophrenia. These findings provide further evidence that while genetic factors contribute to the structural changes found in schizophrenia, environmental factors such as CA can have a lasting impact on specific brain regions.
Collapse
Affiliation(s)
- V Barker
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom; Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom.
| | - C Bois
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - E Neilson
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - E C Johnstone
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - D G C Owens
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom; Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - H C Whalley
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - A M McIntosh
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom; Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - S M Lawrie
- Division of Psychiatry, Centre for Brain Sciences, School of Clinical Sciences, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom; Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| |
Collapse
|
44
|
Davis J, Eyre H, Jacka FN, Dodd S, Dean O, McEwen S, Debnath M, McGrath J, Maes M, Amminger P, McGorry PD, Pantelis C, Berk M. A review of vulnerability and risks for schizophrenia: Beyond the two hit hypothesis. Neurosci Biobehav Rev 2016; 65:185-94. [PMID: 27073049 PMCID: PMC4876729 DOI: 10.1016/j.neubiorev.2016.03.017] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/25/2016] [Accepted: 03/25/2016] [Indexed: 01/15/2023]
Abstract
Schizophrenia risk has often been conceptualized using a model which requires two hits in order to generate the clinical phenotype-the first as an early priming in a genetically predisposed individual and the second a likely environmental insult. The aim of this paper was to review the literature and reformulate this binary risk-vulnerability model. We sourced the data for this narrative review from the electronic database PUBMED. Our search terms were not limited by language or date of publication. The development of schizophrenia may be driven by genetic vulnerability interacting with multiple vulnerability factors including lowered prenatal vitamin D exposure, viral infections, smoking intelligence quotient, social cognition cannabis use, social defeat, nutrition and childhood trauma. It is likely that these genetic risks, environmental risks and vulnerability factors are cumulative and interactive with each other and with critical periods of neurodevelopmental vulnerability. The development of schizophrenia is likely to be more complex and nuanced than the binary two hit model originally proposed nearly thirty years ago. Risk appears influenced by a more complex process involving genetic risk interfacing with multiple potentially interacting hits and vulnerability factors occurring at key periods of neurodevelopmental activity, which culminate in the expression of disease state. These risks are common across a number of neuropsychiatric and medical disorders, which might inform common preventive and intervention strategies across non-communicable disorders.
Collapse
Affiliation(s)
- Justin Davis
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia.
| | - Harris Eyre
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia
| | - Felice N Jacka
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia; Black Dog Institute, Sydney, Australia
| | - Seetal Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Olivia Dean
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Sarah McEwen
- Semel Institute for Neuroscience and Human Behavior, UCLA, United States
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - John McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, 4072, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia
| | - Michael Maes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia
| | - Paul Amminger
- Queensland Brain Institute, The University of Queensland, Brisbane, 4072, Queensland, Australia; Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, 35 Poplar Rd., Parkville, 3052, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, 35 Poplar Rd., Parkville, 3052, Australia; Centre of Youth Mental Health, University of Melbourne, 35 Poplar Rd., Parkville, 3052, Australia
| | - Christos Pantelis
- University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia; Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India; Melbourne Neuropsychiatry Centre, The University of Melbourne & Melbourne Health, Parkville, 3052, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia; Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, 35 Poplar Rd., Parkville, 3052, Australia; Centre of Youth Mental Health, University of Melbourne, 35 Poplar Rd., Parkville, 3052, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| |
Collapse
|
45
|
Turkington A, Duffy M, Barrett S, McCaul R, Anderson R, Cooper SJ, Rushe T, Mulholland C. Exposure to Political Violence in Northern Ireland and Outcome of First Episode Psychosis. Schizophr Bull 2016; 42:626-32. [PMID: 26519953 PMCID: PMC4838087 DOI: 10.1093/schbul/sbv155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The impact of political violence on individuals presenting with an episode of first episode psychosis has not been examined. Individuals were assessed for exposure to political violence in Northern Ireland (the "Troubles") by asking for a response to 2 questions: one asked about the impact of violence "on your area"; the second about the impact of violence "on you or your family's life." The participants were separated into 2 groups (highandlowimpact) for each question. Symptom profiles and rates of substance misuse were compared across the groups at baseline and at 3-year follow up. Of the 178 individuals included in the study 66 (37.1%) reported ahighimpact of the "Troubles" on their life and 81 (45.5%) ahighimpact of the "Troubles" on their area. There were no significant differences in symptom profile or rates of substance misuse betweenhighandlowgroups at presentation. At 3-year follow-uphighimpact of the "Troubles" on life was associated with higher Positive and Negative Symptom Scale (PANSS) Total (P= .01), PANSS-Positive (P< .05), and PANSS-General (P< .01) scores and lower global assessment of functioning disability (P< .05) scores, after adjusting for confounding factors. Impact of the "Troubles" on area was not associated with differences in symptom outcomes. This finding adds to the evidence that outcomes in psychosis are significantly impacted by environmental factors and suggests that greater attention should be paid to therapeutic strategies designed to address the impact of trauma.
Collapse
Affiliation(s)
| | - Michael Duffy
- School of Sociology, Social Policy and Social Work, Queen's University of Belfast, Belfast, UK
| | - Suzanne Barrett
- Department of Psychiatry, Queen's University of Belfast, Belfast, UK
| | | | | | - Stephen J Cooper
- Department of Psychiatry, Queen's University of Belfast, Belfast, UK
| | - Teresa Rushe
- School of Psychology, Queen's University of Belfast, Belfast, UK
| | - Ciaran Mulholland
- Department of Psychiatry, Queen's University of Belfast, Belfast, UK;
| |
Collapse
|
46
|
Effects of childhood trauma on working memory in affective and non-affective psychotic disorders. Brain Imaging Behav 2016; 11:722-735. [DOI: 10.1007/s11682-016-9548-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
47
|
Marshall DF, Passarotti AM, Ryan KA, Kamali M, Saunders EFH, Pester B, McInnis MG, Langenecker SA. Deficient inhibitory control as an outcome of childhood trauma. Psychiatry Res 2016; 235:7-12. [PMID: 26707783 PMCID: PMC6639093 DOI: 10.1016/j.psychres.2015.12.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/04/2015] [Accepted: 12/09/2015] [Indexed: 01/27/2023]
Abstract
Childhood trauma has been linked to the development and severity of psychiatric disorders as well as deficits in cognitive functioning. This study aimed to investigate the performance of bipolar disorder (BD) patients and healthy controls (HC), with or without a history of childhood trauma, on a parametric Go/No-Go (PGNG) task measuring important aspects of executive functions, namely attention and inhibitory control. Two hundred and thirty-three individuals with BD and 90 HC completed diagnostic interview, childhood trauma questionnaire (CTQ), symptom severity scales, and a PGNG task. Four comparison groups were created using a 1.0 standard deviation cut-off of the mean of the HC total CTQ score: BD-trauma, BD-normative, HC-trauma and HC-normative. We assessed interactions between diagnosis and trauma on Go/No-Go levels of interest by using a two-way multivariate analysis of covariance. Results showed a significant main effect of trauma on inhibitory control accuracy, as the trauma group exhibited significantly poorer accuracy on inhibition trials compared to the normative group. There was also a main effect of diagnosis on response time. These findings suggest that early trauma might adversely impact the development of cognitive systems and brain circuits that support inhibitory aspects of executive functioning in individuals with a history of trauma.
Collapse
Affiliation(s)
- David F. Marshall
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Corresponding author at: Department of Psychiatry, University of Michigan, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA. Tel.: + 1 734 763 9259, Fax: + 1 734 936 9262,
| | | | - Kelly A. Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Masoud Kamali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Erika F. H. Saunders
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Bethany Pester
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Scott A. Langenecker
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
48
|
Yung AR, Cotter J, Wood SJ, McGorry P, Thompson AD, Nelson B, Lin A. Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis. Psychol Med 2015; 45:3453-3465. [PMID: 26166153 DOI: 10.1017/s003329171500135x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. METHOD Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). RESULTS Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p < 0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p < 0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. CONCLUSIONS Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.
Collapse
Affiliation(s)
- A R Yung
- Institute of Brain,Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - J Cotter
- Institute of Brain,Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - S J Wood
- School of Psychology,University of Birmingham,Birmingham,UK
| | - P McGorry
- Orygen,The National Centre of Excellence in Youth Mental Health,University of Melbourne,Melbourne,Australia
| | - A D Thompson
- Warwick Medical School,University of Warwick,Coventry,UK
| | - B Nelson
- Orygen,The National Centre of Excellence in Youth Mental Health,University of Melbourne,Melbourne,Australia
| | - A Lin
- Telethon Kids Institute,The University of Western Australia,Subiaco,Australia
| |
Collapse
|
49
|
Cunningham T, Hoy K, Shannon C. Does childhood bullying lead to the development of psychotic symptoms? A meta-analysis and review of prospective studies. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2015. [DOI: 10.1080/17522439.2015.1053969] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
50
|
Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder. PLoS One 2015; 10:e0127151. [PMID: 25992568 PMCID: PMC4438058 DOI: 10.1371/journal.pone.0127151] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/13/2015] [Indexed: 11/19/2022] Open
Abstract
Dissociation, particularly the shutting down of sensory, motor and speech systems, has been proposed to emerge in susceptible individuals as a defensive response to traumatic stress. In contrast, other individuals show signs of hyperarousal to acute threat. A key question is whether exposure to particular types of stressful events during specific stages of development can program an individual to have a strong dissociative response to subsequent stressors. Vulnerability to ongoing shutdown dissociation was assessed in 75 inpatients (46M/29F, M = 31±10 years old) with schizophrenia spectrum disorder and related to number of traumatic events experienced or witnessed during childhood or adulthood. The Maltreatment and Abuse Chronology of Exposure (MACE) scale was used to collect retrospective recall of exposure to ten types of maltreatment during each year of childhood. Severity of shutdown dissociation was related to number of childhood but not adult traumatic events. Random forest regression with conditional trees indicated that type and timing of childhood maltreatment could predictably account for 31% of the variance (p < 0.003) in shutdown dissociation, with peak vulnerability occurring at 13-14 years of age and with exposure to emotional neglect followed by various forms of emotional abuse. These findings suggest that there may be windows of vulnerability to the development of shutdown dissociation. Results support the hypothesis that experienced events are more important than witnessed events, but challenge the hypothesis that “life-threatening” events are a critical determinant.
Collapse
|