title: Reported history of child sexual abuse in schizophrenia: associations with heightened symptom levels and poorer participation over four months in vocational rehabilitation.
abstract: Cross-section research suggests reported childhood abuse in schizophrenia spectrum disorders is linked with graver symptom levels and social dysfunction. To examine this prospectively, we compared biweekly ratings of positive and emotional discomfort symptoms and weekly accounts of hours worked over 4 months of rehabilitation of 12 participants with schizophrenia or schizoaffective disorder and childhood sexual abuse history and 31 with schizophrenia or schizoaffective disorder and no childhood sexual abuse history. Repeated-measures ANOVA revealed the abuse group had consistently higher levels of both symptom components and poorer participation in vocational rehabilitation. A time by group effect was observed for hours of work, with the abuse group working increasingly fewer hours over time. Participants reporting abuse also were more likely to perform poorly on a test of executive function and to have particularly higher levels of hallucinations and anxiety over time. Clinical and theoretical implications are discussed.
authors.affiliation: Day Hospital 116H, Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Beattie
authors.forename: Amy M
authors.initials: AM
authors.lastname: Strasburger
authors.forename: Louanne W
authors.initials: LW
authors.lastname: Davis
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000706:statistics & numerical data; D015897:Comorbidity; D004651:Employment / Q000706:statistics & numerical data; D006212:Hallucinations / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D010358:Patient Participation; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012050:Rehabilitation, Vocational / Q000379:methods*; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D013997:Time Factors; D016896:Treatment Outcome