Abstract

BackgroundA history of Childhood Trauma (CT), i.e., physical or emotional abuse or neglect, and sexual abuse, is reportedly more prevalent in individuals suffering from psychosis than in the general population. Crucial questions remain unclear about the nature of interpersonal functioning in CT survivors, involving the capacity to understand and interpret other people′s thoughts and feelings, especially in individuals with First-Episode of Schizophrenia (FESz). We investigated the Theory of Mind (ToM) performance of patients with FESz related to CT in comparison to healthy controls (HC).MethodsParticipants (n=77) completed the Eye Task Revised (RMET) and the Childhood Experience of Care Abuse Questionnaire (CECA-Q). The Word Accentuation Test (TAP) was used to estimate a premorbid IQ. Seven-teen patients with FESz (Mean age = 24.9, SD = 5.4, Male = 79.6%; Education = 10.7, SD = 1.5 years) were recruited at the First-Episode Psychosis Program, Hospital 12 de Octubre Madrid, and 60 HC (Mean age = 27.6, SD = 7.2; Male = 45.6%; Education = 14.5, SD = 2.8 years) were healthy volunteers. Between-group comparisons were made using ANCOVA, considering group and CT as fixed factors. Age, years of education and IQ were included as covariates.ResultsPreliminary results showed that compared to controls, patients with FESz performed worse on the recognition and interpretation of facial expressions, in both male and female faces (p < .001). Patients with FESz did not perform differently than HC in the recognition and interpretation of positive facial expressions (p = .074). However, lower interpretation of negative facial expressions (p < .001) and of neutral facial expressions (p < .001) was shown in patients with FESz compared to HC. Higher interpretation of facial expressions was shown in FESz patients with CT (n = 12), only of female faces (p < .001), compared to patients without CT (n = 7). It was also shown higher interpretation of facial expressions in HC with CT (n = 28), only of negative facial expressions (p = .014), compared to HC without CT (n = 32). Female patients with FESz performed worse on the recognition and interpretation of negative (p = .024) and neutral faces (p < .001), only of male faces (p = .038), compared to female HC. Male patients with FESz performed worse on the recognition and interpretation of positive (p = .038) and negative facial expressions (p = .001) of male faces (p < .001), compared to male HC. In comparison to male FESz patients without CT, male FESz patients with CT showed higher interpretation of female faces (p = .030). In comparison to male HC without CT, male HC with CT showed higher interpretation of male faces (p = .031).DiscussionAccording to previous research, our preliminary findings indicated theory of mind deficits in patients with FESz. Interestingly, in our study the alterations on the interpretation and recognition of facial expressions were shown only of negative and neutral, but not of positive facial expressions. Furthermore, and contrary to literature, we found more interpretation and recognition of facial expressions in patients and healthy controls survivors of CT. However, the above-mentioned was specifically observed of female faces in patients and of negative facial expressions in healthy controls. In addition, female and male patients and healthy controls seem to interpret differently facial expressions related to childhood trauma. Nevertheless, increasing our sample size would give us the opportunity to draw further conclusions about how adverse experiences during childhood may influence social abilities in patients with FESz.

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