Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition

Kilian, Sanja; Asmal, Laila; Chiliza, Bonginkosi; Olivier, Marius Riaan; Phahladira, Lebogang; Scheffler, Frederika; Seedat, Soraya; Marder, Stephen R.; Green, M F; Emsley, Robin

doi:10.1017/s0033291717003671

Cited by 56 publications

(61 citation statements)

References 36 publications

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“…Because childhood trauma occurs during a critical time for the development of social functioning skills, traumatic experiences can disrupt the development of these skills, resulting in lifelong difficulties in interpersonal functioning. For example, childhood trauma can disrupt the normative development of self‐awareness, social cognitive skills , and the ability to develop secure attachments to others , which have been linked to the development of negative symptoms . Consistent with this notion, in longitudinal studies of early psychosis, childhood trauma predicts social functioning difficulties in adulthood .…”

Section: Discussionmentioning

confidence: 90%

Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder

Velikonja

Velthorst

McClure

et al. 2019

Acta Psychiatr Scand

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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. Significant outcomes• Sexual abuse and emotional abuse were the types of childhood trauma most strongly associated with a SPD diagnosis, especially in severe forms.• Severe forms of sexual abuse showed the strongest magnitude of association with cognitiveperceptual traits, while severe emotional neglect showed the strongest magnitude of association with interpersonal symptoms (e.g., excessive social anxiety, constricted affect) among SPD.• Severe childhood trauma was associated with worse overall cognitive functioning among SPD. Limitations• The evaluation of childhood trauma was based on self-report measures.• A cross-sectional study design does not allow any conclusions about directionality of the associations between childhood trauma types and increased schizotypal personality disorder traits. Causality is compromised by the assumption that childhood trauma preceded the development of SPD.• The neurocognitive assessments were only completed for a subset of our sample, precluding more detailed analysis (e.g., exploring the associations between cognition and different trauma types, sex differences).

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Section: Discussionmentioning

confidence: 90%

Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder

Velikonja

Velthorst

McClure

et al. 2019

Acta Psychiatr Scand

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“…With regard to cognitive performance measures, we found no evidence for associations between trauma exposure and performance on any of the cognitive domains investigated here, regardless of diagnostic status. This is consistent with similar findings from large samples comparing SZ cases to healthy individuals (Green, Chia, et al ., ), in a sample of cases with first‐episode psychosis (Kilian et al ., ), and samples of mixed psychotic cases grouped according to both their levels of psychopathology and trauma exposure (Mansueto et al ., ). However, these findings are at odds with several previous reports in trauma‐exposed healthy youths and adults (Hart & Rubia, ), adults with bipolar disorder (Bucker et al ., ; Jimenez et al ., ; Savitz et al ., ), and adult psychosis samples (Li et al ., ; Lysaker et al ., ; Shannon et al ., ).…”

Section: Discussionmentioning

confidence: 99%

Schizotypal personality traits and social cognition are associated with childhood trauma exposure

Quidé

Cohen‐Woods

O’Reilly

et al. 2018

British J Clinic Psychol

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Findings Childhood trauma exposure is associated with increased schizotypal features (in particular paranoid ideation) and complex social cognitive abilities, independently of the diagnosis of psychotic disorder. Cognitive and social cognitive deficits were larger in schizophrenia compared to bipolar-I cases and healthy controls, but increased schizotypal features were observed in both schizophrenia and bipolar-I disorder relative to healthy controls. Limitations We were unable to distinguish the specific effects of particular childhood trauma exposures due to the high rate of exposure to more than one type of maltreatment. Retrospective assessment of childhood trauma in adulthood cannot be externally validated, and associations with behavioural traits in later life may be confounded by other factors not studied here.

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“…However, this meta‐analysis examined only studies of nonsocial cognition, and did not explore whether different types of adversity or the timing of adversity (e.g., neglect vs. trauma, early vs. late childhood) has differential effects on cognition in schizophrenia. Notably, findings from recent studies suggest that social cognitive impairment is more related to neglect than other types of adversity.…”

Section: Recent Developments and Future Directions For Research On Comentioning

confidence: 99%

Nonsocial and social cognition in schizophrenia: current evidence and future directions

2019

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Cognitive impairment in schizophrenia involves a broad array of nonsocial and social cognitive domains. It is a core feature of the illness, and one with substantial implications for treatment and prognosis. Our understanding of the causes, consequences and interventions for cognitive impairment in schizophrenia has grown substantially in recent years. Here we review a range of topics, including: a) the types of nonsocial cognitive, social cognitive, and perceptual deficits in schizophrenia; b) how deficits in schizophrenia are similar or different from those in other disorders; c) cognitive impairments in the prodromal period and over the lifespan in schizophrenia; d) neuroimaging of the neural substrates of nonsocial and social cognition, and e) relationships of nonsocial and social cognition to functional outcome. The paper also reviews the considerable efforts that have been directed to improve cognitive impairments in schizophrenia through novel psychopharmacology, cognitive remediation, social cognitive training, and alternative approaches. In the final section, we consider areas that are emerging and have the potential to provide future insights, including the interface of motivation and cognition, the influence of childhood adversity, metacognition, the role of neuroinflammation, computational modelling, the application of remote digital technology, and novel methods to evaluate brain network organization. The study of cognitive impairment has provided a way to approach, examine and comprehend a wide range of features of schizophrenia, and it may ultimately affect how we define and diagnose this complex disorder.

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Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition

Abstract: These findings are cross sectional and do not infer causality. Nonetheless, they indicate that associations between one type of childhood adversity (i.e. neglect) and social cognition are present and are not illness-specific.

Cited by 56 publications

References 36 publications

Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder

Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder

Schizotypal personality traits and social cognition are associated with childhood trauma exposure

Nonsocial and social cognition in schizophrenia: current evidence and future directions

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