The Unique Contribution of Past Bullying Experiences to the Presence of Psychosis-Like Experiences in University Students

What Do Four Decades of Research Tell Us About the Association Between Childhood Adversity and Psychosis: An Updated and Extended Multi-Level Meta-Analysis

OBJECTIVE

Estimating the current association between childhood adversity and the risk of psychosis is crucial for prevention and intervention. We provided an updated synthesis of evidence from the past four decades, expanded the available data by investigating a broad array of adversity subtypes, and explored sex differences and the age of psychosis onset as relevant factors.

METHODS

We searched PubMed, EMBASE, PsycINFO, Web of Science, WANFANG, and CNKI, for case-control, cross-sectional and cohort studies on the association between adversity and psychotic symptoms/illness. Multi-level meta-analysis, prediction intervals calculation, and sensitivity analyses were conducted.

RESULTS

The main analysis included 183 study samples (N=349,265), with 119 case-control studies (15,186 cases; 14,879 controls), 51 cross-sectional studies (N=299,659), and 13 cohort studies (N=19,541). Significant associations between adversity and psychosis were observed across all study designs, yielding an overall odds ratio of 2.80 (95% CI=2.18, 3.60). Secondary analyses revealed that exposure to each adversity subtype increased the odds of psychosis, with the highest odds ratio (3.54 [95% CI=3.04, 4.13]) for emotional abuse, and the lowest odds ratio of (1.58 [95% CI=1.48, 1.68]) for parental antipathy. No statistically significant sex differences were observed, although the odds ratio for sexual abuse was higher for women. Onset of psychosis was earlier in adversity-exposed individuals (mean difference=-0.79 years, 95% CI=-1.47 to -0.12).

CONCLUSIONS

This is the largest meta-analysis to date on the association between childhood adversity and psychosis. The results have broad clinical implications, as they highlight the need for selective prevention of exposure to early adversities and the implementation of trauma-informed therapies in the treatment of psychosis.

Early Bullying's Long Shadow: How Victimization in Childhood and Adolescence is Associated with University Students' Mental Health and Loneliness

Bullying victimization in childhood and adolescence is widely acknowledged for its detrimental effects on mental health and loneliness in young adulthood. However, the influence of onset time when bullying happens (in primary and/or secondary school) and of distinct forms of bullying remain underexplored. The study aims to explore the associations between seven forms of victimization (being teased or called nasty names; rumor spreading; physical harm; threat; property damage; robbery; social exclusion) during university students' primary and secondary school years and their current mental health and loneliness in China. A total of 684 university students (mean age = 19.05, SD = 1.56) completed Depression, Anxiety, Stress Scale (DASS-21), UCLA Loneliness Scale, and Retrospective Bullying Questionnaire, which involves recollection of bullying victimization during primary and secondary school years. Stable victim (those who experienced bullying victimization during both primary and secondary school years) was most strongly associated with current higher levels of depression, anxiety, stress, and loneliness. Different forms of bullying victimization in primary and secondary school years were independently associated with mental health and loneliness. Specifically, rumor spreading in secondary school strongly predicted depression, anxiety, and stress, while social exclusion in primary school was closely linked to depression, anxiety, and loneliness. These findings underscore the long-term psychological impact of various forms of bullying victimization experienced in primary and secondary school years and highlight the importance of targeted interventions that address specific types of bullying in primary and secondary school years to mitigate their enduring effects on mental health in young adulthood.

Independent effects of early life adversity on social cognitive function in patients with schizophrenia

Objective

The aim of this study was to investigate the impact of early life adversity on cognitive function in patients with schizophrenia, with a focus on social cognition (SC).

Methods

Two groups of patients with schizophrenia were recruited and matched on sociodemographic and clinical characteristics. One group consisted of 32 patients with a history of childhood trauma (SCZ-ct), and the other group consisted of 30 patients without a history of childhood trauma (SCZ-nct). In addition, 39 healthy controls without a history of childhood trauma (HC-nct) were also recruited. The intelligence of the three groups was assessed using the Wechsler Abbreviated Scale of Intelligence (WAIS-RC) short version. The cognitive function evaluation was conducted using the MATRICS Consensus Cognitive Battery (MCCB), and early life adversity was measured using the Childhood Trauma Questionnaire-Short Form (CTQ) and Bullying Scale for Adults (BSA).

Results

Patients with schizophrenia endosed significantly higher scores on the CTQ (F=67.61, p<0.001) and BSA (F=9.84, p<0.001) compared to the HC-nct. Analysis of covariance (ANCOVA) and post-hoc analyses revealed that SCZ-ct (F=11.20, p<0.001) exhibited the most pronounced cognitive impairment among the three groups, as indicated in MCCB total scores and in the domain score of SC. CTQ exhibited a negative correlation with MCCB (r=-0.405, p< 0.001); SC was negatively correlated with physical abuse (PA) of CTQ (r=-0.271, p=0.030) and emotional abuse (EA) of BSA (r=-0.265, p=0.034) in the whole patient sample. Higher SC performance was significantly predicted by CT_total (Beta =-0.582, p<0.001, 95% CI -0.96-0.46), and years of education (Beta=0.260, p =0.014, 95% CI 0.20-1.75) in schizophrenia.

Conclusions

Besides familial trauma, schizophrenia patients appear to have a higher likelihood of experiencing bullying in their early life. These experiences seem to contribute significantly to their severe impairments in SC.