Childhood trauma and distress experiences associate with psychotic symptoms in patients attending primary and psychiatric outpatient care. Results of the RADEP study

Luutonen, Sinikka; Tikka, Maria; Karlsson, H.; Salokangas, Raimo K. R.

doi:10.1016/j.eurpsy.2011.11.005

Cited by 12 publications

(13 citation statements)

References 44 publications

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“…Higher sensitivity to stress has been associated with psychosis risk (78–80) and also has been reported in SCZ (81) as well as BPD (82). In addition, several reports have associated childhood adversity with risk of psychosis (58, 83), suggesting the importance of documenting lifetime stressors. Abnormalities in the hypothalamic–pituitary–adrenal axis, a key mediator of the stress response, have been implicated in both SCZ (84) and BPD (85, 86).…”

Section: Discussionmentioning

confidence: 99%

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

2016

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Early identification and treatment are associated with improved outcomes in bipolar disorder (BPD) and schizophrenia (SCZ). Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals at earlier stages of illness are often not identified. The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen is a self-report questionnaire originally developed to identify clinical risk for developing bipolar or psychotic disorders. The goal of the current study was to investigate the utility of the WERCAP Screen and two complementary questionnaires, the WERC Stress Screen and the WERC Substance Screen, in identifying individuals with established SCZ or BPD. Participants consisted of 35 BPD and 34 SCZ patients, as well as 32 controls (CON), aged 18–30 years. Univariate analyses were used to test for score differences between groups. Logistic regression and receiver operating characteristic (ROC) curves were used to identify diagnostic predictors. Significant group differences were found for the psychosis section of the WERCAP (pWERCAP; p < 0.001), affective section of the WERCAP (aWERCAP; p = 0.001), and stress severity (p = 0.027). No significant group differences were found in the rates of substance use as measured by the WERC Substance Screen (p = 0.267). Only the aWERCAP and pWERCAP scores were useful predictors of diagnostic category. ROC curve analysis showed the optimal cut point on the aWERCAP to identify BPD among our participant groups was a score of >20 [area under the curve (AUC): 0.87; sensitivity: 0.91; specificity: 0.71], while that for the pWERCAP to identify SCZ was a score of >13 (AUC: 0.89; sensitivity: 0.88; specificity: 0.82). These results indicate that the WERCAP Screen may be useful in screening individuals for BPD and SCZ and that identifying stress and substance-use severity can be rapidly done using self-report questionnaires. Larger studies in undiagnosed individuals will be needed to test the WERCAP Screen’s ability to identify mania or psychosis in the community.

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Section: Discussionmentioning

confidence: 99%

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

2016

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“…Each of the 43 items is rated on a 5-point Likert-scale from “never” to “almost always.” Higher values indicate more severe adversities and trauma. The TADS has been used in adolescent as well as adult samples ( 53 , 54 ) and has been validated in a large general population study showing good internal consistency, inter-method reliability, and concurrent validity ( 52 ).…”

Section: Methodsmentioning

confidence: 99%

Mediators Linking Childhood Adversities and Trauma to Suicidality in Individuals at Risk for Psychosis

et al. 2017

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Suicidality is highly prevalent in patients at clinical high risk (CHR) for psychosis. Childhood adversities and trauma are generally predictive of suicidality. However, the differential effects of adversity/trauma-domains and CHR-criteria, i.e., ultra-high risk and basic symptom criteria, on suicidality remain unclear. Furthermore, the underlying mechanisms and, thus, worthwhile targets for suicide-prevention are still poorly understood. Therefore, structural equation modeling was used to test theory-driven models in 73 CHR-patients. Mediators were psychological variables, i.e., beliefs about one’s own competencies as well as the controllability of events and coping styles. In addition, symptomatic variables (depressiveness, basic symptoms, attenuated psychotic symptoms) were hypothesized to mediate the effect of psychological mediators on suicidality as the final outcome variable. Results showed two independent pathways. In the first pathway, emotional and sexual but not physical adversity/trauma was associated with suicidality, which was mediated by dysfunctional competence/control beliefs, a lack of positive coping-strategies and depressiveness. In the second pathway, cognitive basic symptoms but not attenuated psychotic symptoms mediated the relationship between trauma/adversity and suicidality. CHR-patients are, thus, particularly prone to suicidality if adversity/trauma is followed by the development of depressiveness. Regarding the second pathway, this is the first study showing that adversity/trauma led to suicidality through an increased risk for psychosis as indicated by cognitive basic symptoms. As insight is generally associated with suicidality, this may explain why self-experienced basic symptoms increase the risk for it. Consequently, these mediators should be monitored regularly and targeted by integrated interventions as early as possible to enhance resilience against suicidality.

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“…The TADS includes five domains – emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect – the scores for which are calculated by totaling the corresponding items (Table ). The overall score for the TADS was formed by adding together the TADS domains .…”

Section: Methodsmentioning

confidence: 99%

“…The participants were asked to complete the MDAS, TADS, LEC, and PBI scales once during weeks 32–34 of pregnancy (H32–34). The MDAS questionnaire was filled out by 125 women [mean age ± SD (range) = 29.6 ± 4.9 yrs] and 81 men [31.7 ± 5.6 yrs]. Dropout analysis revealed that women who did not complete the MDAS questionnaire at H32–34 did not differ statistically significantly from those included in the study, according to age, education, parity, physical and mental health, or dental fear.…”

Section: Methodsmentioning

confidence: 99%

Dental fear and previous childhood traumatic experiences, life events, and parental bonding

Hagqvist

Tolvanen

Rantavuori

et al. 2015

European J Oral Sciences

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We aimed to determine whether adult dental fear is associated with traumas, life events, and perceived parental bonding. Pilot data for the FinnBrain Cohort study were used. Of the 254 families expecting a baby, 80% agreed to participate. At 32-34 wk of pregnancy, 125 women and 81 men completed a Modified Dental Anxiety Scale questionnaire and were included in this study. Other instruments used were the Trauma and Distress Scale (TADS), the Life Event Checklist, and the Parental Bonding Index. All scales were analyzed as summated rating scale scores. Associations between dental fear, TADS domains, and life events were evaluated using Spearman correlation coefficients. The association between dental fear and parental bonding was evaluated using the Kruskal-Wallis test. Among women, dental fear did not correlate with trauma measures, but among men dental fear correlated with emotional neglect and abuse. Dental fear correlated positively with the number of life events among women. Life events and dental fear did not correlate among men. Dental fear was not associated with parental bonding among women or men. The association between traumas, life events, and dental fear seems to be different in women and men.

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Childhood trauma and distress experiences associate with psychotic symptoms in patients attending primary and psychiatric outpatient care. Results of the RADEP study

Abstract: Childhood trauma experiences associate with psychotic symptoms. In clinical work, it is important to acknowledge that psychotic symptoms and childhood trauma experiences are common not only in psychiatric care but also in primary care patients, and thus require adequate attention.

Cited by 12 publications

References 44 publications

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

Mediators Linking Childhood Adversities and Trauma to Suicidality in Individuals at Risk for Psychosis

Dental fear and previous childhood traumatic experiences, life events, and parental bonding

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