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Cortes Hidalgo AP, Hammerton G, Heron J, Bolhuis K, Madley-Dowd P, Tiemeier H, van IJzendoorn MH, Zammit S, Jones HJ. Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators. Schizophr Bull 2024; 50:903-912. [PMID: 38437586 PMCID: PMC11283191 DOI: 10.1093/schbul/sbae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND AND HYPOTHESIS Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. STUDY DESIGN We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. STUDY RESULTS In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. CONCLUSIONS Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.
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Affiliation(s)
- Andrea P Cortes Hidalgo
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Gemma Hammerton
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Paul Madley-Dowd
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Social and Behavioural Science, Harvard TH Chan School of Public Health, Boston, USA
| | - Marinus H van IJzendoorn
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, London, UK
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Stanley Zammit
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Hannah J Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
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Dumas LE, Fernandez A, Auby P, Askenazy F. Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: Protocol for a prospective, 2-year, longitudinal case-control study. PLoS One 2024; 19:e0306338. [PMID: 38954699 PMCID: PMC11218996 DOI: 10.1371/journal.pone.0306338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION Auditory-verbal hallucinatory experiences (AVH) have a 12% prevalence in the general pediatric population. Literature reports a higher risk of developing AVH in post-traumatic stress disorder (PTSD). The persistence of AVHs during adolescence represents a risk of evolution into psychotic disorders. Social cognition and emotional markers could be considered prodromes markers of this evolution. The objectives of this prospective observational study are to observe social cognition and emotional markers correlation with the presence and persistence of AVH over two years and with the evolution of PTSD and psychotic diagnosis. METHODS AND ANALYSIS This prospective case-control study, longitudinal over two years (with an interim reassessment at six months and one year), will include 40 participants aged 8 to 16 years old with a diagnosis of PTSD and without a diagnosis of psychosis according to the criteria of DSM-5 (K-SADS-PL). Subjects included are divided into two groups with AVH and without AVH matched by gender, age and diagnosis. The primary outcome measure will be the correlation between social cognition and emotional makers and the presence of AVH in the PTSD pediatric population without psychotic disorders. The social cognition marker is assessed with the NEPSY II test. The emotional marker is assessed with the Differential Emotion Scale IV and the Revised Beliefs About Voices Questionnaire. The secondary outcome measures are the correlation of these markers with the persistence of AVH and the evolution of the patient's initial diagnosis two years later. DISCUSSION The originality of our protocol is to explore the potential progression to psychosis from PTSD by cognitive biases. This study supports the hypothesis of connections between PTSD and AVH through sensory, emotional and cognitive biases. It proposes a continuum model from PTSD to psychotic disorder due to impaired perception like AVH. TRIAL REGISTRATION Clinical trial registration: ClinicalTrials.gov Identifier: NCT03356028.
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Affiliation(s)
- Louise-Emilie Dumas
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Arnaud Fernandez
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
| | - Philippe Auby
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
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Oh HY, Jacob L, Smith L, Leaune E, Zhou S, Shin JI, Koyanagi A. Sexual Minority Status and Psychotic Experiences Among Young Adult College Students in the United States. JOURNAL OF HOMOSEXUALITY 2024; 71:916-933. [PMID: 36318731 DOI: 10.1080/00918369.2022.2132582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
2020-2021 Healthy Minds Study, and used multivariable logistic regression to examine the associations between sexual minority status and psychotic experiences, adjusting for age, gender, and race/ethnicity. We then tested whether psychosocial factors accounted for the association. Sexual minority status was associated with 1.87 times greater odds of having psychotic experiences over the past 12 months (aOR: 1.87; 95% CI: 1.77-1.99; N = 110,551). Several factors mediated the association between sexual orientation and psychotic experiences such as loneliness (26.93%), anxiety (30.90%), depression (33.18%), and marijuana use (13.95%); all factors together accounted for 59.01% of the association between sexual minority status and psychotic experiences. Food insecurity, recent abuse, and discrimination did not significantly mediate the association. Findings should raise clinical awareness that psychotic experiences are more common among sexual minorities than among heterosexuals, which is largely explained by mental health factors, calling for targeted outreach and intervention.
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Affiliation(s)
- Hans Y Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM ISCIII), Barcelona, Spain
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Edouard Leaune
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Sasha Zhou
- Department of Public Health, Wayne State University, Detroit, Michigan, USA
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM ISCIII), Barcelona, Spain
- Institución Catalana de Investigación y Estudios Avanzados (ICREA), Barcelona, Spain
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Lovric S, Klaric M, Lovric I, Camber R, Kresic Coric M, Kvesic J, Kajic-Selak A. Clinical characteristics of psychotic disorders in patients with childhood trauma. Medicine (Baltimore) 2023; 102:e36733. [PMID: 38134067 PMCID: PMC10735130 DOI: 10.1097/md.0000000000036733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Childhood trauma is an important predictor of psychotic disorders, with special emphasis on physical and sexual abuse. It influences the clinical picture and course of psychotic disorders. This study was conducted in the Department of Psychiatry of the University Clinical Hospital Mostar. The sample consisted of 135 participants, aged 18 to 65 years. The screening instrument to examine cognitive status was the short version of MMSE-2. Patients' background information was collected using a sociodemographic questionnaire constructed for this study. To determine childhood trauma, the Child Abuse Experience Inventory was used to examine physical, sexual, and emotional abuse, neglect and domestic violence. The positive and negative syndrome scale scale was used to evaluate the clinical profile of psychoticism, the SSI questionnaire was used to evaluate the severity of suicidality, and the functionality of the participants was evaluated using the WHODAS 2.0. Results indicate that a significant number of participants with psychotic disorders experienced childhood trauma, an important determinant of their illness. Participants who had witnessed abuse had more severe clinical presentations (earlier onset and longer duration of illness) and more pronounced psychotic symptomatology and a lower degree of functionality. Decreased functionality is associated with witnessing abuse and physical abuse. During the civil war, a significant percentage of the participants were in childhood and adolescent development (26.7%) and exposed to frequent emotional abuse and domestic violence. As 1 traumatic event in childhood makes a person more susceptible to more traumatic experiences during life. Childhood trauma is a serious and pervasive problem that has a significant impact on the development, course, and severity of the clinical presentation of psychotic disorders. Accordingly, it is necessary to provide continuous education to mental health workers, primarily psychiatrists, regarding childhood trauma so that treatment may be approached more systematically and a plan of therapeutic interventions may be more adequately designed, which would necessarily include psychosocial support in addition to pharmacotherapy.
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Affiliation(s)
- Sanjin Lovric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Miro Klaric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Ivona Lovric
- Department of Dermatology of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Renata Camber
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Martina Kresic Coric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Josip Kvesic
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Anita Kajic-Selak
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
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Rey MGD, Martín LM, García FA, López FJC, López FR. Trauma infantil y psicosis: una revisión narrativa. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Chen LH, Toulopoulou T. Pathways linking school bullying and psychotic experiences: Multiple mediation analysis in Chinese adolescents and young adults. Front Psychiatry 2022; 13:1007348. [PMID: 36386962 PMCID: PMC9650074 DOI: 10.3389/fpsyt.2022.1007348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/26/2022] [Indexed: 11/21/2022] Open
Abstract
It is found that people with psychotic experiences have a 4-fold increased risk of developing a psychotic disorder later in life. Indeed, accumulating evidence has suggested that the association between school bullying and psychotic experiences works linearly. Previous studies are mainly carried out in a Western context, and only seldomly do studies address whether the association exists in the Chinese population and the related psychological and cognitive mechanisms. Therefore, we carried out the current study to address this gap in the literature focusing on the lifelong school bullying experiences of Chinese adolescents and young adults. We examined them in relation to psychotic experiences while assessing the mediating role of self-esteem, the personality trait of neuroticism, and a cognitive bias in thinking called interpretation bias. We found that multiple victimizations were quite common in Hong Kong secondary schools. In addition to a significant association between school bullying and psychotic experiences, we found partial mediating effects of proposed psychological and cognitive mediators in constructed multiple mediation models utilizing bootstrapping approach. Specifically, bullying quantity reflecting the number of victimizations, had its association with psychotic experiences partially mediated by the personality trait of neuroticism. In contrast, bullying duration reflecting the lasting of victimization was associated with psychotic experiences partially mediated by the personality trait of neuroticism and interpretation bias. Our findings enhance our knowledge of mechanisms underpinning the psychosis spectrum development and have implications for school-based intervention programs targeting bullying victims.
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Affiliation(s)
- Lu Hua Chen
- Department of Rehabilitation Sciences (Neuroscience and Neurological Rehabilitation), Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Timothea Toulopoulou
- Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Kowloon, Hong Kong SAR, China.,Department of Psychology, Bilkent University, Ankara, Turkey.,Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology and Neuroscience at King's College London, London, United Kingdom
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