Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

Abstract

Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified.

Preferential association between childhood emotional abuse and bipolar disorder

“…This is consistent with previous studies showing a dose-effect association between childhood trauma severity and various psychiatric disorders during adulthood (for review see (Read et al, 2005)). Our results thus suggest that, among trauma subtypes, emotional abuse may be preferentially associated with bipolar disorder.…”

“…Since interaction between a given subtype of trauma with specific genetic factors might be the causal link to a given psychiatric condition (Caspi & Moffitt, 2006), the association between bipolar disorder and different subtypes of trauma requires to be formally tested. Finally, a dose-effect of trauma subtypes has never been investigated in bipolar disorder although this effect has previously been reported in other psychopathological conditions, such as in psychosis (Read, van Os, Morrison, & Ross, 2005).…”

The role of stress‐regulation genes in moderating the association of stress and daily‐life psychotic experiences

“…In this context, our significant results of distal stress with the FKBP5 and RGS4 risk haplotypes suggest that after childhood trauma exposure, both variants may be involved in the HPA axis dysregulation associated with the risk for PEs across the extended psychosis phenotype. This is consistent with compelling evidence suggesting that the dysregulation of HPA axis may play a critical role in the expression of the positive dimension of psychotic phenomena 56, 57 due to the synergistic relation between glucocorticoid secretion and an elevated dopaminergic activity in mesolimbic regions (e.g., 58). …”

An examination of the broader effects of warzone experiences on returning Iraq/Afghanistan veterans׳ psychiatric health

“…Within the civilian literature, childhood trauma exposure has been related to the development of obsessive compulsive disorder (OCD; Lochner et al, 2002;Matthews et al, 2008;Grisham et al, 2011), social anxiety disorder (Cougle et al, 2009;Simon et al, 2009), panic disorder (Friedman et al, 2001;Cougle et al, 2009), generalized anxiety disorder (Cougle et al, 2009), specific phobia (Cougle et al, 2009), eating disorders (Wonderlich et al, 1997;Rayworth et al, 2004;Jonas et al, 2011) drug-use disorders , psychosis (Read et al, 2005;Fisher et al, 2010;Alvarez et al, 2011), hypochondriasis (Barsky et al, 1994), and somatization (Sanson et al, 2001;Paras et al, 2009). To date, however, far less research has examined whether critical warzone experiences might also be broadly associated with psychiatric symptomatology.…”