Childhood adversities have been reported to be more common among individuals at ultra-high risk (UHR) for psychosis. This paper systematically reviewed and meta-analysed (i) the severity and prevalence of childhood adversities (childhood trauma exposure, bullying victimisation and parental separation or loss) among the UHR, and (ii) the association between adversities and transition to psychosis (TTP). PsycINFO, PubMed and Embase databases were searched for studies reporting childhood adversities among UHR individuals. Only published articles were included. Risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline (von Elm et al., 2007) and the tool developed by Hoy et al. (2012). Seventeen case–control, cross-sectional and longitudinal studies were included. UHR individuals experienced significantly more severe trauma than controls, regardless of trauma subtype. UHR were 5.5, 2.5 and 3.1 times as likely to report emotional abuse, physical abuse and bullying victimisation, respectively. There was no association with parental separation. However, childhood trauma was not significantly associated with TTP (follow-up periods: 6 months to 15 years), suggesting that trauma alone may not be a sufficient risk factor. Sexual abuse was associated with TTP but this may have been driven by a single large study. Potential confounders and low rates of TTP among UHR are limitations of this review. This is the first meta-analysis that quantitatively summarises the associations between childhood adversities and TTP among UHR, and between specific abuse subtypes and TTP. Specific recommendations have been made to increase the quality of future research. PROSPERO registration no. CRD42017054884.

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Cognitive bias modification is a potential low-intensity intervention for mood disorders, but previous studies have shown mixed success. This study explored whether facial interpretation bias modification (FIBM), a similar paradigm designed to shift emotional interpretation (and/or perception) of faces would transfer to: (i) self-reported symptoms and (ii) a battery of cognitive tasks. In a preregistered, double-blind randomized controlled trial, healthy participants received eight online sessions of FIBM (N = 52) or eight sham sessions (N = 52). While we replicate that FIBM successfully shifts ambiguous facial expression interpretation in the intervention group, this failed to transfer to the majority of self-report or cognitive measures. There was, however, weak, inconclusive evidence of transfer to a self-report measure of stress, a cognitive measure of anhedonia, and evidence that results were moderated by trait anxiety (whereby transference was greatest in those with higher baseline symptoms). We discuss the need for work in both larger and clinical samples, while urging caution that these FIBM training effects may not transfer to clinically relevant domains.

Cognitive bias modification (CBM) is a potential low-intensity intervention for mood disorders, but previous studies have shown mixed success. The current study explored whether CBM designed to shift emotional perception of faces would transfer to: a) a battery of cognitive tasks, and b) self-reported symptoms. In a preregistered, double-blind randomised controlled trial, healthy participants received eight online sessions of CBM (N=52) or eight sham sessions (N=52). While we replicate that CBM successfully shifts ambiguous facial expression interpretation in the intervention group, this failed to transfer to the majority of cognitive or self-report measures. There was, however, weak, inconclusive evidence of transfer to a self-report measure of stress, a cognitive measure of anhedonia, and a ceiling effect (whereby transference was greatest in those with higher symptoms). We discuss the need for work in both larger and clinical samples, whilst urging caution that these CBM training effects may not transfer to clinically relevant domains.

BackgroundA child’s parental bonding, measured using the Parental Bonding Instrument (PBI), has been found to be associated with psychiatric illnesses. In particular, a significantly higher proportion of patients with schizophrenia tend to report affectionless-controlling mothers as compared to healthy controls.This study aims to (i) investigate the applicability of the PBI tool in Singapore, using exploratory factor analysis, and (ii) explore the association between parental bonding, symptom severity and functioning across schizophrenia patients, individuals at ultra-high risk of psychosis (UHR), and healthy controls.MethodsData from 59 schizophrenia patients, 164 UHR, and 510 healthy controls (N = 733) were collected. The Structured Clinical Interview for DSM-IV (SCID) was used to ascertain any psychiatric diagnoses. Positive and Negative Symptoms of Schizophrenia (PANSS) and Global Assessment of Functioning (GAF) were administered on UHR and patients. Social and Occupational Functioning Assessment Scale (SOFAS) was administered on HC and UHR. Calgary Depression Scale for Schizophrenia (CDSS) was administered on UHR only.Two exploratory factor analyses of the PBI were conducted on maternal items and paternal items (oblimin rotation). PBI factor scores were calculated for each individual and compared across groups using one-way ANOVA. Multivariate backward regressions were conducted to elucidate the association(s) between parental bonding factors and the clinical scales.ResultsFactor analyses revealed three-factor solutions for both maternal and paternal items, with factors ‘care’, ‘autonomy’, and ‘overprotection’. All the original ‘care’ items loaded onto the ‘care’ factor for maternal and paternal analyses. The original ‘control’ items were split into ‘autonomy’ (the degree to which children were allowed to make their own decisions, e.g. ‘gave me as much freedom as I wanted’) and ‘overprotection’ (e.g. ‘felt I could not look after myself’). Fit statistics suggested a good fit for both maternal items and paternal items (CFI > 0.9, TLI > 0.9). UHR were 1.61 times as likely to report affectionless-controlling mothers (OR = 1.61, 95% CI: 1.13–2.30, p = .008) and 0.52 times as likely to report having optimal mothers (OR = 0.52, 95% CI: 0.29–0.93, p = 0.028). No significant differences in paternal styles were reported.Compared to HC, patients and UHR reported significantly lower maternal care (F(2,729) = 27.51, p < .001), higher maternal overprotection (F(2,729) = 17.00, p < .001) and paternal overprotection (F(2,711) = 9.30, p < .001) (bonferroni-corrected). Among UHR, higher paternal overprotection was significantly associated with higher total PANSS scores (β = .162, p = .045), higher PANSS general psychopathology subscores (β = .185, p = .022), lower GAF scores (β = -.188, p =.021), lower SOFAS scores (β = -.183, p = .024), and worse CDSS scores (β = .210, p = .009). Among patients, higher maternal overprotection (β = .444, p = .022) and paternal care (β = .400, p = .036) were associated with higher GAF ...