Impact of Interpersonal Trauma on the Social Functioning of Adults With First-Episode Psychosis

Stain, Helen J.; Brønnick, Kolbjørn; Hegelstad, Wenche ten Velden; Joa, Inge; Johannessen, Jan Olav; Langeveld, Johannes; Mawn, Lauren; Larsen, Tor Ketil

doi:10.1093/schbul/sbt166

Cited by 83 publications

(71 citation statements)

References 39 publications

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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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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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“…Patients with a first episode of psychosis and those with established schizophrenia who had experienced childhood trauma exhibited worse premorbid social and academic functioning compared with those without a history of childhood trauma (Schenkel et al 2005;Stain et al 2014). Childhood trauma has also been associated with functional deficits in adulthood in patients with schizophrenia (Lysaker et al 2001a;Spence et al 2006;Gil et al 2009;Choi et al 2011).…”

Section: Psychotic Disordersmentioning

confidence: 99%

“…Among patients with borderline personality disorder, rates of adult experiences of abuse are remarkably high and predict failure to achieve symptomatic remission (Zanarini et al 2005). Stain et al (2014) also reported that 45% of first-episode psychosis patients who had experienced childhood trauma also experienced adulthood trauma. This suggests that the damaging effects of trauma on functioning may be initiated in childhood and maintained into adulthood in a large proportion of patients.…”

Section: Revictimizationmentioning

confidence: 99%

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

Cotter

Kaess

Yung

2014

Ir. j. psychol. Med.

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Objectives. We aimed to examine the association between childhood trauma and functional impairment in psychotic disorders, bipolar disorder and borderline personality disorder, to speculate on possible mechanisms that underlie this association and discuss the implications for clinical work.Methods. Narrative review of the peer-reviewed English language literature in the area.Results. High rates of childhood trauma in psychotic disorders, bipolar disorder and borderline personality disorder were identified. This was associated with impaired social and occupational functioning in both the premorbid and established phases of each of these psychiatric disorders over and above the deficits typically observed in these populations. Possible mechanisms mediating this relationship include neurocognitive deficits, insecure attachment, higher rates of comorbidities and problems with adherence and response to treatment. Conclusions.Routine clinical inquiry about childhood maltreatment should be adopted within mental health settings. This has potentially important treatment implications for identifying those individuals at elevated risk of functional disability. While there is no clear guidance currently available on how to target childhood trauma in the treatment of psychotic disorders, bipolar disorder or borderline personality disorder, there are several promising lines of enquiry and further research is warranted.

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“…Emotional abuse was significantly associated with poor premorbid adjustment in late adolescence and overall trauma was significantly correlated with poor general premorbid adjustment. 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.…”

Section: Introductionmentioning

confidence: 99%

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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Impact of Interpersonal Trauma on the Social Functioning of Adults With First-Episode Psychosis

Cited by 83 publications

References 39 publications

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

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

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

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

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