Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis

Abstract

The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.

Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample

“…The association of emotional abuse, physical abuse, and physical neglect with screening positive for CHR parallels previous research demonstrating that a history of childhood maltreatment represents a strong risk factor for psychotic phenomena and the manifestation of the CHR state ( 19 , 37 , 39 , 42 , 47 , 134 ). Furthermore, the findings regarding emotional abuse are in line with a recent review showing that emotional abuse is the type of adversity most strongly associated with subclinical expressions of psychosis in non-clinical samples ( 135 ). Therefore, our results concerning childhood maltreatment support those obtained across other populations and further highlight the relevance of distinguishing among maltreatment types when investigating associations with psychosis risk.…”

Cognitive reserve moderates the relationship between childhood maltreatment, objective and subjective cognition, and psychosocial functioning in individuals with first-episode psychosis.

“…Despite this, all the patients experienced psychotic symptoms, which have been found to be related to emotional abuse in the previous literature (Ackner et al, 2013). The fact that individuals with nonaffective FEP reported higher levels of emotional abuse than affective FEP might be explained by the fact that emotional abuse was found to be a stronger predictor of schizophrenia-like experiences than other types of abuse (Toutountzidis et al, 2022). Further large-scale studies are therefore needed to distinguish between different CM types and how CR interacts to predict cognitive and psychosocial outcomes in affective versus nonaffective FEP for a better understanding on potential different patterns between diagnoses and to disentangle underlying mechanisms.…”

Time to put aside the false dichotomy between personality disorders and psychotic symptoms

“…Trauma in and of itself was found to predict diverse psychotic symptoms (i.e., hallucinations, paranoia, and delusions) by diverse mediational pathways (dissociation, emotional dysregulation, PTSD symptoms, beliefs/schemas); in comparison, the specific links and mechanisms between psychosis and the new ICD‐11 diagnosis of complex PTSD have yet to be understood (Bloomfield et al, 2021). Thus, since PDs are associated with high rates of trauma, including schizotypal, obsessive‐compulsive, and borderline PDs (Porter et al, 2020; Toutountzidis et al, 2022; Yalch & Froehlich, 2023), and since trauma might lead to dissociative symptoms, the presence of thought dysfunction might be a corollary of trauma (instead of PD per se; as postulated by Beatson, Broadbear, et al, 2019).…”