Childhood trauma and clinical high risk for psychosis

Rachel L. Loewy, Sarah Corey, Felix Amirfathi, Sawsan Dabit, Daniel Fulford, Rahel Pearson, Jessica P.Y. Hua, Danielle Schlosser, Barbara K. Stuart, Daniel H. Mathalon, Sophia Vinogradov

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

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 A1 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.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalSchizophrenia Research
Volume205
DOIs
StatePublished - Mar 2019

Bibliographical note

Funding Information:
This research was funded by grants from the National Institute of Mental Health : K23 MH086618 (RL), T32 MH018261 (DF) and R01 MH076989 (DM), a NARSAD Young Investigator Award (RL), and a gift from the Laszlo N. Tauber Family Foundation .

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

  • Adverse childhood events
  • Prodrome
  • Schizophrenia
  • Stress
  • Ultra high risk

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