scholarly journals Childhood adversity and psychosis: generalised or specific effects?

2015 ◽  
Vol 25 (4) ◽  
pp. 349-359 ◽  
Author(s):  
E. Longden ◽  
M. Sampson ◽  
J. Read
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Negative Symptoms ◽  
Childhood Adversity ◽  
Clinical Intervention ◽  
Current Data ◽  
Psychotic Symptoms ◽  
Multiple Exposures ◽  
Specific Effects ◽  
The Impact

Background.This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psychotic symptoms and specific adversities was also tested, namely: sexual abuse and hallucinations, physical abuse and delusions, and fostering/adoption and delusions.Method.Data were collected through auditing 251 randomly selected medical records, drawn from adult patients in New Zealand community mental health centres. Information was extracted on presence and subtype of psychotic symptoms and exposure to ten types of childhood adversity, including five types of abuse and neglect.Results.Adversity exposure was significantly higher in patients experiencing hallucinations in general, voice hearing, command hallucinations, visions, delusions in general, paranoid delusions and negative symptoms than in patients without these symptoms. There was no difference in adversity exposure in patients with and without tactile/olfactory hallucinations, grandiose delusions or thought disorder. Indication of a dose–response relationship was detected, in that total number of adversities significantly predicted total number of psychotic symptoms. Although fostering/adoption was associated with paranoid delusions, the hypothesised specificity between sexual abuse and hallucinations, and physical abuse and delusions, was not found. The two adversities showing the largest number of associations with psychotic symptoms were poverty and being fostered/adopted.Conclusions.The current data are consistent with a model of global and cumulative adversity, in which multiple exposures may intensify psychosis risk beyond the impact of single events. Implications for clinical intervention are discussed.

scholarly journals Modeling the schizophrenias: subunit-specific NMDAR antagonism dissociates frontal δ and hippocampal θ modulation of ~140 Hz oscillations

2017 ◽  
Author(s):  
Benjamin Pittman-Polletta ◽  
Kun Hu ◽  
Bernat Kocsis
Keyword(s):  
Negative Symptoms ◽  
Paradoxical Sleep ◽  
Positive Symptom ◽  
Saline Control ◽  
Cortical Function ◽  
Specific Effects ◽  
High Frequency Oscillations ◽  
Dopaminergic Tone ◽  
Phase Amplitude ◽  
The Impact

ABSTRACTNMDAR antagonism alters mesolimbic, hippocampal, and cortical function, acutely reproducing the positive, cognitive, and negative symptoms of schizophrenia. These physiological and behavioral effects may depend differentially on NMDAR subtype-and region-specific effects. The dramatic electrophysiological signatures of NMDAR blockade in rodents include potentiated high frequency oscillations (HFOs, ~140 Hz), likely generated in mesolimbic structures, and increased HFO phase-amplitude coupling (PAC), a phenomenon related to goal-directed behavior and dopaminergic tone. This study examined the impact of subtype-specific NMDAR antagonism on HFOs and PAC. We found that positive-symptom-associated NR2A-preferring antagonism (NVP-AAM077), but not NR2B-specific antagonism (Ro25-6985) or saline control, replicated increases in HFO power seen with nonspecific antagonism (MK-801). However, PAC following NR2A-preferring antagonism was distinct from all other conditions. While θ-HFO PAC was prominent or potentiated in other conditions, NVP-AAM077 increased δ-HFO PAC and decreased θ-HFO PAC. Furthermore, active wake epochs exhibiting narrowband frontal δ oscillations, and not broadband sleep-associated δ, selectively exhibited δ-HFO coupling, while paradoxical sleep epochs having a high CA1 θ to frontal δ ratio selectively exhibited θ-HFO coupling. Our results suggest: (1) NR2A-preferring antagonism induces oscillopathies reflecting frontal hyperfunction and hippocampal hypofunction; and (2) HFO PAC indexes cortical vs. hippocampal control of mesolimbic circuits.

scholarly journals S175. CLINICAL OUTCOMES IN PEOPLE AT HIGH RISK FOR PSYCHOSIS RELATED TO INTERACTIONS BETWEEN POLYGENIC RISK SCORES AND CHILDHOOD ADVERSITY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S104-S104
Author(s):  
Anja Richter ◽  
Evangelos Vassos ◽  
Matthew J Kempton ◽  
Mark van der Gaag ◽  
Lieuwe de Haan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Abuse ◽  
High Risk ◽  
Prospective Study ◽  
Physical Abuse ◽  
Clinical Outcomes ◽  
Childhood Trauma ◽  
Childhood Adversity ◽  
Risk Scores ◽  
Polygenic Risk

Abstract Background Genetic vulnerability to psychosis is polygenic, involving multiple genes with small individual effects (Psychiatric Genomics Consortium (PGC), 2014). The risk of psychosis is also related to environmental factors, such as childhood trauma (Lardinois et al, 2011). Although the onset of psychosis is thought to result from the interaction of genetic and environmental risk factors (Walker & Diforio, 1997), the extent to which the influence of childhood trauma depends on genetic susceptibility remains unclear. We sought to address this issue in a large prospective study of people at clinical high risk (CHR) for psychosis. These individuals present with psychotic and affective symptoms, and are at increased risk of developing both schizophreniform and affective psychoses. Methods We studied subjects of European ancestry, drawn from EU-GEI, a large multi-centre prospective study of people at CHR for psychosis. At baseline, DNA was obtained from subjects who met the CAARMS criteria for the CHR state (n=266) and healthy controls (HC; n=42). Childhood trauma was assessed using the childhood trauma questionnaire (CTQ), which comprises 5 subdomains: emotional abuse, physical abuse, sexual abuse, physical neglect, and emotional neglect. Polygenic risk scores (PRSs) for schizophrenia (SCZ), bipolar disorder (BD) and major depressive disorder (MDD) were constructed separately, using results from meta-analyses by the corresponding Disorder Working Groups of the PGC. The CHR subjects were clinically monitored for up to 5 years and clinical outcomes were assessed in terms of transition to psychosis (as defined by the CAARMS), remission from the CHR state (subject no longer meets CAARMS inclusion criteria) and level of functioning (GAF Disability Scale). Logistic regression models were used to investigate the association between each PRSs and childhood trauma as predictors of transition and remission, adjusted by population stratification using the first 10 principal components, age, sex and site. All findings are reported at p<0.017, Bonferroni-corrected for the 3 PRSs. Results Within the CHR sample, the onset of psychosis during follow up was related to interactions between the BD PRS and the total childhood trauma score (OR=0.959, 95% CI 0.930–0.988, p=0.006), and between the BD PRS and physical abuse (OR=0.787, 95% CI 0.689–0.900, p<0.001). Remission from the CHR state was related to an interaction between the SCZ PRS and childhood sexual abuse (OR: 1.110, 95% CI 1.004–1.226, p=0.041). Discussion These data indicate that clinical outcomes in CHR subjects are related to interactions between the polygenic risk for psychotic disorders and childhood adversity. The measurement of interactions between genomic and environmental risk factors may help to predict individual outcomes in people at high risk in a clinical setting.

scholarly journals The Relation between Childhood Adverse Experiences and Disability Due to Mental Health Problems in a Community Sample of Women

2005 ◽  
Vol 50 (12) ◽  
pp. 778-783 ◽  
Author(s):  
Lil Tonmyr ◽  
Ellen Jamieson ◽  
Leslie S Mery ◽  
Harriet L MacMillan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Child Abuse ◽  
Childhood Sexual Abuse ◽  
Physical Abuse ◽  
Mental Health Problems ◽  
Community Sample ◽  
Childhood Adversity ◽  
Health Problems ◽  
Adverse Experiences

Objective: The objective of this study was to examine the association between selected childhood adverse experiences and disability due to mental health problems in a community sample of women. Variables of interest included childhood physical and sexual abuse, parental psychiatric and substance abuse history, and sociodemographic factors. Method: Girls and women (aged 15 to 64 years) from a province-wide community sample ( n = 4239) were asked about disability and most childhood adverse experiences through interview; a self-administered questionnaire inquired about child abuse. Logistic regression (crude and adjusted odds ratios) was used to test the associations between childhood adversity and disability due to mental health problems. Results: Approximately 3% of the women had a disability due to mental health problems. Among women with a disability, about 50% had been abused while growing up. After controlling for income and age, we found that disability showed the strongest association with childhood sexual abuse, physical abuse, and parental psychiatric disorder. Conclusion: Disability due to mental health problems was experienced by women with and without exposure to abuse in childhood. However, childhood sexual abuse and physical abuse were important correlates of disability. Disability creates suffering and loss for the individual and society; this issue merits more research in relation to child abuse.

scholarly journals Personal Beliefs about Experiences in those at Clinical High Risk for Psychosis

2014 ◽  
Vol 43 (6) ◽  
pp. 669-675 ◽  
Author(s):  
Jacqueline Stowkowy ◽  
Diana O. Perkins ◽  
Scott W. Woods ◽  
Karissa Nyman ◽  
Jean Addington
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Intervention Strategies ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Personal Beliefs ◽  
Negative Beliefs ◽  
The Impact ◽  
Important Objective

Background: Negative beliefs about illness in early psychosis have been shown to have an unfavourable impact on one's quality of life. A shift of focus in psychosis research has been on the detection of individuals considered to be at clinical high risk (CHR) of developing psychosis. Little is known about the impact that beliefs about psychotic like experiences or attenuated psychotic symptoms may have on CHR individuals. Aim: To explore these beliefs in a large sample of young people at CHR of developing psychosis using the Personal Beliefs about Experiences Questionnaire (PBEQ). Method: Beliefs about unusual experiences were assessed in 153 CHR individuals with the PBEQ. Prodromal symptoms (measured by the SIPS) and depression (measured by the CDSS) were also assessed. Results: In CHR individuals, holding more negative beliefs was associated with increased severity in depression and negative symptoms. Higher scores on suspiciousness were associated with increased negative beliefs, and higher levels of grandiosity were associated with decreased negative beliefs. Those who later transitioned to psychosis agreed significantly more with statements concerning control over experiences (i.e. “my experiences frighten me”, “I find it difficult to cope). Conclusions: The results suggest that targeting negative beliefs and other illness related appraisals is an important objective for intervention strategies.

scholarly journals The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder

2010 ◽  
Vol 40 (12) ◽  
pp. 1967-1978 ◽  
Author(s):  
H. L. Fisher ◽  
P. B. Jones ◽  
P. Fearon ◽  
T. K. Craig ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Living Arrangements ◽  
Adverse Childhood Experiences ◽  
Psychotic Disorders ◽  
Control Sample ◽  
Childhood Adversity ◽  
Risk Indicator ◽  
Childhood Experiences ◽  
Adverse Childhood

BackgroundChildhood adversity has been associated with onset of psychosis in adulthood but these studies have used only general definitions of this environmental risk indicator. Therefore, we sought to explore the prevalence of more specific adverse childhood experiences amongst those with and without psychotic disorders using detailed assessments in a large epidemiological case-control sample (AESOP).MethodData were collected on 182 first-presentation psychosis cases and 246 geographically matched controls in two UK centres. Information relating to the timing and frequency of exposure to different types of childhood adversity (neglect, antipathy, physical and sexual abuse, local authority care, disrupted living arrangements and lack of supportive figure) was obtained using the Childhood Experience of Care and Abuse Questionnaire.ResultsPsychosis cases were three times more likely to report severe physical abuse from the mother that commenced prior to 12 years of age, even after adjustment for other significant forms of adversity and demographic confounders. A non-significant trend was also evident for greater prevalence of reported severe maternal antipathy amongst those with psychosis. Associations with maternal neglect and childhood sexual abuse disappeared after adjusting for maternal physical abuse and antipathy. Paternal maltreatment and other forms of adversity were not associated with psychosis nor was there evidence of a dose–response effect.ConclusionsThese findings suggest that only specific adverse childhood experiences are associated with psychotic disorders and only in a minority of cases. If replicated, this greater precision will ensure that research into the mechanisms underlying the pathway from childhood adversity to psychosis is more fruitful.

scholarly journals Childhood Maltreatment in Individuals With Schizophrenia Spectrum Disorders: The Impact of Cut-Off Scores on Prevalence Rates

2021 ◽  
Vol 12 ◽  
Author(s):  
Angelina Weitkämper ◽  
Michael Kellner ◽  
Jona Ruben Iffland ◽  
Martin Driessen ◽  
Hanna Kley ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Common Phenomenon ◽  
Prevalence Rates ◽  
Emotional Neglect ◽  
Schizophrenia Spectrum ◽  
Physical Neglect ◽  
The Impact

Childhood maltreatment is a common phenomenon in various psychiatric disorders. Accordingly, patients with disorders from the schizophrenia spectrum (SSD) appear to have high prevalence rates of childhood maltreatment. However, the interpretation and comparability of prevalence rates is impeded by methodological weaknesses and differences such as measures and thresholds used in previous studies. Therefore, we aimed to provide and compare systematically captured data on prevalence rates of all common types of childhood maltreatment in patients with SSD using a standardized and well-established questionnaire and the most frequently used thresholds. The sample consisted of 48 patients with a primary diagnosis of SSD. 58.3–77.1% of the sample experienced at least one type of childhood maltreatment. Prevalence rates for physical abuse, physical neglect, and emotional abuse were dependent on the thresholds used, while equal rates were found for emotional neglect and sexual abuse. Physical neglect (46–67%), and emotional abuse (44–48%) were most commonly reported, followed by emotional neglect (38%), physical abuse (25–38%), and sexual abuse (25%). Additionally, high levels of peer victimization were reported by SSD patients. It appears that childhood maltreatment is a common phenomenon in SSD, even though methodological details, especially cut-off scores, have a substantial impact on the prevalence rates that are determined. Therefore, the methodology of studies should be closely examined when drawing conclusions from presented prevalence rates.

scholarly journals The Impact of Childhood Adversity on the Clinical Features of Schizophrenia

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Physical Abuse ◽  
Emotional Abuse ◽  
Childhood Adversity ◽  
Specific Symptom ◽  
Childhood Neglect ◽  
The Metabolic Syndrome ◽  
Symptom Profile ◽  
Elevated Systolic Blood Pressure ◽  
Abuse And Neglect ◽  
The Impact

Introduction. Recent research has drawn attention to the link between childhood maltreatment and schizophrenia. Child abuse and neglect may have an impact on symptoms and physical health in these patients. This association has not been studied to date in India.Materials and Methods. Clinically stable patients with schizophrenia (n=62) were assessed for childhood adversity using the Childhood Trauma Questionnaire. The association of specific forms of adversity with symptomatology and associated variables was examined.Results. Emotional abuse was reported by 56.5% patients and physical abuse by 33.9%; scores for childhood neglect were also high. Persecutory delusions were linked to physical abuse, while anxiety was linked to emotional neglect and depression to emotional abuse and childhood neglect. Physical abuse was linked to elevated systolic blood pressure, while emotional abuse and neglect in women were linked to being overweight.Conclusions. Childhood adversity is common in schizophrenia and appears to be associated with a specific symptom profile. Certain components of the metabolic syndrome also appear to be related to childhood adversity. These results are subject to certain limitations as they are derived from remitted patients, and no control group was used for measures of childhood adversity.

scholarly journals T193. THE ROLE OF METACOGNITION ON NEGATIVE SYMPTOMS: A PSYCHOLOGICAL MODEL FOR DIMINISHED EXPRESSION IN SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Helena García-Mieres ◽  
Nancy Lundin ◽  
Kyle Minor ◽  
Giancarlo DiMaggio ◽  
Simone Cheli ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Structural Equation ◽  
Negative Symptoms ◽  
Structural Equation Models ◽  
Personal Narratives ◽  
Higher Order ◽  
Psychotic Symptoms ◽  
Situation Models ◽  
Cognitive Symptoms ◽  
The Impact

Abstract Background The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive deficits interact and thus interfere with persons’ ability to understand and express emotions in ways others can recognize. Methods Individuals with schizophrenia-spectrum disorders (N=201) provided personal narratives including their life story and reflections regarding their mental illness and a clinician-rated interview of psychotic symptoms (i.e., Positive and Negative Syndrome Scale; PANSS). Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants’ personal narratives via Coh-Metrix 3.0, an automated program that calculates basic and complex language indices. Diminished expression and cognitive symptoms were measured with the PANSS. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive deficits and situation models on diminished expression. Results SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.083, p = .005, ±95% CI [-.141, -.026]) and fully mediated the influence of cognitive symptoms in diminished expression (β = .099, p = .001, ±95% CI [.038, .160]). Findings persisted after controlling for educational level. Discussion This study is the first of its kind to utilize a mediational model including higher-order linguistic structures, cognitive impairment and metacognition to explain diminished expression in psychosis. Results suggest that self-reflectivity, situation models and cognitive symptoms may be useful targets for intervention in efforts to decrease diminished expression.

Implications of COMT and Subclinical Psychiatric Symptoms on the Phenotypic Variability of 22q11.2 Deletion Syndrome: A Transversal and Longitudinal Approach

2017 ◽  
Vol 41 (S1) ◽  
pp. S82-S83
Author(s):  
S. Guerrera ◽  
M. Armando ◽  
M. Pontillo ◽  
F. Papaleo ◽  
S. Vicari
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Phenotypic Variability ◽  
22Q11.2 Deletion Syndrome ◽  
Structured Interview ◽  
Deletion Syndrome ◽  
Psychotic Symptoms ◽  
22Q11.2 Deletion ◽  
Comt Polymorphism ◽  
The Impact

Introduction22q11.2 deletion syndrome (22q11.2DS) results from a hemizygous microdeletion on chromosome 22 and is characterized by phenotypic variability. Several studies have been conducted on the impact of COMT functional polymorphism in 22q11DS, suggesting that attenuated psychotic manifestations are frequent in children and adolescents and represent one of the strongest predictors for the onset of psychotic disorder.ObjectivesWe explored possible interaction between COMT polymorphism and subclinical psychiatric symptoms in a 22q11.2DS cohort of 42 participants aged 6 to 26 years: 17 hemizygosity for COMT-Met and 25 hemizygosity for COMT-Val.AimsTo analyse impact of COMT gene in 22q11DS and its related psychiatric correlates.MethodEach participant, genotyped for the catechol O-methyltransferase (COMT) Met/Val polymorphism, underwent structured psychiatric and cognitive assessment. Analysis of positive and negative symptoms was performed by the structured interview for prodromal syndromes (SIPS). Finally, longitudinal data available in a subsample of 24 individuals were used to explore the developmental trajectories of psychotic symptoms one year later.ResultsThere was a significant positive correlation between COMT Val polymorphism and positive symptoms; at follow-up, no significant correlation were found between COMT polymorphism and psychiatric symptoms. No other significant differences were found between groups (Comt/Met-Comt/Val) on any other CBCL or QI score.ConclusionsCOMT and additional genes microdeleted might interact in the susceptibility to schizophrenia in 22q11.2DS: psychotic symptoms might result from an epistatic interaction with other genes. Moreover, gene-environment, in presence of genetic vulnerability could increase the risk of schizophrenia in 22q11DS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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