Reliability and Comparability of Psychosis Patients' Retrospective Reports of Childhood Abuse

Abstract

An increasing number of studies are demonstrating an association between childhood abuse and psychosis. However, the majority of these rely on retrospective self-reports in adulthood that may be unduly influenced by current psychopathology. We therefore set out to explore the reliability and comparability of first-presentation psychosis patients' reports of childhood abuse. Psychosis case subjects were drawn from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) epidemiological study and completed the Childhood Experience of Care and Abuse Questionnaire to elicit abusive experiences that occurred prior to 16 years of age. High levels of concurrent validity were demonstrated with the Parental Bonding Instrument (antipathy: r(s)=0.350-0.737, P<.001; neglect: r(s)=0.688-0.715, P<.001), and good convergent validity was shown with clinical case notes (sexual abuse: κ=0.526, P<.001; physical abuse: κ=0.394, P<.001). Psychosis patients' reports were also reasonably stable over a 7-year period (sexual abuse: κ=0.590, P<.01; physical abuse: κ=0.634, P<.001; antipathy: κ=0.492, P<.01; neglect: κ=0.432, P<.05). Additionally, their reports of childhood abuse were not associated with current severity of psychotic symptoms (sexual abuse: U=1768.5, P=.998; physical abuse: U=2167.5, P=.815; antipathy: U=2216.5, P=.988; neglect: U=1906.0, P=.835) or depressed mood (sexual abuse: χ(2)=0.634, P=.277; physical abuse: χ(2)=0.159, P=.419; antipathy: χ(2)=0.868, P=.229; neglect: χ(2)=0.639, P=.274). These findings provide justification for the use in future studies of retrospective reports of childhood abuse obtained from individuals with psychotic disorders.

Childhood adversity and psychosis: generalised or specific effects?

“…Despite guidelines emphasising the need to routinely assess adversity exposure in psychiatric serviceusers (National Health Service Confederation, 2008), research suggests such recommendations are often not implemented (Read et al 2007;Fisher et al 2011;Hepworth & McGowan, 2013).While staff should not pre-suppose a history of maltreatment unless confirmed by the client, the current findings support the contention that clinicians should receive support and training for making routine evaluations for possible experiences of maltreatment. This is particularly important given the significant under-detection of posttraumatic stress in patients diagnosed with psychosis (Salyers et al 2004;Lommen & Restifo, 2009;Mauritz et al 2013), and that such individuals are less likely to receive an appropriate clinical response (e.g., trauma-focused interventions) relative to those with non-psychotic diagnoses (Agar & Read, 2002;Salyers et al 2004;Grubaugh et al 2011) especially in instances where healthcare workers have strong convictions about biogenetic aetiology (Read & Fraser, 1998;Young et al 2001;Agar & Read, 2002).…”

Social anxiety in first-episode psychosis: The role of childhood trauma and adult attachment

“…individuals avoidant of attachment could perceive themselves instead to be independent and secure in their attachment relations). The alternative would be to use an interview based assessment, such as the Adult Attachment Interview (AAI) (60). However, this interview is particularly lengthy, time-consuming and requires extensive training.…”

Trauma, Dissociation and Synthetic Metacognition in Schizophrenia

“…Similarly, Gil et al (2009) found that physical neglect had an effect on adult functionality. On the other hand, other studies didn't show a significant relevance between trauma and severity of symptoms (Fisher et al, 2011;Vogel et al, 2006). Moreover, beyond childhood trauma also symptoms of psychosis or an experience with psychiatric services, predominantly hospitalization, may play a causative role of trauma for development of comorbid PTSD (Morrison et al, 2003) and chronic schizophrenia patients exhibit clinically significant trauma symptoms .…”