Cumulative sociodemographic disadvantage partially mediates associations between childhood trauma and schizotypy

Sociodemographic profile and clinical presentation of young children unintentionally exposed to marijuana: A single site retrospective cohort

BACKGROUND AND OBJECTIVES

Legalization of medical marijuana has increased unintentional exposure to marijuana in young children. We aim to explore the sociodemographic disadvantage profile, prevalence, and clinical presentation of children diagnosed with unintentional exposure to marijuana.

METHODS

We conducted a retrospective chart abstraction of 121 children (aged 0-6) seen at the Emergency Department (ED) at a single tertiary hospital center in Dayton, Ohio between January 01, 2010 and January 09, 2022.

RESULTS

Majority were female (62.8%), white (50.4%), and with Medicaid as their primary insurance (84.3%). The median age at exposure was 1.8 years. There was a 14-fold increase in unintentional marijuana cases pre-2017 (7 cases) versus post-2017 (114 cases), the year of legalization of medical marijuana in the state of Ohio. Majority of the patients were using public assistance (66.4%). 26.7% of the cases had a prior social work consultation and 38.1% had a prior children services consultation. 51.3% of the children had a social disadvantage index score of 3 or greater (range 0-5) with higher scores indicating greater disadvantage.

DISCUSSION AND CONCLUSIONS

The number of patients presenting to the ED at the hospital has increased 14-fold since the legalization of medical marijuana in Ohio. Half of the children displayed a higher sociodemographic disadvantage index score.

SCIENTIFIC SIGNIFICANCE

Our study is the first study investigating the sociodemographic profile of children exposed to marijuana. The findings of this study may be utilized to inform policy for safely dispensing recreational and medicinal marijuana products and focus the efforts on families with sociodemographic disadvantage.

Childhood trauma moderates schizotypy-related brain morphology: analyses of 1182 healthy individuals from the ENIGMA schizotypy working group

BACKGROUND

Schizotypy represents an index of psychosis-proneness in the general population, often associated with childhood trauma exposure. Both schizotypy and childhood trauma are linked to structural brain alterations, and it is possible that trauma exposure moderates the extent of brain morphological differences associated with schizotypy.

METHODS

We addressed this question using data from a total of 1182 healthy adults (age range: 18-65 years old, 647 females/535 males), pooled from nine sites worldwide, contributing to the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Schizotypy working group. All participants completed both the Schizotypal Personality Questionnaire Brief version (SPQ-B), and the Childhood Trauma Questionnaire (CTQ), and underwent a 3D T1-weighted brain MRI scan from which regional indices of subcortical gray matter volume and cortical thickness were determined.

RESULTS

A series of multiple linear regressions revealed that differences in cortical thickness in four regions-of-interest were significantly associated with interactions between schizotypy and trauma; subsequent moderation analyses indicated that increasing levels of schizotypy were associated with thicker left caudal anterior cingulate gyrus, right middle temporal gyrus and insula, and thinner left caudal middle frontal gyrus, in people exposed to higher (but not low or average) levels of childhood trauma. This was found in the context of morphological changes directly associated with increasing levels of schizotypy or increasing levels of childhood trauma exposure.

CONCLUSIONS

These results suggest that alterations in brain regions critical for higher cognitive and integrative processes that are associated with schizotypy may be enhanced in individuals exposed to high levels of trauma.

Trauma and Social Pathways to Psychosis, and Where the Two Paths Meet

The pathways from trauma-via dissociation-to psychosis have been thoroughly tested and evidenced, but what has received less attention has been the social pathways-via dissociation-to psychosis. Often social factors are more commonly linked to other influences, e.g., to appraisals and the creation of negative schema in cognitive models, or to unsupportive caregiving experiences where there is high "expressed emotion." However, evidence is now emerging that negative social rank experiences, such as being excluded or shamed, may themselves have dissociative properties, which poses intriguing questions as to how trauma pathways and social pathways might interact. This article reviews the state of knowledge in trauma and social pathways to psychosis and then considers the potential mechanisms and the relationships between them, specifically (i) dissociation, (ii) attachment, and (iii) social rank. Recommendations are suggested for future modeling and testing of three-way interactions (dissociation × attachment × social rank) in the pathway from trauma to psychosis.