Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients

Alameda, Luis; Ferrari, Carina; Baumann, Philipp S.; Gholamrezaee, M.M.; Q., Kim; Conus, Philippe

doi:10.1017/s0033291715000690

Cited by 100 publications

(108 citation statements)

References 62 publications

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“…In contrast to several previous studies [26,15, 17, 27–28] we did not find higher rates of childhood trauma in patients compared with matched controls. However, this may be explained by the fact that the rates of childhood trauma documented in both patients and controls in this study were generally higher than those reported in other studies.…”

Section: Discussioncontrasting

confidence: 99%

“…In comparison, in a UK-based study, 16% of first episode psychosis patients and 13% controls reported severe sexual abuse and 24% patients and 13% controls reported severe physical abuse [26]. In a study conducted in Switzerland, 12% patients reported sexual abuse and 17.7% reported physical abuse [17]. Our findings are consistent with those of a meta-analysis that compared rates of childhood trauma across countries and found that that Lower and Middle Income Countries (LMIC) had higher rates than upper income countries [29].…”

Section: Discussionmentioning

confidence: 99%

“…Stain [16] specifically investigated the association between childhood trauma and social functioning in 233 patients with a first-episode of schizophrenia-spectrum disorder and reported that childhood trauma was significantly associated with poorer premorbid social functioning in childhood, early adolescence and late adolescence. Finally, Alameda [17] investigated the relationship between childhood abuse and functional outcome in 225 early psychosis patients. They found that physical and sexual abuse were associated with poor premorbid social functioning in early adolescence and that the age of first trauma exposure correlated significantly with social functioning in patients at follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia

et al. 2017

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Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia

et al. 2017

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“…However, when adjusting all analysis for gender, the differences we observed remained significant, suggesting exposure to trauma is indeed an important characteristic of such patients. In line with others [39][40][41][42] we observed in a previous study that exposure to adverse experiences during childhood is associated with poorer functional [25] and symptomatic [26] recovery; the fact that LO patients were more likely to have been exposed to trauma may hence play a role in their failure to return to their pre-morbid functional level.…”

Section: Discussionsupporting

confidence: 90%

Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?

et al. 2017

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Background: While there is suggestion that early onset of psychosis is a determinant of outcome, knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients.Methods: 256 early psychosis patients aged 18-35 were followed-up prospectively over 36 months. Patients with onset after 26 ("later onset", LO) were compared to the rest of the sample.Results: LO patients (32% of the sample) had shorter DUP, were less likely to be male, had better premorbid functioning and were more likely to have been exposed to trauma. They had greater insight at presentation and less negative symptoms overall. The trajectories for positive and depressive symptoms were similar in both groups. Evolution of functional level was similar in both groups, but while LO patients recovered faster, they were significantly less likely to return to premorbid functional level. Conclusions:Later psychosis onset correlates with better pre-morbid functioning and higher rate of trauma exposure; the latter should therefore be a treatment focus in such patients. LO patients were less likely to return to premorbid functional level, which suggests that current treatment strategies may not be efficient to help patients maintain employment. The possibility of distinct illness mechanisms according to onset age and the more central role for trauma in patients with onset after age 26 needs to be further explored.

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“…However, due to power issues, multiple testing and to follow earlier research in our sample (Heins et al, 2011), we currently chose to use a division in abuse and neglect. Also, future studies may want to incorporate detailed information concerning the age at which childhood trauma occurred as this seems to impact functional outcome (Alameda et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

The effect of childhood trauma and Five-Factor Model personality traits on exposure to adult life events in patients with psychotic disorders

Pos¹,

Boyette

Meijer³

et al. 2016

Cognitive Neuropsychiatry

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Introduction: Recent life events are associated with transition to and outcome in psychosis. Childhood trauma and personality characteristics play a role in proneness to adult life events. However, little is known about the relative contribution and interrelatedness of these characteristics in psychotic disorders. Therefore, we investigated whether Five-Factor Model (FFM) personality traits and childhood trauma (abuse and neglect) predict adult life events, and whether the effect of childhood trauma on life events is mediated by personality traits. Method: One hundred and sixty-three patients with psychotic disorders were assessed at baseline on history of childhood maltreatment and FFM personality traits, and on recent life events at 3-year follow-up. Results: Childhood abuse is associated with negative life events, and part of the effect of childhood abuse on negative life events is mediated by openness to experience. Openness to experience and extraversion are associated with more positive and negative life events. Childhood neglect and lower extraversion are related to experiencing less positive events. Conclusion: The association between childhood trauma and recent life events is partly mediated by personality. Future research could focus on mechanisms leading to positive life events, as positive life events may buffer against development of mental health problems.

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Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients

Cited by 100 publications

References 62 publications

Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia

Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia

Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?

The effect of childhood trauma and Five-Factor Model personality traits on exposure to adult life events in patients with psychotic disorders

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