Abstract
BackgroundCognitive impairment is a core feature of schizophrenia spectrum disorders (SSDs). Exposure to childhood trauma (CT), defined as physical, sexual and emotional abuse, and physical and emotional neglect, has been associated with SSDs across study designs and populations. Possibly, there is a relationship between exposure to CT and cognitive impairment in individuals with SSDs. Research has shown that a history of CT may be related to decline in cognitive performance in the general population, as well as in SSDs, whereas other studies have failed to find evidence for an association between CT and cognitive impairments in patients with SSDs. Findings on the relation between CT and cognitive impairment in individuals with SSDs is not conclusive, and a minority of the studies to date have examined the effects of frequency and severity of CT subtypes in SSDs and the relation to cognitive abilities. We hypothesize that there will be a negative relationship between the frequency and severity of CT and cognitive functioning, possibly in a dose dependent matter. CT subtypes may influence this relationship.MethodsThe present study is part of the Bergen Psychosis project 2 (BP2), Haukeland University Hospital, Norway. Patients were recruited at the Medical University in Innsbruck, Innsbruck, Austria; Stavanger University Hospital, Stavanger, Norway; and Haukeland University Hospital, Bergen, Norway, and gave informed consent to participate. To be included, patients had to meet ICD-10 criteria for SSDs (F20-F29), be > 16 years of age, and score ≥ 4 on at least one of the psychosis items on the Positive and Negative Syndrome Scale (PANSS). Childhood trauma (physical, emotional, sexual abuse, and physical, emotional neglect) was measured by the Childhood Trauma Questionnaire Short-Form (CTQ-SF). Cognitive functioning was examined by means of a comprehensive neuropsychological test battery. The following cognitive domains were assessed: verbal and visuospatial abilities, learning, memory, attention and working memory, executive functioning, and processing speed. The assessments were completed within three months of inclusion to the study.ResultsThe relationship between the frequency and severity of CT and cognition will be examined, in addition to the possible influence of CT subtypes. Preliminary findings will be reported.DiscussionThe clinical implications of our findings will be discussed.
Highlights
Sub-clinical or attenuated psychosis symptoms (APS) in the general population has become a focus of considerable research interest over the past two decades, as they appear to index an increased risk for psychotic outcomes
59 patients diagnosed with schizophrenia, 164 individuals at Ultra-High Risk for psychosis (UHR) and 60 healthy individuals were recruited from the clinic and the community and assessed using the Structured Clinical Interview for DSM-IV (SCID), Comprehensive Assessment of At-Risk Mental State (CAARMS), Global Assessment of Functioning (GAF) and Childhood Trauma Questionnaire
The severity of traumatic experiences reported by patients and UHR individuals was consistently higher compared with controls, with effect sizes ranging from a minimum of Cohen’s d= 0.54 to a maximum of Cohen’s d= 0.97
Summary
Life adversity (ELA), including physical abuse or neglect and emotional abuse or neglect, is a significant risk factor for schizophrenia. In particular social cognition, are associated with this disorder. Immune function was measured using C-reactive protein and Interleukin-6 Analysis was run both for the full sample and for individuals presenting with a history of psychotic symptoms at age 12. Results: Early life adversity was associated with poorer performance on a range of both general and social cognitive measures. Increased immune activation was associated with cognitive performance, but was not observed to mediate the effects of ELA on cognition. Discussion: While increased immune response has been associated with both early life adversity and cognitive impairment, this response was not observed to mediate the relationship between these two variables. Dauvermann, Gary Donohoe2 1Cognitive Genetics and Cognitive Therapy Group, National University of Ireland, Galway; 2National University of Ireland, Galway
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