Abstract
BackgroundWe investigated to what degree environmental exposure (childhood trauma, urbanicity, cannabis use, and discrimination) impacts symptom connectivity using both continuous and categorical measures of psychopathology.MethodsOutcomes were continuous symptom dimensions of self-reported psychopathology using the Self-report Symptom Checklist-90-R in 3021 participants from The Early Developmental Stages of the Psychopathology (EDSP) study and binary DSM-III-R categories of mental disorders and a binary measure of psychotic symptoms in 7076 participants from The Netherlands Mental Health Survey and Incidence Study (NEMESIS-1). For each symptom dimension in the EDSP and mental disorder in the NEMESIS-1 as the dependent variable, regression analyses were carried out including each of the remaining symptom dimensions/mental disorders and its interaction with cumulative environmental risk load (the sum score of environmental exposures) as independent variables.ResultsAll symptom dimensions in the EDSP and related diagnostic categories in the NEMESIS-1 were strongly associated with each other, and environmental exposures increased the degree of symptom connectivity in the networks in both cohorts.ConclusionsOur findings showing strong connectivity across symptom dimensions and related binary diagnostic constructs in two independent population cohorts provide further evidence for the conceptualization of psychopathology as a contextually sensitive network of mutually interacting symptoms.
Highlights
We investigated to what degree environmental exposure impacts symptom connectivity using both continuous and categorical measures of psychopathology
Recent findings in large general population cohort studies suggest that exposure to environmental risk factors reinforces connectivity between symptoms of affective dysregulation and psychosis expression in a dose response fashion, in accordance with the theory of environment-induced disturbances spreading through the psychopathology network, increasing psychosis admixture, and progressively expanding and reinforcing connectivity that gives rise to transition to a more severe, distinct clinical syndrome requiring medical care [7,8,9,10,11,12]
If the environment impacts on the connection between psychosis and affective dysregulation, the question rises to what degree this is specific for these two domains of psychopathology
Summary
We investigated to what degree environmental exposure (childhood trauma, urbanicity, cannabis use, and discrimination) impacts symptom connectivity using both continuous and categorical measures of psychopathology. Recent findings in large general population cohort studies suggest that exposure to environmental risk factors (childhood trauma, urbanicity, cannabis use, and discrimination) reinforces connectivity between symptoms of affective dysregulation and psychosis expression in a dose response fashion, in accordance with the theory of environment-induced disturbances spreading through the psychopathology network, increasing psychosis admixture, and progressively expanding and reinforcing connectivity that gives rise to transition to a more severe, distinct clinical syndrome requiring medical care [7,8,9,10,11,12]. If the environment impacts on the connection between psychosis and affective dysregulation, the question rises to what degree this is specific for these two domains of psychopathology. In order to examine to what degree the findings would be stable across categorically and dimensionally defined psychopathology, connectivity was examined at the level of both continuous dimensions of self-reported psychopathology using the Selfreport Symptom Checklist-90-R (SCL-90-R) and binary DSM-III-R categories of mental disorders and a binary measure of psychotic symptoms
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