Cannabis use and psychosis: re-visiting the role of childhood trauma

BackgroundCannabis consumption continues to be identified as a causal agent in the onset and development of psychosis. However, recent findings have shown that the effect of cannabis on psychosis may be moderated by childhood traumatic experiences.MethodUsing hierarchical multivariate logistic analyses the current study examined both the independent effect of cannabis consumption on psychosis diagnosis and the combined effect of cannabis consumption and childhood sexual abuse on psychosis diagnosis using data from the Adult Psychiatric Morbidity Survey 2007 (n=7403).ResultsFindings suggested that cannabis consumption was predictive of psychosis diagnosis in a bivariate model; however, when estimated within a multivariate model that included childhood sexual abuse, the effect of cannabis use was attenuated and was not statistically significant. The multivariate analysis revealed that those who had experienced non-consensual sex in childhood were over six times [odds ratio (OR) 6.10] more likely to have had a diagnosis of psychosis compared with those who had not experienced this trauma. There was also a significant interaction. Individuals with a history of non-consensual sexual experience and cannabis consumption were over seven times more likely (OR 7.84) to have been diagnosed with psychosis compared with those without these experiences; however, this finding must be interpreted with caution as it emerged within an overall analytical step which was non-significant.ConclusionsFuture studies examining the effect of cannabis consumption on psychosis should adjust analyses for childhood trauma. Childhood trauma may advance existing gene–environment conceptualisations of the cannabis–psychosis link.

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Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.083642 ◽

2011 ◽

Vol 199 (1) ◽

pp. 29-37 ◽

Cited By ~ 166

Author(s):

Paul Bebbington ◽

Sarah Jonas ◽

Elizabeth Kuipers ◽

Michael King ◽

Claudia Cooper ◽

...

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Psychiatric Morbidity ◽

Population Attributable Risk ◽

Population Sample ◽

Cannabis Use ◽

Anxiety And Depression ◽

Computer Assisted ◽

Cross Sectional Survey ◽

Cross Sectional

BackgroundA number of studies in a range of samples attest a link between childhood sexual abuse and psychosis.AimsTo use data from a large representative general population sample (Adult Psychiatric Morbidity Survey 2007) to test hypotheses that childhood sexual abuse is linked to psychosis, and that the relationship is consistent with mediation by revictimisation experiences, heavy cannabis use, anxiety and depression.MethodThe prevalence of psychosis was established operationally in a representative cross-sectional survey of the adult household population of England (n = 7353). Using computer-assisted self-interview, a history of various forms of sexual abuse was established, along with the date of first abuse.ResultsSexual abuse before the age of 16 was strongly associated with psychosis, particularly if it involved non-consensual sexual intercourse (odds ratio (OR) = 10.14, 95% CI 4.8–21.3, population attributable risk fraction 14%). There was evidence of partial mediation by anxiety and depression, but not by heavy cannabis use nor revictimisation in adulthood.ConclusionsThe association between childhood sexual abuse and psychosis was large, and may be causal. These results have important implications for the nature and aetiology of psychosis, for its treatment and for primary prevention.

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Prevalence of Childhood Sexual Abuse Among Women Using the Childhood Trauma Questionnaire: A Worldwide Meta-Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3373847 ◽

2019 ◽

Cited By ~ 1

Author(s):

Yuli Pan ◽

Xiujin Lin ◽

Jianbo Liu ◽

Shengjie Zhang ◽

Xuan Zeng ◽

...

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Childhood Trauma ◽

Meta Analysis ◽

Childhood Trauma Questionnaire

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Childhood Sexual Abuse, Adult Psychiatric Morbidity, and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

Journal of Child Sexual Abuse ◽

10.1080/10538712.2013.751951 ◽

2013 ◽

Vol 22 (2) ◽

pp. 191-208 ◽

Cited By ~ 7

Author(s):

Mairead Dolan ◽

Helen Whitworth

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Psychiatric Morbidity ◽

Forensic Service

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The interplay between childhood trauma, cognitive biases, and cannabis use on the risk of psychosis in nonclinical young adults in Poland

European Psychiatry ◽

10.1192/j.eurpsy.2020.31 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Dorota Frydecka ◽

Błażej Misiak ◽

Kamila Kotowicz ◽

Renata Pionke ◽

Martyna Krężołek ◽

...

Keyword(s):

Young Adults ◽

Childhood Trauma ◽

Online Survey ◽

Cognitive Biases ◽

Adult Population ◽

Traumatic Events ◽

Cannabis Use ◽

Traumatic Experience ◽

Traumatic Experiences ◽

The Relationship

Abstract Background. Childhood traumatic events are risk factors for psychotic-like experiences (PLEs). However, the mechanisms explaining how trauma may contribute to the development of PLEs are not fully understood. In our study, we investigated whether cannabis use and cognitive biases mediate the relationship between early trauma and PLEs. Methods. A total sample of 6,772 young adults (age 26.6 ± 4.7, 2,181 male and 3,433 female) was recruited from the general population to participate in an online survey. We excluded 1,158 individuals due to a self-reported lifetime diagnosis of any mental disorder. The online survey included selected items from the following questionnaires: Traumatic Experience Checklist (TEC, 3 items), Childhood Experience of Care and Abuse Questionnaire (CECA.Q, 3 items), Cannabis Problems Questionnaire (CPQ, 10 items), Davos Assessment of Cognitive Biases Scale (DACOBS-18, 9 items), and Prodromal Questionnaire-16 (PQ-16). Mediation analyses were performed with respect to different categories of traumatic experiences (emotional, physical and sexual abuse as well as emotional neglect). Results. Our results showed significant associations of any time of childhood trauma with higher scores of cannabis use (CPQ), cognitive biases (DACOBS), and PLEs (PQ-16) (p < 0.001). We found a direct effect of childhood trauma on PLEs as well as significant indirect effect mediated through cannabis use and cognitive biases. All models tested for the effects of specific childhood adversities revealed similar results. The percentage of variance in PQ-16 scores explained by serial mediation models varied between 32.8 and 34.2% depending on childhood trauma category. Conclusion. Cannabis use and cognitive biases play an important mediating role in the relationship between childhood traumatic events and the development of PLEs in a nonclinical young adult population.

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Factors that mediate between child sexual abuse and adult psychological outcome

Psychological Medicine ◽

10.1017/s0033291700028154 ◽

1995 ◽

Vol 25 (1) ◽

pp. 127-142 ◽

Cited By ~ 86

Author(s):

S. E. Romans ◽

J. L. Martin ◽

J. C. Anderson ◽

M. L. O'Shea ◽

P. E. Mullen

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Community Sample ◽

Psychiatric Morbidity ◽

Self Esteem ◽

Abused Women ◽

School Factors ◽

Psychological Outcome ◽

Good Outcome ◽

Poor Outcome

SynopsisThe psychological outcome for a random community sample of women who had experienced significant childhood sexual abuse was assessed, using two outcome measures: (i) psychiatric morbidity (measured with the short PSE); (ii) self-esteem. Sexual abused women with a good outcome, i.e. who were not a PSE ‘case’ or who had high self-esteem were compared with abused women with a poor outcome. This paper describes the post-abuse factors that modified the two outcomes.In general, a range of variables, all correlated with each other in a complex manner, distinguished good outcome subjects from poor outcome subjects. Post-abuse adolescent variables included family factors (poor mother–father and parent–child relationships), high school factors (poor academic, sporting and social performance) and early pregnancy. Women who had a good adolescent relationship with their father did better than expected statistically. Sport emerged as an alternative at secondary school to academic achievement in catalysing a good psychological outcome.Adult factors included the quality of relationship with partner, which was associated with a good outcome on both measures. Current paid employment was linked to high self-esteem but not to lowered psychiatric morbidity, while the converse applied for high socio-economic status. These findings imply that different processes operate for each outcome measure.A clear recognition by the school of childhood sexual abuse may help to provide the opportunity for the girl to experience success in some arena; this in turn may protect her against the likely adult consequences of low self-esteem and increased psychiatric morbidity.

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Implications of Childhood Trauma for Depressed Women: An Analysis of Pathways From Childhood Sexual Abuse to Deliberate Self-Harm and Revictimization

American Journal of Psychiatry ◽

10.1176/appi.ajp.161.8.1417 ◽

2004 ◽

Vol 161 (8) ◽

pp. 1417-1425 ◽

Cited By ~ 187

Author(s):

Gemma L. Gladstone ◽

Gordon B. Parker ◽

Philip B. Mitchell ◽

Gin S. Malhi ◽

Kay Wilhelm ◽

...

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Childhood Trauma ◽

Deliberate Self Harm ◽

Self Harm

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Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation

The British Journal of Psychiatry ◽

10.1192/bjp.182.6.543 ◽

2003 ◽

Vol 182 (6) ◽

pp. 543-547 ◽

Cited By ~ 151

Author(s):

Paul Hammersley ◽

Anton Dias ◽

Gillian Todd ◽

Kim Bowen-Jones ◽

Bernadette Reilly ◽

...

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Affective Disorder ◽

Childhood Trauma ◽

Bipolar Affective Disorder ◽

Preliminary Investigation ◽

Behavioural Therapy ◽

Auditory Hallucinations ◽

Spontaneous Reports ◽

The Relationship

BackgroundStrong evidence exists for an association between childhood trauma, particularly childhood sexual abuse, and hallucinations in schizophrenia. Hallucinations are also well-documented symptoms in people with bipolar affective disorder.AimsTo investigate the relationship between childhood sexual abuse and other childhood traumas and hallucinations in people with bipolar affective disorder.MethodA sample of 96 participants was drawn from the Medical Research Council multi-centre trial of cognitive–behavioural therapy for bipolar affective disorder. The trial therapists recorded spontaneous reports of childhood sexual abuse made during the course of therapy. Symptom data were collected by trained research assistants masked to the hypothesis.ResultsA significant association was found between those reporting general trauma (n=38) and auditory hallucinations. A highly significant association was found between those reporting childhood sexual abuse (n=15) and auditory hallucinations.ConclusionsThe relationship between childhood sexual abuse and hallucinations in bipolar disorder warrants further investigation.

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