title: Gender differences in the association between childhood physical and sexual abuse, social support and psychosis.
abstract: OBJECTIVE
  Childhood adversity (variously defined) is a robust risk factor for psychosis, yet the mitigating effects of social support in adulthood have not yet been explored. This study aimed to investigate the relationships between childhood sexual and physical abuse and adult psychosis, and gender differences in levels of perceived social support.
  
  
  METHODS
  A sample of 202 individuals presenting for the first time to mental health services with psychosis and 266 population-based controls from south-east London and Nottingham, UK, was utilised. The Childhood Experience of Care and Abuse Questionnaire was used to elicit retrospective reports of exposure to childhood adversity, and the Significant Others Questionnaire was completed to collect information on the current size of social networks and perceptions of emotional and practical support.
  
  
  RESULTS
  There was evidence of an interaction between severe physical abuse and levels of support (namely, number of significant others; likelihood ratio test χ(2) = 3.90, p = 0.048). When stratified by gender, there were no clear associations between childhood physical or sexual abuse, current social support and odds of psychosis in men. In contrast, for women, the highest odds of psychosis were generally found in those who reported severe abuse and low levels of social support in adulthood. However, tests for interaction by gender did not reach conventional levels of statistical significance.
  
  
  CONCLUSIONS
  These findings highlight the importance of investigating the potential benefits of social support as a buffer against the development of adult psychosis amongst those, particularly women, with a history of early life stress.
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. charlotte.gayer-anderson@kcl.ac.uk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gayer-Anderson
authors.affiliation: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
authors.affiliation: Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Fearon
authors.affiliation: Psychiatry Unit, University of the West Indies, Trinidad, Trinidad and Tobago.
authors.forename: Gerard
authors.initials: G
authors.lastname: Hutchinson
authors.affiliation: Department of Psychology, University of Westminster, London, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Morgan
authors.affiliation: Psychosis Studies Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: Psychosis Studies Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Boydell
authors.affiliation: Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Doody
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: Psychosis Studies Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|Psychosis Studies Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Craig
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, NIHR Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012944:Social Support; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Childhood adversity; Onset; Psychosis; Social networks; Social support