Childhood trauma and clinical high risk for psychosis

SCHIZOPHRENIA RESEARCH

卷:205

Article

Loewy, Rachel L.¹  Corey, Sarah²  Amirfathi, Felix¹  Dabit, Sawsan³  Fulford, Daniel^4,12  Pearson, Rahel⁵  Hua, Jessica P. Y.⁶  Schlosser, Danielle^1,7  Stuart, Barbara K.^8,9  Mathalo, Daniel H.^1,10  Vinogradov, Sophia¹¹ 

[1] Univ Calif San Francisco, Dept Psychiat, Weill Inst Neurosci, 401 Parnassus Ave,Box 0984 PAR, San Francisco, CA 94143 USA

[2] Partners HealthCare, 399 Revolut Dr, Somerville, MA 02145 USA

[3] Posit Sci Corp, 160 Pine St,Suite 200, San Francisco, CA 94111 USA

[4] Boston Univ, Dept Occupat Therapy & Rehabil Sci, 635 Commonwealth Ave, Boston, MA 02215 USA

[5] Univ Texas Austin, Inst Mental Hlth Res, Dept Psychol, 305 E 23rd St Stop A9000, Austin, TX 78712 USA

[6] Univ Missouri, Dept Psychol Sci, 210 McAlester Hall, Columbia, MO 65211 USA

[7] Verily Life Sci, 269 E Grand Ave, San Francisco, CA 94080 USA

[8] Univ Calif San Francisco, Dept Psychiat, Zuckerberg San Francisco Gen Hosp, 1001 Potrero Ave,Bldg 5,Room 7G42, San Francisco, CA 94110 USA

[9] Univ Calif San Francisco, Trauma Ctr, 1001 Potrero Ave,Bldg 5,Room 7G42, San Francisco, CA 94110 USA

[10] Vet Affairs San Francisco Healthcare Syst, Mental Hlth Serv, San Francisco, CA 94121 USA

[11] Univ Minnesota, Dept Psychiat, Med Sch, F282-2A West,2450 Riverside Ave, Minneapolis, MN 55454 USA

[12] Boston Univ, Dept Psychol & Brain Sci, 635 Commonwealth Ave, Boston, MA 02215 USA

关键词: Adverse childhood events;    Prodrome;    Schizophrenia;    Stress;    Ultra high risk;   

DOI  :  10.1016/j.schres.2018.05.003

来源: Elsevier

【 摘 要 】

As a risk factor for psychosis, childhood trauma rates are elevated in the clinical-high-risk (CHR) syndrome compared to the general population. However, it is unknown whether trauma is typically experienced in childhood or adolescence/young adulthood, whether it occurred prior to CHR syndrome onset, and how severe trauma relates to presenting symptoms. In this study, we examined the relationship of trauma history to symptoms and functioning in individuals diagnosed with the CHR syndrome on the Structured Interview for Psychosis-Risk Syndromes (N = 103). Trauma, defined as meeting the DSM-IV Al criterion of actual or threatened death or injury, was assessed by semi-structured interview. A large proportion of CHR participants (61%) reported trauma exposure, including interpersonal trauma, trauma prior to CHR onset, and childhood trauma prior to age 12. Those with a trauma history (versus those without trauma) were rated as having more severe perceptual disturbances, general/affective symptoms and more impairment on the Global Assessment of Functioning Scale. The number of traumatic events correlated with more severe ratings in those three domains. Additionally, the number of interpersonal traumas was correlated with ratings of suspiciousness. Trauma was unrelated to specific measures of social and role functioning. A small proportion of CHR participants were diagnosed with formal PTSD (14%), which was unrelated to symptom severity or functioning. Thus, we demonstrate that trauma exposure is often early in life (before age 12), occurs prior to the onset of the CHR syndrome, and is related to both positive and affective symptoms. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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