Clinical correlates of maltreatment and traumatic experiences in childhood and adolescence among predominantly African American, socially disadvantaged, hospitalized, first-episode psychosis patients

Abstract

Associations among maltreatment and traumatic experiences in childhood and adolescence, later substance use, and subsequent mental health outcomes for individuals with schizophrenia-spectrum disorders have been initially explored in previous studies; however, research on these factors in socially disadvantaged patients with first-episode psychosis is unavailable. This exploratory, correlational analysis examined associations between maltreatment and trauma-related variables (e.g., traumatic experiences, parental harsh discipline, violence exposure) and: social variables (years of education attained and extent of Axis IV psychosocial problems at initial hospitalization), substance abuse (age at initiation of alcohol and cannabis use, as well as estimates of lifetime intake of both), and positive and negative symptom severity. Rates of childhood abuse and traumatic events were remarkably high in the sample. Years of educational attainment and number of Axis IV psychosocial problems were substantially correlated with several domains of childhood abuse/traumatic events. Age at initiation of alcohol and cannabis use, and lifetime alcohol and cannabis intake, were correlated with a number of trauma domains. Whereas positive symptom severity was correlated with four of the trauma variables, negative symptom severity was correlated only with prior emotional neglect. These results provide insights into the relations among childhood traumatic events, substance use, and clinical features of first-episode psychosis, creating hypotheses for future research.

The prevalence and correlates of childhood trauma in patients with early psychosis

“…Similarly, Bendall et al (2013b) reported that EP patients exposed to childhood sexual abuse had more severe hallucinations and delusions, and Wang and colleagues (2013) found CT was significantly correlated with hallucinations (r = 0.174, P = 0.049) in EP patients but not patients with chronic psychosis. Finally, a study by Ramsay et al (2011) found correlations between childhood emotional abuse and neglect and positive and negative psychotic symptoms, respectively, in disadvantaged, African-American EP inpatients.…”

Childhood trauma as a risk factor for psychosis: A sib-pair study

“…In a first pilot study (Compton et al, 2004) with 18 first episode psychosis patients, they described preliminary evidence of a more frequent childhood abuse among patients with comorbid cannabis dependence (n ¼ 8) than among those without it (n ¼ 10). In a subsequent analysis (Ramsay et al, 2011) of 61 first episode psychosis patients, the authors reported a significant bivariate association between emotional abuse in childhood and current positive symptoms.…”

“…We have found only one clinical study (Compton et al, 2004), which was subsequently expanded (Ramsay et al, 2011), addressing the relationship between childhood trauma, cannabis use and psychosis development. According to the authors, they arrived at provisional results, not at strong conclusions.…”

“…To our knowledge there is only one study that analyses the correlation between these two factors, presented in two successive reports (Compton et al, 2004;Ramsay et al, 2011). This study found that first episode psychosis patients with comorbid cannabis dependence reported significantly greater childhood trauma than those without comorbid cannabis dependence.…”

“…In two recent meta-analyses (Varese et al, 2012;Matheson et al, 2013), childhood adversity and trauma were found to be associated with an increased risk of psychosis. Proposed hypotheses explaining this relationship integrate social, psychological and biological factors (Read et al, 2001;.…”