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

Published online by Cambridge University Press:  24 February 2010

H. L. Fisher
Affiliation:
Institute of Psychiatry, King's College London, UK
P. B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, UK
P. Fearon
Affiliation:
Institute of Psychiatry, King's College London, UK
T. K. Craig
Affiliation:
Institute of Psychiatry, King's College London, UK
P. Dazzan
Affiliation:
Institute of Psychiatry, King's College London, UK National Institute of Health Research Biomedical Research Centre for Mental Health, London, UK
K. Morgan
Affiliation:
Department of Psychology, Westminster University, London, UK
G. Hutchinson
Affiliation:
Psychiatry Unit, Faculty of Medical Sciences, University of the West Indies, Trinidad
G. A. Doody
Affiliation:
Division of Psychiatry, University of Nottingham, UK
P. McGuffin
Affiliation:
Institute of Psychiatry, King's College London, UK
J. Leff
Affiliation:
Institute of Psychiatry, King's College London, UK
R. M. Murray
Affiliation:
Institute of Psychiatry, King's College London, UK National Institute of Health Research Biomedical Research Centre for Mental Health, London, UK
C. Morgan
Affiliation:
Institute of Psychiatry, King's College London, UK National Institute of Health Research Biomedical Research Centre for Mental Health, London, UK
Corresponding

Abstract

Background

Childhood 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).

Method

Data 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.

Results

Psychosis 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.

Conclusions

These 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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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References

Agid, O, Shapira, B, Zislin, J, Ritsner, M, Hanin, B, Murad, H, Troudart, T, Bloch, M, Heresco-Levy, U, Lerer, B (1999). Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia. Molecular Psychiatry 4, 163172.CrossRefGoogle Scholar
Beattie, N, Shannon, C, Kavanagh, M, Mulholland, C (2009). Predictors of PTSD symptoms in response to psychosis and psychiatric admission. Journal of Nervous and Mental Disease 197, 5660.CrossRefGoogle ScholarPubMed
Bebbington, P, Nayani, T (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research 5, 1120.Google Scholar
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004). Psychosis, victimization and childhood disadvantage. British Journal of Psychiatry 185, 220226.CrossRefGoogle ScholarPubMed
Bendall, S, Jackson, HJ, Hulbert, CA, McGorry, PD (2008). Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophrenia Bulletin 34, 568579.CrossRefGoogle Scholar
Bernstein, DP, Fink, L (1998). Childhood Trauma Questionnaire: A Retrospective Self-report Manual. The Psychological Corporation: New York, NY.Google Scholar
Bifulco, A, Bernazzani, O, Moran, PM, Jacobs, C (2005). The Childhood Experiences of Care and Abuse Questionnaire (CECA.Q) – validation in a community series. British Journal of Clinical Psychology 44, 563581.CrossRefGoogle Scholar
Blaauw, E, Arensman, E, Kraaij, V, Winkel, FW, Bout, R (2002). Traumatic life events and suicide risk among jail inmates: the influence of types of events, time period and significant others. Journal of Traumatic Stress 15, 9–16.CrossRefGoogle Scholar
Bowlby, J (1951). Maternal Care and Mental Health. Schocken: New York, NY.Google ScholarPubMed
Bowlby, J (1977). The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrists, 19 November 1976. British Journal of Psychiatry 130, 201210.CrossRefGoogle Scholar
Briere, J, Woo, R, McRae, B, Foltz, J, Sitzman, R (1997). Lifetime victimization history, demographics and clinical status in female psychiatric emergency room patients. Journal of Nervous and Mental Disease 185, 95–101.CrossRefGoogle ScholarPubMed
Brown, GW, Craig, TK, Harris, TO, Handley, RV, Harvey, AL (2007). Development of a retrospective interview measure of parental maltreatment using the Childhood Experience of Care and Abuse (CECA) instrument – a life-course study of adult chronic depression – 1. Journal of Affective Disorders 103, 205215.CrossRefGoogle ScholarPubMed
Campbell, ML, Morrison, AP (2007). The relationship between bullying, psychotic-like experiences and appraisals in 14–16-year olds. Behaviour, Research and Therapy 45, 15791591.CrossRefGoogle ScholarPubMed
Clausen, AH, Crittenden, PM (1991). Physical and psychological maltreatment: relations among types of treatment. Child Abuse and Neglect 15, 5–18.CrossRefGoogle Scholar
Cohen, LJ, Campos, JJ (1974). Father, mother, and stranger as elicitors of attachment behaviors in infancy. Developmental Psychology 10, 146154.CrossRefGoogle Scholar
Coid, J, Petruckevitch, A, Chung, W-S, Richardson, J, Moorey, S, Feder, G (2003). Abusive experiences and psychiatric morbidity in women primary care attenders. British Journal of Psychiatry 183, 332339.CrossRefGoogle ScholarPubMed
Colins, O, Vermeiren, R, Vreugdenhil, C, Schuyten, G, Broekaert, E, Krabbendam, A (2009). Are psychotic experiences among detained juvenile offenders explained by trauma and substance use? Drug and Alcohol Dependence 100, 3946.CrossRefGoogle ScholarPubMed
Croudace, TJ, Kayne, R, Jones, PB, Harrison, GL (2000). Non-linear relationship between an index of social deprivation, psychiatric admission prevalence and the incidence of psychosis. Psychological Medicine 30, 177185.CrossRefGoogle Scholar
Fisher, H, Craig, T (2008). Childhood adversity and psychosis. In Society and Psychosis (ed. Morgan, C., McKenzie, K. and Fearon, P.), pp. 95–111. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Fisher, H, Morgan, C, Dazzan, P, Craig, TK, Morgan, K, Hutchinson, G, Jones, PB, Doody, GA, Pariante, C, McGuffin, P, Murray, RM, Leff, J, Fearon, P (2009 a). Gender differences in the association between childhood abuse and psychosis. British Journal of Psychiatry 194, 319325.CrossRefGoogle ScholarPubMed
Fisher, HL, Craig, TK, Fearon, P, Morgan, K, Dazzan, P, Lappin, J, Hutchinson, G, Doody, GA, Jones, PB, McGuffin, P, Murray, RM, Leff, J, Morgan, C (2009 b). Reliability and comparability of psychosis patients' retrospective reports of childhood abuse. Schizophrenia Bulletin. Published online: 7 October 2009. doi:10.1093/schbul/sbp103.Google ScholarPubMed
Garety, PA, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E (2007). Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine 37, 13771391.CrossRefGoogle ScholarPubMed
Gilbert, R, Widom, CS, Browne, K, Fergusson, D, Webb, E, Janson, S (2009). Burden and consequences of child maltreatment in high-income countries. Lancet 373, 6881.CrossRefGoogle ScholarPubMed
Hammersley, P, Dias, A, Todd, G, Bowen-Jones, K, Reilly, B, Bentall, RP (2003). Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation. British Journal of Psychiatry 182, 543547.CrossRefGoogle ScholarPubMed
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: a review of the evidence. Journal of Child Psychology and Psychiatry 45, 260273.CrossRefGoogle Scholar
Harris, T (1987). Recent developments in the study of life events in relation to psychiatric and physical disorders. In Psychiatric Epidemiology: Progress and Prospects (ed. Cooper, B.), pp. 81–102. Croom Helm: London.Google Scholar
Heads, TC, Taylor, PJ, Leese, M (1997). Childhood experiences of patients with schizophrenia and a history of violence: a special hospital sample. Criminal Behaviour and Mental Health 7, 117130.CrossRefGoogle Scholar
Heins, T, Gray, A, Tennant, M (1990). Persisting hallucinations following childhood sexual abuse. Australian and New Zealand Journal of Psychiatry 24, 561565.CrossRefGoogle ScholarPubMed
Hlastala, SA, McClellan, J (2005). Phenomenology and diagnostic stability of youths with atypical psychotic symptoms. Journal of Child and Adolescent Psychopharmacology 15, 497509.CrossRefGoogle ScholarPubMed
Houston, JE, Murphy, J, Adamson, G, Stringer, M, Shevlin, M (2008). Childhood sexual abuse, early cannabis use, and psychosis: testing an interaction model based on the National Comorbidity Survey. Schizophrenia Bulletin 34, 580585.CrossRefGoogle ScholarPubMed
Howard, LM (1993). Allegations of abuse in psychotic patients. American Journal of Psychiatry 150, 839840.Google ScholarPubMed
Janssen, I, Krabbendam, L, Bak, M, Hanssen, M, Vollebergh, W, de Graaf, R, van Os, J (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica 109, 3845.CrossRefGoogle ScholarPubMed
Jenkins, R, Meltzer, H (1995). The national survey of psychiatric morbidity in Great Britain. Social Psychiatry and Psychiatric Epidemiology 30, 14.CrossRefGoogle ScholarPubMed
Jones, P, Rodgers, B, Murray, R, Marmot, M (1994). Child development risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet 344, 13981402.CrossRefGoogle ScholarPubMed
Keiley, MK, Howe, TR, Dodge, KA, Bates, JE, Petti, GS (2001). The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Development and Psychopathology 13, 891912.Google ScholarPubMed
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C, Cannon, M (2008). Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378382.CrossRefGoogle ScholarPubMed
Kilcommons, AM, Morrison, AP (2005). Relationships between trauma and psychosis: an exploration of cognitive and dissociative factors. Acta Psychiatrica Scandinavica 112, 351359.CrossRefGoogle ScholarPubMed
Kim, D, Kaspar, V, Noh, S, Nam, JH (2006). Sexual and physical abuse among Korean female inpatients with schizophrenia. Journal of Traumatic Stress 19, 279289.CrossRefGoogle ScholarPubMed
Kirkbride, J, Fearon, P, Morgan, C, Dazzan, P, Morgan, K, Tarrant, J, Fung, WL, Holloway, J, Mallett, R, Harrison, G, Leff, J, Jones, PB, Murray, RM, AESOP Study Group (2006). Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Archives of General Psychiatry 63, 250258.CrossRefGoogle ScholarPubMed
Lataster, T, van Os, J, Drukker, M, Henquet, C, Feron, F, Gunther, N, Myin-Germeys, I (2006). Childhood victimisation and developmental expression of nonclinical delusional ideation and hallucinatory experiences: victimisation and nonclinical psychotic experiences. Social Psychiatry and Psychiatric Epidemiology 41, 423428.CrossRefGoogle Scholar
Mallett, R (1997). Sociodemographic Schedule. Section of Social Psychiatry, Institute of Psychiatry: London.Google Scholar
May-Chahal, C, Cawson, P (2005). Measuring child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect. Child Abuse and Neglect 29, 969984.CrossRefGoogle ScholarPubMed
McNeil, TF, Schubert, EW, Cantor-Graae, E, Brossner, M, Schubert, P, Henriksson, KM (2009). Unwanted pregnancy as a risk factor for offspring schizophrenia-spectrum and affective disorders in adulthood: a prospective high-risk study. Psychological Medicine 39, 957965.CrossRefGoogle ScholarPubMed
Morgan, C, Dazzan, P, Morgan, K, Jones, P, Harrison, G, Leff, J, Murray, R, Fearon, P, AESOP Study Group (2006). First episode psychosis and ethnicity: initial findings from the AESOP study. World Psychiatry 5, 4046.Google ScholarPubMed
Morgan, C, Fisher, H (2007). Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma – a critical review. Schizophrenia Bulletin 33, 3–10.CrossRefGoogle ScholarPubMed
Morgan, C, Kirkbride, J, Leff, J, Craig, T, Hutchinson, G, McKenzie, K, Morgan, K, Dazzan, P, Doody, GA, Jones, P, Murray, R, Fearon, P (2007). Parental separation, loss and psychosis in different ethnic groups: a case-control study. Psychological Medicine 37, 495503.CrossRefGoogle ScholarPubMed
Mulder, RT, Beautrais, AL, Joyce, PR, Fergusson, DM (1998). Relationship between dissociation, childhood sexual abuse, childhood physical abuse, and mental illness in a general population sample. American Journal of Psychiatry 155, 806811.Google Scholar
Myhrman, A, Rantakallio, P, Isohanni, M, Jones, P, Partanen, U (1996). Unwantedness of a pregnancy and schizophrenia in the child. British Journal of Psychiatry 169, 637640.CrossRefGoogle ScholarPubMed
Neria, Y, Bromet, EJ, Sievers, S, Lavelle, J, Fochtmann, LJ (2002). Trauma exposure and posttraumatic stress disorder in psychosis: findings from a first-admission cohort. Journal of Consulting and Clinical Psychology 70, 246251.CrossRefGoogle ScholarPubMed
NHS Confederation (2008). Implementing National Policy on Violence and Abuse. The NHS Confederation: London.Google Scholar
Office of National Statistics (2002). The National Statistics Socio-economic Classification User Manual. Office for National Statistics: London.Google Scholar
Parker, G, Fairley, M, Greenwood, J, Jurd, S, Silove, D (1982). Parental representations of schizophrenics and their association with onset and course of schizophrenia. British Journal of Psychiatry 141, 573581.CrossRefGoogle ScholarPubMed
Plomin, R, DeFries, JC, Loehlin, JC (1977). Genotype–environment interaction and correlation in the analysis of human behaviour. Psychological Bulletin 84, 309322.CrossRefGoogle Scholar
Romero, S, Birmaher, B, Axelson, D, Goldstein, T, Goldstein, BI, Gill, MK, Iosif, AM, Strober, MA, Hunt, J, Esposito-Smythers, C, Ryan, ND, Leonard, H, Keller, M (2009). Prevalence and correlates of physical and sexual abuse in children and adolescents with bipolar disorder. Journal of Affective Disorders 112, 144150.CrossRefGoogle ScholarPubMed
Rosenberg, SD, Lu, W, Mueser, KT, Jankowski, MK, Cournos, F (2007). Correlates of adverse childhood events among adults with schizophrenia spectrum disorders. Psychiatric Services 58, 245253.CrossRefGoogle ScholarPubMed
Rubino, IA, Nanni, RC, Pozzi, DM, Siracusano, A (2009). Early adverse experiences in schizophrenia and unipolar depression. Journal of Nervous and Mental Disease 197, 6568.CrossRefGoogle ScholarPubMed
Schäfer, I, Harfst, T, Aderhold, V, Briken, P, Lehmann, M, Moritz, S, Read, J, Naber, D (2006). Childhood trauma and dissociation in female patients with schizophrenia spectrum disorders: an exploratory study. Journal of Nervous and Mental Disease 194, 135138.CrossRefGoogle Scholar
Schenkel, L, Spaulding, W, DiLillo, D, Silverstein, S (2005). Histories of childhood maltreatment in schizophrenia: relationships with premorbid functioning, symptomatology, and cognitive deficits. Schizophrenia Research 76, 273286.CrossRefGoogle ScholarPubMed
Schilling, EA, Aseltine, RH Jr, Gore, S (2008). The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations. Social Science and Medicine 66, 11401151.CrossRefGoogle Scholar
Schofield, W, Balian, L (1959). A comparative study of the personal histories of schizophrenic and nonpsychiatric patients. Journal of Abnormal Social Psychology 59, 216225.CrossRefGoogle ScholarPubMed
Shevlin, M, Dorahy, MJ, Adamson, G (2007 a). Trauma and psychosis: an analysis of the National Comorbidity Survey. American Journal of Psychiatry 164, 166169.CrossRefGoogle ScholarPubMed
Shevlin, M, Dorahy, MJ, Adamson, G (2007 b). Childhood traumas and hallucinations: an analysis of the National Comorbidity Survey. Journal of Psychiatric Research 41, 222228.CrossRefGoogle ScholarPubMed
Shevlin, M, Houston, JE, Dorahy, MJ, Adamson, G (2008). Cumulative traumas and psychosis: an analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey. Schizophrenia Bulletin 34, 193199.CrossRefGoogle ScholarPubMed
Sidebotham, P, Heron, J, ALSPAC Study Team (2006). Child maltreatment in the ‘children of the nineties’: a cohort study of risk factors. Child Abuse and Neglect 30, 497522.CrossRefGoogle Scholar
Smith, N, Lam, D, Bifulco, A, Checkley, S (2002). Childhood Experience of Care and Abuse Questionnaire (CECAQ): validation of a screening instrument for childhood adversity in clinical populations. Social Psychiatry and Psychiatric Epidemiology 37, 572579.CrossRefGoogle Scholar
Sommer, IE, Daalman, K, Rietkerk, T, Diederen, KM, Bakker, S, Wijkstra, J, Boks, MP (2008). Healthy individuals with auditory verbal hallucinations; who are they? Psychiatric assessments of a selected sample of 103 subjects. Schizophrenia Bulletin. Published online: 9 October 2008. doi:10.1093/schbul/sbn130.Google ScholarPubMed
Spauwen, J, Krabbendam, L, Lieb, R, Wittchen, HU, van Os, J (2006). Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness. British Journal of Psychiatry 188, 527533.CrossRefGoogle ScholarPubMed
Steele, H, Steele, M, Fonagy, P (1996). Associations among attachment classifications of mothers, fathers, and their infants. Child Development 67, 541555.CrossRefGoogle ScholarPubMed
Thornberry, TP, Ireland, TO, Smith, CA (2001). The importance of timing: the varying impact of childhood and adolescent maltreatment on multiple problem outcomes. Development and Psychopathology 13, 957979.Google ScholarPubMed
van der Vegt, EJ, van der Ende, J, Ferdinand, RF, Verhulst, FC, Tiemeier, H (2009). Early childhood adversities and trajectories of psychiatric problems in adoptees: evidence for long lasting effects. Journal of Abnormal Child Psychology 37, 239249.CrossRefGoogle ScholarPubMed
Weber, K, Rockstroh, B, Borgelt, J, Awiszus, B, Popov, T, Hoffmann, K, Schonauer, K, Watzl, H, Pröpster, K (2008). Stress load during childhood affects psychopathology in psychiatric patients. BMC Psychiatry 8, 63.CrossRefGoogle ScholarPubMed
Wexler, BE, Lyons, L, Lyons, H, Mazure, CM (1997). Physical and sexual abuse during childhood and development of psychiatric illnesses during adulthood. Journal of Nervous and Mental Disease 185, 522524.CrossRefGoogle ScholarPubMed
Whitfield, C, Dube, S, Felitti, V, Anda, R (2005). Adverse childhood experiences and hallucinations. Child Abuse and Neglect 29, 797810.CrossRefGoogle ScholarPubMed
Widom, CS, Czaja, SJ, Dutton, MA (2008). Childhood victimization and lifetime revictimization. Child Abuse and Neglect 32, 785796.CrossRefGoogle ScholarPubMed
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
WHO (1994). Schedules for the Clinical Assessment of Neuropsychiatry. World Health Organization: Geneva.Google Scholar
WHO (2002). The World Health Report 2002: Reducing Risks, Promoting Healthy Life. World Health Organization: Geneva.Google Scholar
Young, M, Read, J, Barker-Collo, S, Harrison, R (2001). Evaluating and overcoming barriers to taking abuse histories. Professional Psychology, Research and Practice 32, 407414.CrossRefGoogle Scholar

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