Protective Factors for Psychotic Symptoms Among Poly-victimized Children

Abstract

BackgroundExperiencing victimization in early life has been repeatedly shown to be associated with the emergence of psychotic symptoms in childhood. However, most victimized children do not develop psychotic symptoms and why this occurs is not fully understood. This study investigated which individual, family-level, and wider community characteristics were associated with an absence of psychotic symptoms among children at risk for psychosis by virtue of their exposure to multiple victimization experiences (poly-victimization).MethodsParticipants were from the Environmental Risk Longitudinal Twin Study, a nationally representative cohort of 2232 UK-born twins. Exposure to maltreatment, bullying and domestic violence prior to age 12 was determined from interviews with mothers, children, and observations by research workers at ages 5, 7, 10, and 12. Children were interviewed about psychotic symptoms at age 12. Protective factors were measured at ages 5, 7, 10, and 12.ResultsChildhood poly-victimization was associated with age-12 psychotic symptoms (OR = 4.61, 95% CI 2.82–7.52), but the majority of poly-victimized children did not report symptoms (80.7%). Having a relatively high IQ, more positive atmosphere at home, and higher levels of neighborhood social cohesion were found to be protective against childhood psychotic symptoms among poly-victimized children and also in the whole sample. However, “protected” poly-victimized children displayed elevated levels of other mental health problems compared to nonvictimized children.ConclusionsChildren’s characteristics, family context, and the wider community were all found to protect children from developing early psychotic symptoms, even when they were victimized multiple times. These findings indicate targets for multilevel preventive interventions.

Association of Trauma Type, Age of Exposure, and Frequency in Childhood and Adolescence With Psychotic Experiences in Early Adulthood

“…The risk of psychotic experiences was stronger after exposure to multiple types of trauma or repeated episodes of trauma at multiple age periods, which is consistent with a dose-response relationship and findings from other studies. 25 Adolescence was the age period during which exposure to trauma was most strongly associated with risk of psychotic experiences. Possible explanations for this pattern of associations include the following: (1) temporal proximity to the outcome affects risk more than age of exposure, and natural resolution of trauma-related psychopathologic status occurs over time, which is consistent with findings from 2 other studies 15,23 ; (2) adolescence represents a particularly sensitive period of risk for the association of interpersonal trauma with psychosis, support for which comes from animal and human studies showing an increase in hypothalamic-pituitary-adrenal activation and anxiety after exposure to stress among adolescents compared with other age groups 26-29 ; (3) weaker associations with earlier trauma measures may indicate greater measurement error in our study, perhaps because these measures were obtained from parental reports only, although this explanation seems unlikely given the results from our sensitivity analy-ses addressing informant-related measurement variance (eResults in the Supplement).…”

Protective factors for psychotic experiences amongst adolescents exposed to multiple forms of victimization

“…This is despite calls for a shift towards investigating what enables some victimized individuals to avoid developing psychotic experiences in the hope that such findings could inform preventive interventions ( Morgan and Gayer-Anderson, 2016 ). In a recent study ( Crush et al, 2017 ), we found that having a relatively high IQ, a more positive atmosphere at home, and higher levels of neighborhood social cohesion (meaning neighbors get along well and share common values) were associated with a reduced likelihood of psychotic symptoms emerging at age 12 amongst poly-victimized children. The current paper extends these findings by considering whether similar factors are protective amongst individuals exposed to poly-victimization during adolescence in relation to psychotic experiences at age 18.…”

The protective effect of neighbourhood social cohesion on adolescent mental health following stressful life events

“…Few studies have previously investigated whether neighbourhood social cohesion buffers such stressors, although one study showed that higher perceived neighbourhood cohesion attenuated the effects of maternal hostility on child externalizing behaviours, including symptoms of conduct disorder and property offences (Silk et al, 2004). Two further studies from the same sample have shown that greater neighbourhood social cohesion moderates the effects of childhood poly-victimization on early and late adolescent psychotic symptoms (Crush et al, 2018a(Crush et al, , 2018b. Our results suggest similar mechanisms may be at play with regards to neighbourhood social cohesion.…”