Childhood Experience Of Care And Abuse Questionnaire Research Articles

Dimensional model of adolescent personality pathology, reflective functioning, and emotional maltreatment.

Childhood emotional abuse (CEA) is a recognized risk factor for adolescent mentalizing challenges. However, there's limited understanding about how CEA might influence personality development and elevate the risk of adolescent personality pathology. A deeper grasp of these pathways is crucial, given that adolescence is a pivotal developmental phase for identity integration, personality consolidation, and the emergence of personality disorders. As the emphasis shifts to dimensional perspectives on adolescent personality pathology, the spotlight is increasingly on adolescents' evolving personality organization (PO). Within this framework, personality disorder manifestations stem from inherent vulnerabilities in PO. A comprehensive understanding of how CEA leads to these inherent vulnerabilities in PO can inform enhanced interventions for at-risk adolescents. Nonetheless, our comprehension lacks insight into potential pathways to PO, especially those involving external factors like maltreatment and individual traits like mentalizing. This study sought to bridge these gaps by employing latent factor analysis and structural equation modeling to explore connections between emotional maltreatment, adolescent mentalizing, and PO. A community-based cohort of 193 adolescents (aged 12-17) took part in self-report assessments: the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), the Reflective Functioning Questionnaire for Youth (RFQ-Y), and the Inventory for Personality Organization for Adolescents (IPO-A). The structural equation model revealed a significant direct influence of CEA on both RFQ-Confusion and PO, and a noteworthy direct effect of RFQ-Confusion on PO. Remarkably, the model accounted for 76.9% of the PO variance. CEA exhibited a significant indirect impact on PO through RFQ-Confusion, which was accountable for 52.3% of the CEA effect on PO, signifying a partial mediation by mentalizing. These insights carry substantial clinical implications, especially for devising integrated, trauma-informed strategies for adolescents with personality pathologies. This is particularly relevant for enhancing mentalizing and bolstering personality consolidation among adolescent CEA survivors.

Psychometric properties of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) in a sample of individuals with schizophrenia from Poland

Aim of the study: The Childhood Experience of Care and Abuse Questionnaire (CECA.Q) is a semi-structured self-report that has been developed to record a history of adverse childhood experiences (ACEs). Moreover, the CECA.Q has been widely used in subjects with psychotic disorders. In this study, we aimed to investigate psychometric properties of the Polish version of the CECA.Q in individuals with schizophrenia spectrum disorders. Material and methods: The CECA.Q was administered to 127 individuals with schizophrenia spectrum disorders (aged 39.1 ± 13.8 years, 48.0% males). Internal consistency was assessed using the Cronbach’s  and polychoric correlations. Confirmatory factor analysis (CFA) was performed using the unweighted least squares estimation method. Results: The Cronbach’s  was as follows: 0.835 for mother antipathy, 0.780 for mother neglect, 0.845 for father antipathy, 0.849 for father neglect, 0.787 for mother physical abuse, 0.831 for father physical abuse and 0.870 for sexual abuse, indicating acceptable-to-good internal consistency. Correlations of single item scores with the total scores of specific categories of ACEs were significant. The CFA confirmed factorial structure of the CECA.Q with acceptable goodness-of-fit indices. Conclusions: The present study indicates good psychometric properties of the CECA.Q in subjects with schizophrenia spectrum disorders. This self-report can be implemented by studies investigating ACEs in this clinical population in Poland.

Childhood and Adulthood Severe Stressful Experiences and Biomarkers Related to Glucose Metabolism: A Possible Association?

Background: No study investigated the association between stress exposure in different stages of life and metabolic dysfunction.Aim: We explore the association between stress exposure and several biomarkers related to glucose metabolism (insulin, c-peptide, GIP, GLP-1, glucagon) in a group of 72 healthy individuals.Method: We used the Childhood Experience of Care and Abuse-Questionnaire (CECA-Q) and a modified version of the Life Events Scale to define exposure to stress, according to four categories: no exposure to childhood trauma (CT) nor to stressful life events (SLEs) (46%), only to CT (25%), only to SLEs (21%), to both (8%).Results: We found that c-peptide (p = 0.006) and insulin (p = 0.002) levels differed among the four categories: 0.77 ng/ml (SD 0.27) and 0.21 ng/ml (SD 0.06) for none, 0.77 (SD 0.37) and 0.20 (SD 0.08) for only SLEs, 0.88 (SD 0.39) and 0.27 (SD 0.12) for only CT, 1.33 (SD 0.57) and 0.40 (SD 0.28) for both, respectively. The highest levels of biomarkers were found in subjects exposed to both CT and SLEs.Conclusion: Our preliminary results seem to suggest that CT might be specifically associated with a dysfunction of glucose metabolism, which might increase the risk of poorer health outcomes in adulthood. This association seems to be even stronger in individuals additionally exposed to SLEs in adulthood. In conclusion, if confirmed in other studies, subjects exposed to both CT and SLEs appear the most vulnerable individuals, for whom preventative interventions, such as healthy lifestyle education programs, might ameliorate the risk of developing metabolic abnormalities.

Childhood care and abuse in firefighters assessed for mental ill-health following the Fort McMurray fire of May 2016.

• All of the firefighters reporting sexual abuse had at least one mental disorder. • A same-age childhood confidant was protective for anxiety, depression and PTSD. • Parents’ use of physical punishment related to substance use disorders and PTSD. • PTSD related to both childhood experiences and events during and since the fire. • Treatment of mental disorders in firefighters should address this complex etiology. We aimed to determine the relationship between childhood abuse and mental ill-health in firefighters deployed to a devastating fire that engulfed Fort McMurray A stratified sample of 282 firefighters was selected from a cohort of 1234 for assessment by Structured Clinical Interview (SCID) for DSM-5 diagnostic criteria and the Childhood Experience of Care and Abuse questionnaire (CECA-Q). Diagnoses were grouped as post-traumatic stress disorder (PTSD), anxiety disorders, depressive disorders and substance use disorders. Scales extracted from the CECA-Q included parental loss, antipathy, neglect, physical punishment, sexual abuse and support from a same-age confidant. The relation to diagnostic group was examined by multivariable logistic regression 192 SCID interviews and 188 CECA-Qs were completed: 124 met DSM-5 criteria for diagnoses including anxiety disorder (56), depressive disorder (54), PTSD (77) and substance use disorder (43). Childhood sexual abuse was reported by 24 firefighters all of whom met DSM-5 diagnostic criteria. Sexual abuse and a childhood confidant differentiated diagnoses in an initial multivariable model of those with psychiatric disorders. Compared to those without a psychiatric diagnosis, father's antipathy was related to anxiety and substance use, physical punishment to PTSD and substance use. A childhood same-age confidant protected against anxiety, depression and PTSD. Fire exposures related only to PTSD. The comparison group without mental disorders was small. Childhood abuse information was collected retrospectively and may be biased by current state. Firefighters’ mental health is a function of both work-role traumas and childhood events. Occupational health provision must address this complexity.

Short-term reliability of retrospective childhood trauma reports in schizophrenia spectrum psychosis.

Childhood trauma (CT) refers to severe early life adversities, especially experiences of parental abuse and neglect. Patients with schizophrenia spectrum psychosis (SSP) report higher CT rates than the general population. As CT assessment in SSP samples has been mainly conducted retrospectively through adult recollections of childhood adverse events, reservations about the reliability and validity of these reports have arisen. We sought to explore the short-term reliability of retrospective CT reports in sixty-three patients with SSP, by assessing the concurrent validity and test-retest reliability of the data. Two CT self-report measures, the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the Parental Bonding Instrument (PBI) were employed for this task. High concurrent validity was detected between CECA.Q antipathy scales and PBI care and overprotection scales; and between CECA.Q neglect scales and PBI care scales. High test-retest reliability was confirmed for all CECA.Q and PBI scales. Our findings indicate that retrospective CT self-report measures are a reliable means of assessing early life adversities in SSP. However, further provisions should be taken to increase the reliability of retrospective reports, especially corroboration of the events through other sources and removal of latent confounders, such as psychopathology, memory fallacies and social desirability biases.

Toward a Complex Network of Risks for Psychosis: Combining Trauma, Cognitive Biases, Depression, and Psychotic-like Experiences on a Large Sample of Young Adults.

Although the linkage between traumatic life events and psychotic-like experiences (PLEs) is well established, the knowledge of potential mechanisms of this relationship is scarce. The aim of the present study was to better understand the structure of connections between traumatic life events and PLEs by considering at the same time the role of cognitive biases and depressive symptoms in the population of young adults (18-35 years of age, M = 26.52, SD = 4.74, n = 6772). Our study was conducted within a framework of network analysis. PLEs were measured with the Prodromal Questionnaire (PQ-16), cognitive biases were measured with nine items from the Davos Assessment of Cognitive Biases Scale-18 (DACOBS-18), depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale (CESD-R) and exposure to traumatic life events was measured with a combination of Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and Traumatic Experience Checklist (TEC). The results present a network of all nodes being interconnected within and between domains, with no isolated factors. Exposures to sexual trauma were the most central node in the network. Pathways were identified from trauma to PLEs via cognitive biases and depressive symptoms. However, the shortest pathway between the most central traumatic life event and PLEs was through other traumatic life events, without cognitive biases or depressive symptoms along the way. Our findings suggest the importance of environmental adversities as well as dysfunctional information processing and depression in the network of psychosis risks.

The Psychometric Properties of the Persian Version of Childhood Experience of Care and Abuse Questionnaire (CECA).

Background: The present study aimed to determine the psychometric properties of the Persian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), a tool based on a retrospective interview with the child. Materials and Methods: To this aim, 251 adolescents from four regions of Tehran megacity completed the questionnaire. The reliability of the questionnaire was examined, along with the face and content validity. In addition, the construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: EFA and CFA supported a 4-factor solution including mother’s role scale items, father’s role scale items, maternal behavior scale items, and paternal behavior scale items. The total variance extracted in EFA ranged from 33.9 to 60.7. The internal consistency for mother’s role, father’s role, maternal behavior, and paternal behavior was 0.61, 0.65, 0.86, and 0.9 respectively. Thus, the questionnaire had a suitable fit, as well as reasonable reliability and validity. Conclusion: The Persian version of the CECA.Q had adequate reliability and validity as a self-report measurement for childhood experience of care and abuse.

The Psychometric Properties of the Persian Version of Childhood Experience of Care and Abuse Questionnaire (CECA)

Background: The present study aimed to determine the psychometric properties of the Persian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), a tool based on a retrospective interview with the child. Materials and Methods: To this aim, 251 adolescents from four regions of Tehran megacity completed the questionnaire. The reliability of the questionnaire was examined, along with the face and content validity. In addition, the construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: EFA and CFA supported a 4-factor solution including mother’s role scale items, father’s role scale items, maternal behavior scale items, and paternal behavior scale items. The total variance extracted in EFA ranged from 33.9 to 60.7. The internal consistency for mother’s role, father’s role, maternal behavior, and paternal behavior was 0.61, 0.65, 0.86, and 0.9 respectively. Thus, the questionnaire had a suitable fit, as well as reasonable reliability and validity. Conclusion: The Persian version of the CECA.Q had adequate reliability and validity as a self-report measurement for childhood experience of care and abuse. [GMJ.2020;9:e1663]

T106. CHILDHOOD TRAUMA IS ASSOCIATED WITH THEORY OF MIND IMPAIRMENT IN SCHIZOPHRENIA-SPECTRUM PSYCHOSIS

BackgroundChildhood trauma (CT), a generic term encompassing experiences of severe abuse and neglect during childhood and adolescence, has been established as an important risk factor for the emergence of psychosis. Among the potential pathways involved in the CT-psychosis association, Theory of Mind (ToM) disruption holds a central position. ToM reflects the ability to attribute distinct mental states to oneself and other people, and correctly infer the beliefs, wishes, intentions and dispositions of others in order to predict their behavior and produce proper social responses. ToM is further elaborated in 1st order ToM (ToM1: the ability to understand that someone may hold a false belief about the state of the world) and 2nd order ToM (ToM2: the ability to understand that one person may hold a false belief about the belief of another person). Research shows that patients with schizophrenia-spectrum psychosis (SSP) exhibit marked deficits in ToM. CT may increase SSP risk by disrupting the emergence of normal ToM skills, thus inducing a vulnerability for cognitive errors, perceptual aberrations and impaired reality testing. Our study sought to explore the effect of CT on ToM performance in a group of SSP patients and a healthy control group (HC).MethodsWe compared 63 SSP patients to a healthy control group on measures of CT and ToM. CT (presence of parental antipathy, parental neglect, physical abuse, sexual abuse) was assessed with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). ToM1 and ToM2 performance was measured with the Perception of Social Inference Test (PESIT). Chi-squared analysis was performed to compare CT rates between SSP patients and HCs. Mann-Whitney U tests were employed to detect differences in ToM between the two groups. Within each group, the impact of CT and polytraumatization (accumulation of different CT types) on ToM performance was examined.ResultsSSP patients displayed significantly higher CT rates (χ2 (1, N = 124) = 34.5, p < .001) and worse ToM performance (ToM1: U = 653,5, p < .001; ToM2: U = 435,5, p < .001) than HCs. SSP inpatients were 11.6 times more likely to have been exposed to severe CT than HCs. Within the SSP group, CT was associated with increased ToM2 deficits (U = 259, p = .020), while polytraumatization was negatively correlated to both ToM1 (rs = -.297, p = .020) and ToM2 (rs = -.341, p = .007) performance. Maternal antipathy (U = 207, p = .036) and neglect (U = 148, p = .017) were the CT subtypes associated with worse ToM2 performance. No similar effects were detected within the HC group.DiscussionOur finding of ToM deficits in SSP patients may indicate a bidirectional association, involving on the one hand a negative effect of psychotic illness on ToM skills, and on the other hand a vulnerability towards psychosis induced by severe, early disruptions in normal ToM acquisition. Worse ToM performance in SSP patients with cumulative CT may signify an additive or synergistic effect of CT and psychosis on ToM skills. The involvement of maternal antipathy and neglect in the aforementioned association highlights the pivotal role of the mother in the development of the child’s capacity to envision distinct mental states in self and others, a prerequisite for self-awareness and self-other individuation. The failure to detect similar effects in HCs may be attributed to the low frequency of CT in this group, potentially restricting the strength of this analysis. On the same matter, another explanation could be that CT by itself is not a sufficient condition for ToM impairment, and only becomes relevant when it acts in synergy with other harmful processes inherent in psychosis.

The moderating effect of attachment styles on the relationships between maltreatment experiences and internalizing and externalizing problems among adolescents: Implications for custody issues

Multiple studies have documented the relationship between child maltreatment and internalizing and externalizing problems. Evidence suggests that the link between child maltreatment and these psychopathological outcomes may be moderated by various factors. Attachment styles may be one such moderating factor in this relationship. This study seeks to explore whether different attachment style profiles are associated with different forms of maltreatment as well as internalizing and externalizing symptoms, and whether attachment styles may moderate the link between different forms of maltreatment and internalizing and externalizing problems. For this purpose, 387 students from Italian public high schools were recruited. We used the Italian version of the Attachment Style Questionnaire (ASQ) to assess different dimensions of attachment, the Italian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) to assess experiences of maltreatment, and the Italian version of the Youth Self-Report (YSR) to assess internalizing and externalizing problems. Results showed that different types of attachment style profiles were specifically associated with maltreatment variables and internalizing/externalizing problems as well as attachment style profiles moderated the relationships between maltreatment and internalizing problems. The findings are discussed in light of the theoretical framework and limitations, and implications for practice and child custody are presented.

PS-06-004 Psychosexual correlates of unwanted sexual experiences in women consulting for female sexual dysfunction according to their timing across the life span

Our aim was to investigate the prevalence of unwanted sexual experiences (USEs) in a setting of female sexual dysfunction (FSD) and to examine whether they are associated with different psychosexual parameters depending on the timing of occurrence. A consecutive series of 200 heterosexual women attending our clinic for FSD was consecutively recruited. Patients underwent a structured interview and completed the Female Sexual Function Index (FSFI), the Middlesex Hospital Questionnaire (MHQ), the Female Sexual Distress Scale Revised (FSDS-R), the Body Uneasiness Test (BUT), and the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). 47 women (23.5%) reported USEs, occurring in childhood (<14 years), adolescence (<17 and ≥14), and adult life (≥17) in 38.3% (n=18), 31.9% (n=15), and 29.8% (n=14) of cases, respectively. We observed an association between history of lifetime USEs and indexes of psychopathology, specifically diagnosis of psychiatric diseases, use of psychiatric medications, and anxiety symptoms (MHQ free-floating anxiety score, MHQ-A). USEs were associated with lower orgasm ability (FSFI orgasm domain), higher sexually related distress levels (FSDS-R total score), and higher body image concerns (BUT) including depersonalization symptoms. Notably, women exposed to USEs in adolescence reported a stronger impairment of arousal, orgasm, and satisfaction domains and higher sexual distress when compared to women without a history of USEs or reporting USEs in childhood. Women exposed to USEs in childhood exhibited higher body image concerns and depersonalization symptoms when compared to those not reporting USEs.

Stressful life events at the onset and during the evolution of systemic sclerosis

Objective: Stressful life events, such as Childhood Adverse Events (CAE) and Recent Stressful Events (RSE) may play a role in the pathogenesis of autoimmune disorders. The present study investigated their occurrence in Systemic Sclerosis (SSc). Methods: 110 SSc patients and 110 controls were enrolled. Stressful events assessment included a semi-structured interview and the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). A normative evaluation of RSE was made by means of the Paykel’s scoring of life events. The clinical status of patients with a very early diagnosis of Systemic Sclerosis (VEDOSS) during the first year after the diagnosis was evaluated in order to detect patients with a significant clinical worsening. Results: All investigated CAE were more frequently reported in SSc patients compared to controls, although with a significant difference only for the events “loss of mother” (p<0.05) and “sexual abuse” (p<0.05). SSc patients reported higher occurrence of at least one RSE (p<0.01), number of RSE (p<0.01), and stress load (mean total Paykel’s score) (p<0.01) in the year prior to the diagnosis compared to the year prior to the interview for controls. This was particularly true for severe and independent RSE (p<0.001). VEDOSS subjects who worsened during the first year after the diagnosis, compared to those who did not, reported a higher impact of severe and independent RSE in the same year (p<0.05). Conclusions: CAE may represent potential predisposing factors for SSc, while the occurrence of RSE may play a role in the onset and worsening of the disease.

Different types of childhood adversity and 5-year outcomes in a longitudinal cohort of first-episode psychosis patients

Little is known about the impact of different forms of childhood adversity on outcomes in first-episode psychosis (FEP) patients beyond the first year of treatment. We investigated associations between different types of childhood adversity and outcomes of FEP patients over the 5 years following their first contact with mental health services for psychosis. 237 FEP cases aged 18–65 years were followed on average for 5 years after first presentation to psychiatric services in South London, UK. Childhood adversity prior to 17 years of age was assessed at baseline using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). The results showed that exposure to at least one type of childhood adversity was significantly associated with a lower likelihood of achieving symptomatic remission, longer inpatient stays, and compulsory admission over the 5-year follow-up. There was no evidence though of a dose-response effect. Some specificity was evident. Childhood parental separation was associated with significantly greater likelihood of non-compliance with antipsychotic medications, compulsory admission, and substance dependence. Institutional care was significantly associated with longer total length of inpatient stays; and parental death was significantly associated with compulsory admissions. Clinicians should screen FEP patients for childhood adversity and tailor interventions accordingly to improve outcomes.

Childhood Maltreatment, Pathological Personality Dimensions, and Suicide Risk in Young Adults.

Several studies have demonstrated that child maltreatment (psychological, physical, and sexual abuse, and neglect) may be a significant factor in the development of pathological personality traits that increase the risk for suicidal ideation and behavior from adolescence to adulthood. Currently, the challenge is to understand how different forms of early negative experiences render an individual prone to develop specific personality traits and, in turn, be more vulnerable to suicide risk. To understand the relationship between childhood maltreatment and personality dimensions in suicide risk, our study aims to explore the role of self-criticism and dependency, two different pathological personality traits, as potential mediators of the link between different types of childhood maltreatment and suicide risk in young adults. For this purpose, 306 students from three Italian public universities were recruited. We used the Italian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) to assess experiences of lack of care by parents (i.e., antipathy and neglect) as well as psychological and physical abuse before the age of 17 years. The Depressive Experiences Questionnaire (DEQ) was used to assess the personality dimensions of self-criticism and dependency, and the Suicide History Self-Rating Screening Scale was administered to assess suicide risk. Results revealed that lack of care and psychological abuse were significantly associated with suicide risk and this association was partially mediated by the maladaptive personality dimension of self-criticism. These findings suggest that the combined effect of specific forms of dysfunctional parental behavior during childhood and the development of rigid and dysfunctional negative personality traits may increase the risk for suicidal ideation and behavior during adulthood.

Interaction between childhood adversity and functional polymorphisms in the dopamine pathway on first-episode psychosis

BackgroundThere is consistent evidence of a cumulative relationship between childhood adversity and psychosis, with number of adversities experienced increasing the probability of psychosis onset. It is possible that genetic factors moderate the association between childhood adversity and psychosis, potentially by influencing how an individual reacts biologically and/or psychologically following exposure to adversity, in such a way as to set them off on the path to psychosis. However, identifying the specific genetic variants involved and how they interact with childhood adversity remains challenging. We examined whether the association between cumulative exposure to childhood adversity and development of psychotic disorder was moderated by the COMT Val158Met, AKT1 rs2494732 or DRD2 rs1076560 polymorphisms, known to affect dopamine levels. MethodsParticipants were 285 first-presentation psychosis cases and 256 geographically-matched controls drawn from the Genetics and Psychosis (GAP) study. Childhood adversity was assessed using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and blood- and cheek-derived genotype data were collected. ResultsOur findings revealed no main effect of COMT Val158Met, AKT1 rs2494732 and DRD2 rs1076560 polymorphisms on psychosis case status or reports of childhood adversity. Individuals reporting a history of multiple adversities were more likely to be psychosis patients than controls, regardless of their genetic risk. There was no evidence of candidate genotype by childhood adversity interactions in relation to psychosis onset. ConclusionThese findings did not provide evidence of a possible role of COMT Val158Met, AKT1 rs2494732 or DRD2 rs1076560 genotypes in modifying the association between childhood adversity and onset of psychosis.

Adverse childhood experiences, personality disorders and addiction: Which relationship?

IntroductionStressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.AimsThis study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).MethodsA cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)ResultsThe prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P &lt; 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).ConclusionsPDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Interplay between Schizophrenia Polygenic Risk Score and Childhood Adversity in First-Presentation Psychotic Disorder: A Pilot Study.

A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to number or severity of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing genetic vulnerability. Research on gene-environment interaction in psychosis has primarily focused on candidate genes, although the genetic effects are now known to be polygenic. This pilot study investigated whether the effect of childhood adversity on psychosis is moderated by the polygenic risk score for schizophrenia (PRS). Data were utilised from the Genes and Psychosis (GAP) study set in South London, UK. The GAP sample comprises 285 first-presentation psychosis cases and 256 unaffected controls with information on childhood adversity. We studied only white subjects (80 cases and 110 controls) with PRS data, as the PRS has limited predictive ability in patients of African ancestry. The occurrence of childhood adversity was assessed with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the PRS was based on genome-wide meta-analysis results for schizophrenia from the Psychiatric Genomics Consortium. Higher schizophrenia PRS and childhood adversities each predicted psychosis status. Nevertheless, no evidence was found for interaction as departure from additivity, indicating that the effect of polygenic risk scores on psychosis was not increased in the presence of a history of childhood adversity. These findings are compatible with a multifactorial threshold model in which both genetic liability and exposure to environmental risk contribute independently to the etiology of psychosis.

Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women.

To explore the relationship between individual and co-occurring childhood sexual, physical, and verbal abuse, prenatal depressive (PDS) and anxiety symptoms (PAS), and history of suicidal behavior (HSB) among Mexican pregnant women at risk of depression. A sample of 357 women screened for PDS was interviewed using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), the Beck Depression Inventory (BDI-II), the anxiety subscale of the Hopkins Symptoms Checklist (SCL-90), and specific questions on verbal abuse and HSB. Logistic regression analyses showed that women who had experienced childhood sexual abuse (CSA) were 2.60 times more likely to develop PDS, 2.58 times more likely to develop PAS, and 3.71 times more likely to have HSB. Childhood physical abuse (CPA) increased the risk of PAS (odds ratio [OR] = 2.51) and HSB (OR = 2.62), while childhood verbal abuse (CVA) increased PDS (OR = 1.92). Experiencing multiple abuses increased the risk of PDS (OR = 3.01), PAS (OR = 3.73), and HSB (OR = 13.73). Childhood sexual, physical, and verbal abuse, especially when they co-occur, have an impact on PDS and PAS and lifetime HSB. These findings suggest that pregnant women at risk for depression should also be screened for trauma as a risk factor for perinatal psychopathology.

Brain derived neurotropic factor (BDNF) is associated with childhood abuse but not cognitive domains in first episode psychosis

BackgroundThe Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome. AimsWe investigated the hypothesis that BDNF is associated with both CT and cognitive deficits in a sample of first-episode psychosis (FEP) cases and unaffected controls. MethodParticipants with FEP and healthy controls were recruited between August 2008 and July 2011 from South London, UK. Childhood traumatic events were detected using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). Neuropsychological data were also collected. BDNF plasma levels were measured from fasting blood samples. ResultsData were available on 87 FEP patients and 152 controls. Our results showed a significant effect of separation (F=5.5; df=1,115; p=.02), physical (F=4.7; df=1, 118; p=.03) and sexual abuse (F=5.4; df=1,117; p=.02) on BDNF levels with lower levels among those who experienced the traumatic event compared to those who did not. Physical abuse predicted lower plasma levels of BDNF (β=−.30; p=.03) whereas sexual and/or physical abuse showed a trend (β=−.26; p=.06) in FEP patients but not in unaffected controls. No association between BDNF plasma levels and cognitive functions was found among patients with FEP and controls. ConclusionOur findings suggest the possible involvement of BDNF in the onset of first-episode psychosis in individuals exposed to early trauma and propose BDNF as a potential clinical biomarker to detect the detrimental effects of CT on human brain plasticity.

Childhood trauma associates with clinical features of bipolar disorder in a sample of Chinese patients

ObjectivesChildhood trauma is a major public health problem which has a long-term consequence, a few studies have examined the relationship between childhood trauma and clinical features of bipolar disorder, most in western culture, with no such studies done in Chinese culture. MethodsThe CTQ-SF was administered to 132 Chinese patients with DSM-IV bipolar disorder. Participants also completed the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), the Impact of Events Scale-Revised (IES-R), and the State-Trait Anxiety Inventory (STAI). The CTQ-SF cut-off scores for exposure were used to calculate the prevalence of trauma. The relationship between childhood trauma and clinical features of bipolar disorder were examined. ResultsThe internal consistency of CTQ-SF was good (Cronbach׳s α=0.826) and four week test–retest reliability was high (r=0.755). 61.4% of this sample reported physical neglect (PN) in childhood, followed by emotional neglect (EN, 49.6%), sexual abuse (SA, 40.5%), emotional abuse (EA, 26.0%) and physical abuse (PA,13.1%). Significant negative correlations existed between age of onset and EA and EN score (r=−0.178~–0.183, p<0.05). Significant positive correlations were observed between EA, CTQ-SF total score and intrusion and hyper-arousal scores of IES-R (r=0.223~0.309, p<0.05). Similarly, significant positive correlations were found between EN, PN, CTQ-SF total and STAI score (r=0.222~0.425, p<0.05). LimitationsData on childhood trauma were derived from a retrospective self-report questionnaire without independent corroboration. A number of potential patients (more severe or chronic patients) was excluded because they were either refused to participate or inappropriate to participate in research. ConclusionsSignificant number of subjects in patients with BD reported experience of childhood abuse and neglect. Exposure to childhood trauma is associated with age of onset of illness, co morbid PTSD and anxiety symptoms. To study the pathogenesis of childhood trauma on bipolar disorder and explanation the interaction between childhood trauma and susceptibility genes are proposed.