title: Impact of childhood adversity on the onset and course of subclinical psychosis symptoms--results from a 30-year prospective community study.
abstract: The study objective was to examine childhood adversity in association with intra-individual changes and inter-individual differences in subclinical psychosis in a representative community cohort over a 30-year period of observation. We analyzed two psychosis syndromes derived from the SCL-90-R - schizotypal signs and schizophrenia nuclear symptoms - in 335 participants. Participants were repeatedly assessed between 1978 (around age 20) and 2008 (around age 50). We focused specifically on inter-individual differences and intra-individual changes over time by applying structural equation modeling, generalized linear models, and generalized estimating equations. Several weak inter-individual differences revealed that increased schizotypal signs are related to various childhood adversities, such as being repeatedly involved in fights and parents having severe conflicts among themselves. We also found a significant positive association between schizotypal signs and the total number of adversities a subject experienced. This pointed toward a modest dose-response relationship. The intra-individual change in schizotypal signs over time was rather weak, although some adjustment did occur. In contrast, inter-individual schizophrenia nuclear symptoms were mainly unrelated to childhood adversity. However, some striking intra-individual changes in distress were noted over time, especially those linked with severe punishment and the total adversity score. In conclusion, we have confirmed previous positive findings about the association between childhood adversity and subsequent subclinical psychosis symptoms: An increase in adversity is weakly related to an increase of the psychosis symptom load. However, depending on the kind of adversity experienced the psychosis symptom load decreases gradually in adult life.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institue of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil. Electronic address: roessler@dgsp.uzh.ch.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hengartner
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
authors.affiliation: University of Zurich & ETH Zurich, Institute for Biomedical Engineering, Translational Neuromodeling Unit, Zurich, Switzerland.
authors.forename: Helene
authors.initials: H
authors.lastname: Haker
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D015331:Cohort Studies; D003156:Community Mental Health Services; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D057566:Self Report; D012917:Social Adjustment; D055815:Young Adult
keywords: Abuse; Childhood adversity; Epidemiology; Etiology; Maltreatment; Neglect; Psychological adjustment; Psychosis continuum; Schizotypy; Subclinical psychosis