Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study

Childhood maltreatment influences adult brain structure through its effects on immune, metabolic, and psychosocial factors

Childhood maltreatment (CM) leads to a lifelong susceptibility to mental ill-health which might be reflected by its effects on adult brain structure, perhaps indirectly mediated by its effects on adult metabolic, immune, and psychosocial systems. Indexing these systemic factors via body mass index (BMI), C-reactive protein (CRP), and rates of adult trauma (AT), respectively, we tested three hypotheses: (H1) CM has direct or indirect effects on adult trauma, BMI, and CRP; (H2) adult trauma, BMI, and CRP are all independently related to adult brain structure; and (H3) childhood maltreatment has indirect effects on adult brain structure mediated in parallel by BMI, CRP, and AT. Using path analysis and data from N = 116,887 participants in UK Biobank, we find that CM is related to greater BMI and AT levels, and that these two variables mediate CM's effects on CRP [H1]. Regression analyses on the UKB MRI subsample (N = 21,738) revealed that greater CRP and BMI were both independently related to a spatially convergent pattern of cortical effects (Spearman's ρ = 0.87) characterized by fronto-occipital increases and temporo-parietal reductions in thickness. Subcortically, BMI was associated with greater volume, AT with lower volume and CPR with effects in both directions [H2]. Finally, path models indicated that CM has indirect effects in a subset of brain regions mediated through its direct effects on BMI and AT and indirect effects on CRP [H3]. Results provide evidence that childhood maltreatment can influence brain structure decades after exposure by increasing individual risk toward adult trauma, obesity, and inflammation.

Clinical illness course and family-related outcomes among parents with a first episode of schizophrenia spectrum disorder: a 20-year follow-up of the OPUS trial

BACKGROUND

Studies investigating parenthood and how it affects long-term outcomes are lacking among individuals with schizophrenia spectrum disorders. This study aimed to examine the life of participants 20 years after their first diagnosis with a special focus on parenthood, clinical illness course, and family-related outcomes.

METHODS

Among 578 individuals diagnosed with first-episode schizophrenia spectrum disorder between 1998 and 2000, a sample of 174 participants was reassessed at the 20-year follow-up. We compared symptom severity, remission, clinical recovery, and global functioning between 75 parents and 99 non-parents. Also, family functioning scored on the family assessment device, and the children's mental health was reported. We collected longitudinal data on psychiatric admission, supported housing, and work status via the Danish registers.

RESULTS

Participants with offspring had significantly lower psychotic (mean (s.d.) of 0.89 (1.46) v. 1.37 (1.44), p = 0.031) negative (mean [s.d.] of 1.13 [1.16] v. 1.91 [1.07], p < 0.001) and disorganized symptom scores (mean [s.d.] of 0.46 [0.80] v. 0.85 [0.95], p = 0.005) and more were in remission (59.5% v. 22.4%, p < 0.001) and in clinical recovery (29.7% v. 11.1%, p = 0.002) compared to non-parents. When investigating global functioning over 20 years, individuals becoming parents after their first diagnosis scored higher than individuals becoming parents before their first diagnosis and non-parents. Regarding family-related outcomes, 28.6% reported unhealthy family functioning, and 10% of the children experienced daily life difficulties.

CONCLUSIONS

Overall, parents have more favorable long-term outcomes than non-parents. Still, parents experience possible challenges regarding family functioning, and a minority of their children face difficulties in daily life.

Preschool Aggression and Victimization: A Short-Term Longitudinal Analysis of the Immediate Social Environment

Introduction

Preschool aggression, a significant concern, requires an in-depth examination beyond individual factors. This study explored the link between individual characteristics, immediate social environment variables, and the likelihood of preschoolers being nominated as aggressors or victims. The novelty of the study lies in its comprehensive longitudinal examination, using a multi-informant approach, of how family dynamics, peer relations, teacher-child interactions, and community factors are related to preschool aggression within the context of Bronfenbrenner's ecological system theory.

Methods

Data was collected at two points, four months apart, to investigate the interplay among sociodemographic, individual, family, and school factors and subsequent child aggression. The study included 394 children (184 girls, 210 boys), aged 3 to 6 years (M = 4.36, SD = 0.87). Caregivers completed questionnaires on socioeconomic status, community relationships, children's emotional regulation, and family functioning. Teachers rated closeness with each child, while children nominated liked and disliked peers, as well as those exhibiting aggressive or victimized behaviour.

Results

Logistic regression models revealed stronger associations between peer aggression and victimization and individual factors over microsystems. Surprisingly, community cohesion showed a robust positive link with an increased likelihood of children being nominated as victims, challenging the assumption that positive parenting practices and strong community cohesion always leads to positive outcomes for individuals.

Discussion

The study advances theoretical understanding by examining how factors within preschoolers' microsystems influence aggressive behaviors, contributing to more holistic models for addressing preschool aggression and victimization in schools. The findings highlight the significance of targeted interventions, emphasizing early identification of aggression or victimization signs and customized programs for social and emotional skill development. Addressing parental stress and interparental conflict is crucial. Additionally, community-based initiatives, like strengthening support networks, play a pivotal role in fostering healthier social dynamics among preschoolers.

Parental mental disorders and offspring schizotypy in middle childhood: an intergenerational record linkage study

PURPOSE

To investigate relationships between distinct schizotypy risk profiles in childhood and the full spectrum of parental mental disorders.

METHODS

Participants were 22,137 children drawn from the New South Wales Child Development Study, for whom profiles of risk for schizophrenia-spectrum disorders in middle childhood (age ~ 11 years) were derived in a previous study. A series of multinomial logistic regression analyses examined the likelihood of child membership in one of three schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) relative to the children showing no risk, according to maternal and paternal diagnoses of seven types of mental disorders.

RESULTS

All types of parental mental disorders were associated with membership in all childhood schizotypy profiles. Children in the true schizotypy group were more than twice as likely as children in the no risk group to have a parent with any type of mental disorder (unadjusted odds ratio [OR] = 2.27, 95% confidence intervals [CI] = 2.01-2.56); those in the affective (OR = 1.54, 95% CI = 1.42-1.67) and introverted schizotypy profiles (OR = 1.39, 95% CI = 1.29-1.51) were also more likely to have been exposed to any parental mental disorder, relative to children showing no risk.

CONCLUSION

Childhood schizotypy risk profiles appear not to be related specifically to familial liability for schizophrenia-spectrum disorders; this is consistent with a model where liability for psychopathology is largely general rather than specific to particular diagnostic categories.

Leveraging Administrative Data to Better Understand and Address Child Maltreatment: A Scoping Review of Data Linkage Studies

BACKGROUND

This scoping review aimed to overview studies that used administrative data linkage in the context of child maltreatment to improve our understanding of the value that data linkage may confer for policy, practice, and research.

METHODS

We searched MEDLINE, Embase, PsycINFO, CINAHL, and ERIC electronic databases in June 2019 and May 2020 for studies that linked two or more datasets (at least one of which was administrative in nature) to study child maltreatment. We report findings with numerical and narrative summary.

RESULTS

We included 121 studies, mainly from the United States or Australia and published in the past decade. Data came primarily from social services and health sectors, and linkage processes and data quality were often not described in sufficient detail to align with current reporting guidelines. Most studies were descriptive in nature and research questions addressed fell under eight themes: descriptive epidemiology, risk factors, outcomes, intergenerational transmission, predictive modelling, intervention/service evaluation, multi-sector involvement, and methodological considerations/advancements.

CONCLUSIONS

Included studies demonstrated the wide variety of ways in which data linkage can contribute to the public health response to child maltreatment. However, how research using linked data can be translated into effective service development and monitoring, or targeting of interventions, is underexplored in terms of privacy protection, ethics and governance, data quality, and evidence of effectiveness.

Self-reported mental health of children known to child protection services: an Australian population-based record linkage study

Maltreated children are vulnerable to adverse mental health outcomes. Information about how children's mental health needs vary according to different levels of child protection contact (potentially culminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10 years and self-reported mental health difficulties at age 11 years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placed in OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placement and 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment.

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.

Families, Parenting and Aggressive Preschoolers: A Scoping Review of Studies Examining Family Variables Related to Preschool Aggression

BACKGROUND

A growing body of research has shown that children behave aggressively from an early age. In recent decades, such behaviour has become a focus of scientific interest, not only because of the adverse consequences of these interactions, but also because high levels of aggression, especially at an early age, may be a risk factor for the use of other forms of aggression, such as bullying, later on during their development. These behaviours are related not only to individual characteristics, but also to peer relationships, teacher behaviours, school variables, family factors and cultural influences.

METHOD

In order to find out which family variables have been researched in relation to preschool aggression and which family variables are associated with perpetration and victimisation, a scoping review was conducted in accordance with the PRISMA guidelines. Four databases (Web of Science, Scopus, PubMed and PsycINFO) were used to map the studies published between 2000 and 2022.

RESULTS

This scoping review included 39 peer-reviewed articles from an initial sample of 2002 of them. The majority of studies looked only at perpetration behaviours. The main family variables covered in the articles concern parental behaviours, adverse childhood experiences in the family environment, and the household structural and sociodemographic characteristics.

CONCLUSION

This scoping review shows that different factors within the family environment increase the risk of developing aggressive and victimising behaviours in the preschool setting. However, the relationship between the family variables and preschool aggression is complex, and it may be mediated by other factors such as gender, child-teacher closeness or parent-child dyads.

Early childhood developmental vulnerability associated with parental mental disorder comorbidity

OBJECTIVES

Parental mental health has a profound influence on the mental health and well-being of their offspring. With comorbid mental disorders generally the rule rather than the exception, increased knowledge of the impact of parental mental disorder comorbidity on early child development may facilitate improved targeting and delivery of early intervention for vulnerable offspring.

METHODS

Participants were 66,154 children and their parents in the New South Wales Child Development Study - a prospective, longitudinal, record-linkage study of a population cohort of children born in NSW between 2002 and 2004. Early childhood developmental vulnerability was assessed at age ~5 years using the Australian Early Development Census, and information on parental mental disorders was obtained from administrative health records. Binomial and multinomial logistic regression were used to assess the relationship between parental mental disorders and early childhood developmental vulnerability on emotional and behavioural domains, as well as membership of latent developmental risk classes reflecting particular classes of vulnerability.

RESULTS

Multiple diagnoses of mental disorders in mothers and fathers were associated with an increased likelihood of early childhood emotional and behavioural developmental vulnerability in offspring, relative to parents without mental disorder. The likelihood of offspring vulnerability increased with the number of parental comorbidities, particularly maternal comorbidities.

CONCLUSION

Early childhood developmental vulnerability was strongly associated with parental mental ill-health, with the strength of associations increasing in line with a greater number of mental disorder diagnoses among mothers and fathers. New and expectant parents diagnosed with multiple mental disorders should be prioritised for intervention, including attention to the developmental well-being of their offspring.

The impact of parent history of severe mental illness on schizophrenia outcomes: results from the real-world FACE-SZ cohort

Parent history of severe mental illness (PHSMI) may have long-term consequences in adult offspring due to genetic and early environmental factors in preliminary studies. To compare the outcomes associated in subjects with PHSMI to those in patients without PHSMI. The participants with schizophrenia and schizoaffective disorders were recruited in the ongoing FACE-SZ cohort at a national level (10 expert centers) and evaluated with a 1-day-long standardized battery of clinician-rated scales and patient-reported outcomes. PHSMI was defined as history of schizophrenia or bipolar disorders in at least one parent and was included as explanatory variable in multivariate models. Of the 724 included patients, 78 (10.7%) subjects were classified in the PHSMI group. In multivariate analyses, PHSMI patients had a better insight into schizophrenia and the need for treatment and reported more often childhood trauma history compared to patients without PHSMI. More specifically, those with paternal history of SMI reported more severe outcomes (increased childhood physical and emotional abuses, comorbid major depression and psychiatric hospitalizations). PHSMI is associated with increased risk of childhood trauma, major depressive disorder and psychiatric hospitalization and better insight in individuals with schizophrenia. Specific public health prevention programs for parents with SMI should be developed to help protect children from pejorative psychiatric outcomes. PHSMI may also explain in part the association between better insight and increased depression in schizophrenia.

Adolescent Social Functioning Deficits in Association With Adoptive Family Functioning and Genetic Risk for Schizophrenia Spectrum Disorders: The Finnish Adoptive Family Study of Schizophrenia

Social functioning deficits (SFDs) during adolescence represent potential vulnerability indicators to schizophrenia spectrum disorders, but little is known about how both family environmental and genetic factors contribute to SFDs. The aim of this study was to examine the association of adoptees' adolescent social functioning with adoptive family functioning and adoptees' high (HR) or low (LR) genetic risk for schizophrenia spectrum disorders. The present subsample from the nationwide Finnish Adoptive Family Study of Schizophrenia included 88 HR and 83 LR adoptees. Adolescent social functioning was assessed using UCLA Social Attainment Survey. Assessment of adoptive family functioning was based on Global Family Ratings. Results indicated that dysfunctional family processes and high genetic risk for schizophrenia spectrum disorders contributed approximately equally to adoptees' adolescent social functioning. Our findings underscore the importance of functional family processes in adolescent social functioning, particularly in individuals at high genetic risk for severe psychiatric disorder.

Association Between Accumulation of Child Maltreatment and Salivary Oxytocin Level Among Japanese Adolescents

Background: Child maltreatment is related to oxytocin (OT), which is related to social functioning. It may hamper the OT level to avoid a harmful situation and increase the OT level to adapt to the situation using a tend-and-befriend stress reaction. Objective: This study aims to examine the association between the accumulation of moderate-severe childhood maltreatment and salivary OT levels in Japanese adolescents. Participants: We used convenience samples of adolescents living in an institution (n = 31) and those living with their parents (n = 46). Methods: Child maltreatment experiences were measured with the Childhood Trauma Questionnaire. The salivary OT levels were assessed by enzyme linked immunosorbent assay. A multivariate regression analysis was performed to see the association between the accumulation of child maltreatment types and the salivary OT levels adjusted for covariates (i.e., age, sex, and duration of institutionalization). Results: Physical abuse was associated with higher OT, while emotional neglect showed an inverse association with OT. OT was the lowest with one maltreatment type group, which was significantly lower than the non-maltreatment group. As the number of maltreatment types increased from one maltreatment type to 2-3 types and to 4-5 types, OT also increased. This U-shaped association between the number of maltreatment types and OT was confirmed with the significant result of a square term of number of maltreatment type in the model (p = 0.012). Conclusion: We found herein a U-shaped association between the accumulation of child maltreatment and salivary OT levels. Also, different types of maltreatment had varied effects on the salivary OT. Further study is needed to elucidate the non-linear association between child maltreatment and OT levels.

Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol

Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.

Childhhood Trauma in Schizophrenia Spectrum Disorders: Dissociative, Psychotic Symptoms, and Suicide Behavior

Current evidence suggests a high prevalence of childhood trauma (CT) among adult patients diagnosed with schizophrenia spectrum disorders. Exposure to CT might lead to clinical differences eventually observed in these patients. We present a cross-sectional study with 54 patients with schizophrenia spectrum disorder (schizophrenia and schizoaffective disorder). We obtained sociodemographic data, as well as data on CT, dissociation, suicide history, and intensity of positive and negative psychotic symptoms. More than 75% of the patients reported a history of CT. We observed a link between CT and suicidal behavior. Patients showed high rates of dissociation. Dissociative experiences were related to CT, both in terms of intensity of trauma and number of traumas experienced. All CT forms except emotional neglect showed direct correlations with dissociative experiences. We found no correlation between intensity of CT and intensity of positive psychotic symptoms, yet we observed a moderate inverse correlation with negative psychotic symptoms.

Intimate Partner Violence Among Patients Diagnosed With Severe Mental Disorder

Intimate partner violence (IPV) has a remarkable impact on mental health and is common in people diagnosed with severe mental disorders (SMDs). Data of 102 outpatients were collected from clinical records and the Traumatic Life Events Questionnaire (TLEQ). Global estimation of lifetime IPV exposure was obtained by combining answers to selected TLEQ questions about physical, psychological, and sexual IPV. Overall, 24.5% of the participants reported at least one lifetime episode of IPV victimization. Female gender (odds ratio [OR] = 3.15, p = 0.016) and childhood trauma (OR = 4.7, p = 0.002) significantly increased the likelihood of IPV victimization. Conversely, posttraumatic stress disorder was not significantly increased in IPV victims. These findings are in line with current literature and suggest a remarkable and transdiagnostic prevalence of lifetime IPV victimization in SMD. Gender, childhood trauma, and SMD are relevant factors in IPV analysis and prevention. Diathesis of trauma, psychosocial vulnerability to revictimization and intersectional feminist theory help explain our results.

Repeated maternal separation causes transient reduction in BDNF expression in the medial prefrontal cortex during early brain development, affecting inhibitory neuron development

It is widely accepted that maternal separation (MS) induces stress in children and disrupts neural circuit formation during early brain development. Even though such disruption occurs transiently early in life, its influence persists after maturation, and could lead to various neurodevelopmental disorders. Our recent study revealed that repeated MS reduces the number of inhibitory neurons and synapses in the medial prefrontal cortex (mPFC) and causes mPFC-related social deficits after maturation. However, how MS impedes mPFC development during early brain development remains poorly understood. Here, we focused on brain-derived neurotrophic factor (BDNF) involved in the development of inhibitory neurons, and examined time-dependent BDNF expression in the mPFC during the pre-weaning period in male rats exposed to MS. Our results show that MS attenuates BDNF expression only around the end of the first postnatal week. Likewise, mRNA expression of activity-regulated cytoskeleton-associated protein (Arc), an immediate-early gene whose expression is partly regulated by BDNF, also decreased in the MS group along with the reduction in BDNF expression. On the contrary, mRNA expression of tropomyosin-related kinase B (TrkB), which is a BDNF receptor, was scarcely altered, while its protein expression decreased in the MS group only during the weaning period. In addition, MS reduced mRNA levels of glutamic acid decarboxylase (GAD) 65, a GABA synthesizing enzyme, only during the weaning period. Our results suggest that repeated MS temporarily attenuates BDNF signaling in the mPFC during early brain development. BDNF plays a crucial role in the development of inhibitory neurons; therefore, transient attenuation of BDNF signaling may cause delays in GABAergic neuron development in the mPFC.

Associations of childhood experiences with event-related potentials in adults with autism spectrum disorder

Childhood maltreatment is defined as experiencing of physical, emotional and sexual abuse and neglect in childhood. Maltreatment in childhood leads to substantial psychosocial problems later in life in the general population. Individuals with autism spectrum disorder (ASD) have a higher risk of experiencing stressful and traumatic events, such as maltreatment, during childhood. Although childhood maltreatment reportedly leads to psychosocial problems in adults with ASD, the biological associations between childhood experiences and brain function in this population remain understudied. Here, we evaluated the relationships between childhood experiences and event-related potential (ERP) components during the auditory odd-ball task in adults with ASD (N = 21) and typically developed (TD) individuals (N = 22). We found that the higher the severity of sexual abuse, the larger the amplitude of P300 at Fz, Cz, C3, and C4 in individuals with ASD. Conversely, the severity of child maltreatment was associated with P300 latency at Cz and C3 in TD individuals. Moreover, full IQ was significantly associated with the MMN amplitude at Fz, Cz, C3, and C4 in TD individuals. These findings provide the first evidence that ERPs could be used to study the impacts childhood experiences on the brain of individuals with ASD and that childhood sexual abuse has salient impacts on brain function in this population.

Neurocognitive Adaptation and Mental Health Vulnerability Following Maltreatment: The Role of Social Functioning

Childhood maltreatment is associated with a lifetime increase in risk of mental health disorder. We propose that such vulnerability may stem in large part from altered patterns of social functioning. Here, we highlight key findings from the psychological and epidemiological literature indicating that early maltreatment experience compromises social functioning and attenuates social support in ways that increase mental health vulnerability. We then review the extant neuroimaging studies of children and adolescents, focusing on three domains implicated in social functioning: threat processing, reward processing, and emotion regulation. We discuss how adaptations in these domains may increase latent vulnerability to mental health problems by impacting on social functioning via increased stress susceptibility as well as increased stress generation. Finally, we explore how computational psychiatry approaches, alongside systematically reported measures of social functioning, can complement studies of neural function in the creation of a mechanistic framework aimed at informing approaches to prevention and intervention.

The effects of early life stress on the excitatory/inhibitory balance of the medial prefrontal cortex

Aversive environmental conditions during early life are known to cause long-lasting social deficits, similar to those observed in patients with neurodevelopmental disorders. However, the mechanism of how early life stress can cause social deficits is not well understood. To clarify how being in an aversive environment during development affects sociability, we conducted various analyses focusing on the excitatory and inhibitory (E/I) balance in the medial prefrontal cortex (mPFC) and how it is related to social deficits, with young adult male rats that had been exposed to maternal separation (MS). In our MS procedure, part of the pups were separated from each dam for 3 h, twice a day, during postnatal days 2-20, and then were used for each analysis at 9 weeks old. We identified that MS mainly reduced pre- and post-synaptic protein expression of inhibitory neurons in the mPFC, and that decreased the number of GAD67-positive interneurons and inhibitory synapses in the mPFC. Furthermore, MS impaired social behavior related to social recognition, which is closely linked to the mPFC, in the three-chamber sociability and social novelty test (3-CST). With relation to this social deficit, immunohistological analysis revealed that c-fos-positive cells in the mPFC of rats exposed to MS decreased during the 3-CST. Considering that inhibitory neurons in the mPFC play a role in synchronizing neural activation for information processing, our findings demonstrate that MS-induced E/I imbalance associated with cell activity in the mPFC leads to deficits in social recognition.

Children of parents who have been hospitalised with psychiatric disorders are at risk of poor school readiness

AIMS.

Children of parents with psychiatric disorders are at risk of poor outcomes. However, there is limited evidence regarding the relationship between parental psychiatric disorders and child school readiness, which is linked to later academic achievement. This study aims to investigate these relationships and broaden the evidence underlying the rationale for family-focused interventions for parental psychiatric disorders.

METHOD.

This study used linked administrative data. Children's school readiness in multiple developmental domains (physical, social, emotional, communicative, cognitive) was measured by the Australian Early Development Census (AEDC) for 19 071 Western Australian children (mean age 5.5 years). Children scoring in the bottom 25% on any AEDC domain were considered developmentally vulnerable, or at risk of vulnerability, on that domain. Biological child-parent pairs were identified using birth records. Parents with psychiatric disorders were identified from hospital records, which included information on diagnosis and frequency/duration of psychiatric admissions. Logistic regressions, adjusted for parent age, mother's marital status, child Aboriginality, child English language status, local community remoteness and socioeconomic index, estimated the odds of children being vulnerable/at-risk on each of the AEDC domains.

RESULTS.

A total of 719 mothers and 417 fathers had a psychiatric hospitalisation during the study period (12 months prior to the child's birth, up to the end of 2009). Children whose parents had psychiatric disorders had increased odds of being classified as vulnerable/at-risk for school readiness. This increase in odds was evident for both maternal (adjusted odds ratio, aOR 1.37- 1.51) and paternal psychiatric disorders (aOR 1.38-1.50); and for a single admission of one day (aOR 1.32-1.59), a single admission of multiple days (aOR 1.30-1.47), and multiple admissions (aOR 1.35-1.63). Some variability in child outcome was found depending on the parents' psychiatric diagnosis (mood, anxiety, substance abuse or comorbid disorder).

CONCLUSIONS.

Children of parents who have been hospitalised with psychiatric disorders are at risk for poor school readiness. These findings add support to recommendations that mental health professionals consider dependent children in discharge and treatment planning for adult psychiatric inpatients. It is also important to ensure that the impact of psychiatric illness in fathers is not overlooked in assessment and intervention. Family-based approaches to adult psychiatric care could meet the dual needs of intervention for parents and preventative measures for children. These findings can inform policy regarding the importance of integrating and coordinating services to meet the needs of families.

Timing of the first report and highest level of child protection response in association with early developmental vulnerabilities in an Australian population cohort

BACKGROUND

Childhood maltreatment is associated with early childhood developmental vulnerabilities. However, the extent to which higher levels of child protection responses confer benefit to developmental competencies, and the impact of earlier timing of first reports in relation to early childhood vulnerability remains unclear.

OBJECTIVE

We examined associations between early developmental vulnerabilities and (1) the highest level of child protection response (where OOHC was deemed the highest response among other types of reports/responses), and (2) the developmental timing of the first child protection report.

PARTICIPANTS AND SETTING

Participants included 67,027 children from the New South Wales Child Development Study, of whom 10,944 were reported to child protection services up to age 5 years.

METHODS

A series of Multinomial Logistic Regressions were conducted to examine focal associations.

RESULTS

Children with substantiated maltreatment reports showed the strongest odds of vulnerability on three or more developmental domains (adjusted OR = 4.90; 95% CI = 4.13-5.80); children placed in OOHC showed slightly better physical, cognitive and communication competencies (adjusted ORs from 1.83 to 2.65) than those with substantiated reports that did not result in OOHC placements (adjusted OR from 2.77 to 3.67), when each group was compared to children with no child protection reports. Children with first maltreatment reports occurring in the first 18 months of life showed the strongest likelihood of developmental vulnerabilities on three or more developmental domains (adjusted OR = 3.56; 95% CI = 3.15-4.01) relative to children with no child protection reports.

CONCLUSION

Earlier reports of maltreatment may signal the need for targeted remediation of early developmental competencies to mitigate early developmental difficulties.

Childhood trauma and the likelihood of increased suicidal risk in schizophrenia

The aims of the present study were to investigate the dimensions of childhood trauma (CT) in patients with schizophrenia, and to predict suicidal risk (e.g., current suicidal ideation and lifetime suicide attempts) by CT dimensions and clinical factors (positive and negative symptoms and depression). Eighty-two inpatients with schizophrenia completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide Ideation (BSSI); they were also administered the Positive and Negative Syndrome Scale (PANSS).The presence of lifetime suicide attempts was assessed by structured diagnostic clinical interview. Patients with lifetime suicide attempts scored higher on sexual abuse than those without attempts after controlling for depression severity. Patients with high suicidal risk had higher scores on physical neglect than those without high risk after controlling for depression severity. Patients with high CT had higher scores on negative and positive symptoms, current suicidal ideation, and depression than those with low CT. Logistic regression analyses indicated that sexual abuse was a unique predictor of lifetime suicide attempts, and that physical neglect and depression were unique predictors of current suicidal ideation. These findings indicate that patients with schizophrenia who have experienced CT may be at increased risk for suicide.