Impact Of Childhood Adversity Research Articles

Childhood adversity and adolescent mental health: Examining cumulative and specificity effects across contexts and developmental timing.

Associations between adversity and youth psychopathology likely vary based on the types and timing of experiences. Major theories suggest that the impact of childhood adversity may either be cumulative in type (the more types of adversity, the worse outcomes) or in timing (the longer exposure, the worse outcomes) or, alternatively, specific concerning the type (e.g., parenting, home, neighborhood) or the timing of adversity (e.g., specific developmental periods). In a longitudinal sample from the Future of Families and Wellbeing Study (N = 4,210), we evaluated these competing hypotheses using a data-driven structured life-course modeling approach using risk factors examined at child age 1 (infancy), 3 (toddlerhood), 5 (early childhood), and 9 (middle childhood). Results showed that exposures to more types of adversity for longer durations (i.e., cumulative in both type and timing) best predicted youth psychopathology. Adversities that occurred at age 9 were better predictors of youth psychopathology as compared to those experienced earlier, except for neglect, which was predictive of internalizing symptoms when experienced at age 3. Throughout childhood (across ages 1-9), aside from the accumulation of all adversities, parental stressand low collective efficacy were the strongest predictors of internalizing symptoms, whereas psychological aggression was predictive of externalizing symptoms.

Impact of childhood adversity and resilience on behavioral outcomes: Well-being and parental support as mediators

This study investigated the relationships between childhood adversity, resilience, and behavioral outcomes in children aged 9–12 years, along with the mediating variables of well-being (an internal factor) and parental support (an environmental factor). We recruited 250 children (125 boys and 125 girls) from schools across districts of Punjab, India. Structural equation modeling results revealed there was a statistically significant relationship between adversity and resilience and that parental support was the primary mediator of this relationship. These findings highlight the significance of environmental factors, such as parents who help their children through hardship, and the relevance of internal factors that play an equal role in influencing behavioral outcomes. Theoretical and practical implications are discussed.

How immigration detention harms children: A conceptual framework to inform policy and practice.

This paper identifies the multiple adversities and trauma experienced by children who are detained after seeking asylum. A conceptual framework identifies the specific impact of immigration detention on the psychosocial development and mental health of refugee children that can inform policy and prevent additional migration-related trauma. The paper draws on international evidence about the impact of childhood adversity, challenges faced by all displaced children, and the additional negative consequences of immigration detention. It integrates socioecological, temporal, and relational approaches to identify the pathways through which detention of forcibly displaced children causes preventable harm. The public health and human rights implications are identified. The framework draws on Bronfenbrenner's socioecological model and has the child, their development, and experience at the center. Refugee children are exposed to cumulative adversity during displacement, flight, and resettlement. Immigration detention is associated with multiple additional adversities and human rights violations. International and national contexts and the detention environment impact on family functioning and directly on the child's well-being. Immigration detention is a preventable and profoundly negative reception experience for already vulnerable children. It is unavoidably associated with multiple additional adverse exposures with significant health and public health consequences. The proposed framework demonstrates adversity in each socioecological sphere of the detained child's life and across time. The framework can inform migration, child protection, and public health policy. Advocacy and political action to end this practice are urgently required to prevent further harm. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Childhood Adversity on Life Course Alcohol Use Patterns and Health Status Among People Living with HIV

Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) was applied to estimate both direct and indirect pathways between childhood hardship and physical and mental health. Participants were mostly male; Black (84%); and averaged 48 years of age. SEM results supported both direct and indirect pathways between childhood experiences and adult health. ACEs were connected to physical health directly and mental health both directly and indirectly through age at first drink and drinking heaviness during ages 10–20. Childhood economic hardship related to mental health indirectly through higher drinking levels during ages 10–20. Childhood adverse experiences, economic hardship, and early drinking patterns appear to accumulate, resulting in later life physical and mental health concerns for PWH. Findings support taking a life course approach to health. This includes considering individual trauma histories in HIV care engagement and taking preventative approaches which support the economic and social well-being of vulnerable children to improve health in subsequent decades.

The association of adverse childhood experiences with long-term outcomes of psychosis: a 21-year prospective cohort study after a first episode of psychosis.

Evidence suggests a possible relationship between exposure to childhood adversity (CA) and functional impairment in psychosis. However, the impact of CA on long-term outcomes of psychotic disorders remains poorly understood. Two hundred and forty-three patients were assessed at their first episode of psychosis for CA and re-assessed after a mean of 21 years of follow-up for several outcome domains, including symptoms, functioning, quality of life, cognitive performance, neurological dysfunction, and comorbidity. The unique predictive ability of CA exposure for outcomes was examined using linear regression analysis controlling for relevant confounders, including socioeconomic status, family risk of schizophrenia, and obstetric complications. There were 54% of the patients with a documented history of CA at mild or higher levels. CA experiences were more prevalent and severe in schizophrenia than in other psychotic disorders (p < 0.001). Large to very large effect sizes were observed for CA predicting most role functioning variables and negative symptoms (ΔR2 between 0.105 and 0.181). Moderate effect sizes were observed for positive symptoms, personal functioning, impaired social cognition, impaired immediate verbal learning, poor global cognition, internalized stigma, poor personal recovery, and drug abuse severity (ΔR2 between 0.040 and 0.066). A dose-response relationship was observed between levels of CA and severity of outcome domains. Our results suggest a strong and widespread link between early adversity exposure and outcomes of psychotic disorders. Awareness of the serious long-term consequences of CA should encourage better identification of those at risk and the development of effective interventions.

The impact of childhood adversity on female‐perpetrated intimate partner violence in young adulthood

AbstractPurposeA common conception of intimate partner violence (IPV) is that women rarely use violence against romantic partners, and when they do, this is usually in self‐defence. However, evidence demonstrates that women perpetrate IPV at least as frequently as men, particularly in young adult populations. Despite this, there is still a significant lack of research focusing on women's IPV perpetration, particularly in determining risk markers. The unique relationship between adversity in childhood and IPV perpetration has been recognized in males and it is thought that this relationship may be even more marked in females. The present study aimed to investigate this relationship to see whether experiencing increasing numbers of adverse childhood experiences (ACEs) would be associated with higher incidence of female‐perpetrated IPV.MethodsExposure to ACEs and frequency of IPV perpetration was measured through an online survey of young adult females from the general population.ResultsRegression analysis revealed that ACEs did significantly predict the frequency of IPV perpetrated by females. The results showed that the more adversity a female has experienced in childhood, the greater their risk of IPV perpetration in young adulthood.ConclusionsIt is suggested that this relationship potentially exists because adversity in childhood impacts the individual's attachments and processing of social environments, thus resulting in dysfunctional, violent responses to relationship dilemmas throughout life. These results stress the importance of tailoring treatment strategies for female perpetrators to address potential childhood adversity in which their violence may be rooted.

Impact of Childhood Adversity, as Early Life Distress, on Cytokine Alterations in Schizophrenia.

Even though inflammation theory has been introduced in the pathophysiology of psychosis almost a century ago, many of its aspects have remained unelucidated. Numerous studies have shown cytokine dysregulation in schizophrenia and a predominance of pro-inflammatory cytokines, but on another side, various cytokines in a pro-inflammatory group have different trends in all subtypes of schizophrenia. Alterations are also present in anti-inflammatory and regulatory cytokines, but findings are still not consistent. On the other hand, it is well known that abuse and neglect in childhood may be predictors of psychotic disorders, and childhood adversity is also associated with alterations of the immune and inflammatory response (through various mechanisms including HPA dysregulation as well). This review aims to analyze conducted studies and elucidate the link between childhood abuse, schizophrenia, and cytokine alterations. Putting together this complex psycho-immunological puzzle for the subgroup of schizophrenia-diagnosed patients with distinct immunological abnormalities and a history of childhood abuse can help us to answer the question about the future treatment of these patients.

Risk factors for intimate partner violence perpetration among college students: Impact of childhood adversities

Objective Intimate partner violence (IPV) among college students is a significant problem that negatively affects their physical and emotional health. This study aimed at examining risk factors, especially childhood adversities at the individual, relationship, and community levels, of IPV perpetration among college students. Methods: The sample from seven universities in the U.S. and Canada (N = 3,725) completed an online survey. Major variables included IPV perpetration, five types of childhood adversities, alcohol and drug use, depression, and demographic information. Logistic regression was performed. Results: Peer violence victimization, witnessing parental IPV, experiencing child maltreatment, drug use, and depression were associated with a higher odd of perpetrating IPV. Conclusions: Research and practice must account for exposure to multiple risk factors when intervening with college students. An integrative approach that combines trauma-informed interventions with substance use and mental health treatment may be most successful at IPV perpetration prevention and intervention among college students.

Childhood Exposure to Family Violence and Later-Life Sibling Relationships

There has been a growth in research examining the long-term effects of childhood adversity on later life outcomes; however, only a few studies have examined the impact that childhood adversity has on sibling relationships in late adulthood. To address this gap in the literature, the current study examines the latent class structure of childhood exposure to family violence and investigates whether a latent class membership is associated with aspects of later-life sibling relationships, including geographical proximity, frequency of contact, perceived closeness, similarity in outlook, and exchange of support. Using data from 3,921 adult participants in the Wisconsin Longitudinal Study and the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA), we identified five latent classes (prevalence rate noted): “Never experienced violence (75%),” “experienced sibling violence (7%),” “experienced parental abuse & witnessed domestic violence (4%),” “experienced father’s abuse & witnessed domestic violence (10%),” “experienced mother’s abuse & witnessed domestic violence (5%)”. Childhood exposure to family violence was a significant predictor of later-life sibling relationships. Specifically, adults who experienced sibling violence and their mother’s and/or father’s abuse in childhood showed significantly lower perceived closeness and similarity in outlook with their siblings in adulthood than those who did not experience violence. Our findings suggest that childhood exposure to family violence may have a long-term negative impact on the emotional aspect of sibling relationships. Future research may explore how the impact of childhood adversity on sibling relationships affects other aspects of adult lives, such as individual well-being or caregiving for aging parents.

The Relationships Between Childhood Abuse and Neglect, Sub-clinical Symptoms of Psychosis and Self-harm in a Non-clinical Community Sample.

There is now substantial evidence that childhood adverse events are a significant risk factor for symptoms of psychosis in both clinical and community samples. Both childhood trauma and positive symptoms of psychosis are associated with an increased risk of self-harming behaviours. Therefore the current study aimed to consider the relationship between retrospective reports of childhood adversity, sub-clinical positive symptoms of psychosis and self-harm in a non-clinical community sample. The study employed a cross-sectional survey design, distributed online. Participants were asked to complete psychometric assessments relating to: demographic characteristics including past-year substance misuse; childhood adversity; sub-clinical symptoms of psychosis (delusions and hallucinations) and self-harming behaviours. The results found that, after controlling for substance misuse, childhood adversity predicted significant variance in sub-clinical delusions and hallucinations in the general population. Both symptoms of psychosis and childhood adversity increased the risk of self-harming behaviours. Positive symptoms partially mediated the relationship between early adversity and self-harming behaviours. For some people, the sequelae of early adversity including sub-clinical delusions and hallucinations may increase the risk of self-harming behaviours. Future research would benefit from considering the role of dissociation in these relationships and the affective impact of pseudo-psychotic experiences. Practitioners should consider the impact of childhood adversity, unusual perceptual experiences and distorted beliefs when working with people who self-harm. The current research was limited by the cross-sectional survey design and non-random sampling methodology.

The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms.

Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes. In a cross-sectional study using a sample of mothers of 2-10 month-old infants (N = 367) we first examined depressive symptoms as a mediator, and then, the indirect effect of adult attachment through depressive symptoms between childhood adversity and parenting stress. Results showed that the effect of childhood adversity on parenting stress was mediated by an indirect pathway through depressive symptoms alone, and an indirect pathway of adult attachment through depressive symptoms. The indirect effect of adult attachment through depressive symptoms was found to be stronger than the indirect effect of depressive symptoms alone, supporting the hypothesis that adult attachment insecurity together with depressive symptoms are particularly important risk factors to be considered in this relationship. Results suggest that childhood adversity is a risk factor for parenting stress, and not a determinant of later parenting stress per se. Instead, mediators in this association, adult attachment, and depressive symptoms, were identified as potential targets of intervention to prevent negative effects of childhood adversity on parenting stress. A limitation of the study lies in its cross-sectional design. Future studies should examine these associations longitudinally to allow for interpretation of causality.

The impact of childhood adversity on addictive behaviours through impulsivity among adolescents

Abstract Background Little is known about the mechanism by which Adverse childhood experience (ACE) affects adolescent's engagement in addictive behaviours in the African context. We investigated the role of impulsivity in the link between ACE and behavioural addiction among schooled youth in Tunisia. Methods We performed a cross sectional study among 1940 schooled adolescents in the region of Mahdia (Tunisia) from January to February 2020. We used the validated Arabic version of the World Health Organization ACE questionnaire. The Barratt Impulsivity Scale as well as the Internet Addiction Test were used as screening tools for impulsivity and internet addiction. Results A total of 1940 adolescents returned the questionnaires. About 97.5% reported experiencing at least one ACE. We found that ACEs score predict addictive behaviours through impulsiveness (p &amp;lt; 0.001; % mediated = 16.7%). Particularly, intra-familial ACEs (p &amp;lt; 0.001; % mediation = 27.8%) demonstrated the most mediation by impulsivity followed by exposure to extra-familial ACEs (p &amp;lt; 0.001; % mediation = 10.5%). There were interactions between ACE and impulsivity in terms of their impact on internet addiction (p &amp;lt; 0.001; % mediation = 37.5%). Conclusions The mediation part of impulsivity in the association between ACE and cyberaddiction is alarming. Key messages Impulsive behaviors mediates the effect of childhood adversity on addictive behaviors. Great mediation part of impulsivity (37.5%) for internet addiction among Tunisian youth.

Efficacy of a transdiagnostic ecological momentary intervention for improving self-esteem (SELFIE) in youth exposed to childhood adversity: study protocol for a multi-center randomized controlled trial

BackgroundTargeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorder, but psychological help remains difficult to access and accept for youth, calling for novel, youth-friendly approaches. Mobile Health (mHealth) and, most prominently, ecological momentary interventions (EMIs) provide a unique opportunity to deliver youth-friendly, personalized, real-time, guided self-help interventions. The aim of this study is to investigate the efficacy of a novel, accessible, transdiagnostic ecological momentary intervention for improving self-esteem (‘SELFIE’) in youth with prior exposure to childhood adversity.Methods/designIn a parallel-group, assessor-blind, multi-center randomized controlled trial, individuals aged 12–26 years with prior exposure to childhood adversity and low self-esteem will be randomly allocated to SELFIE in addition to treatment as usual (TAU) as the experimental condition or the control condition of TAU only, which will include access to all standard health care. SELFIE is a digital guided self-help intervention administered through a smartphone-based app to allow for interactive, personalized, real-time and real-world transfer of intervention components in individuals’ daily lives, blended with three training sessions delivered by trained mental health professionals over a 6-week period. Outcomes will be assessed at baseline, post-intervention, and 6-month follow-up by blinded assessors. The primary outcome will be the level of self-esteem as measured with the Rosenberg Self-Esteem Scale (RSES).DiscussionThe current study is the first to establish the efficacy of an EMI focusing on improving self-esteem transdiagnostically in youth exposed to childhood adversity. If this trial provides evidence on the efficacy of SELFIE, it has significant potential to contribute to minimizing the deleterious impact of childhood adversity and, thereby, preventing the development of mental disorder later in life.Trial registrationNetherlands Trial Register NL7129 (NTR7475). Registered on 9 November 2018

Impact of childhood adversity on network reconfiguration dynamics during working memory in hypogonadal women

Many women with no history of cognitive difficulties experience executive dysfunction during menopause. Significant adversity during childhood negatively impacts executive function into adulthood and may be an indicator of women at risk of a mid-life cognitive decline. Previous studies have indicated that alterations in functional network connectivity underlie these negative effects of childhood adversity. There is growing evidence that functional brain networks are not static during executive tasks; instead, such networks reconfigure over time. Optimal dynamics are necessary for efficient executive function; while too little reconfiguration is insufficient for peak performance, too much reconfiguration (supra-optimal reconfiguration) is also maladaptive and associated with poorer performance. Here we examined the impact of adverse childhood experiences (ACEs) on network flexibility, a measure of dynamic reconfiguration, during a letter n-back task within three networks that support executive function: frontoparietal, salience, and default mode networks. Several animal and human subject studies have suggested that childhood adversity exerts lasting effects on executive function via serotonergic mechanisms. Tryptophan depletion (TD) was used to examine whether serotonin function drives ACE effects on network flexibility. We hypothesized that ACE would be associated with higher flexibility (supra-optimal flexibility) and that TD would further increase this measure. Forty women underwent functional imaging at two time points in this double-blind, placebo controlled, crossover study. Participants also completed the Penn Conditional Exclusion Test, a task assessing abstraction and mental flexibility. The effects of ACE and TD were evaluated using generalized estimating equations. ACE was associated with higher flexibility across networks (frontoparietal β = 0.00748, D = 2.79, p = 0.005; salience β = 0.00679, D = 3.02, p = 0.003; and default mode β = 0.00910, D = 3.53, p = 0.0004). While there was no interaction between ACE and TD, active TD increased network flexibility in both ACE groups in comparison to sham depletion (frontoparietal β = 0.00489, D = 2.15, p = 0.03; salience β = 0.00393, D = 1.91, p = 0.06; default mode β = 0.00334, D = 1.73, p = 0.08). These results suggest that childhood adversity has lasting impacts on dynamic reconfiguration of functional brain networks supporting executive function and that decreasing serotonin levels may exacerbate these effects.

Impact of adverse childhood experiences on cardiovascular disease risk factors in adulthood among Mexican women

BackgroundChildhood adversities are prevalent worldwide and might affect adult cardiovascular health. However, in middle-income countries such as Mexico, research on the impact of childhood adversities on cardiovascular disease (CVD) in adulthood is lacking. ObjectiveTo evaluate the prevalence of adverse childhood experiences (ACEs) and their association with risk factors for CVD in adult Mexican women. Participants and settingThe study population comprised 9853 women from the Mexican Teachers´ Cohort. MethodsParticipants responded to an online questionnaire including a 10-item instrument on ACEs and questions on CVD risk factors, between 2014 and 2017. Multivariate logistic regression models were used to evaluate the association between ACEs and adult behavioral and medical CVD risk factors. ResultsAbout 61% of participants reported at least one ACE and 14% reported four or more. After multivariable adjustment, women who reported ≥4 ACEs had 58% (95%CI 1.37, 1.81) higher odds of having ever smoked and 17% (95%CI 0.69, 0.99) lower odds of being physically active, compared with women who reported no ACEs. Women who reported ≥4 ACEs also had higher odds of hypertension (OR = 1.19; 95%CI 1.00, 1.43), diabetes (OR = 1.49; 95%CI 1.13, 1.96), high cholesterol (OR = 1.49; 95%CI 1.26, 1.75), and obesity (OR = 1.37; 95%CI 1.19, 1.57). In addition, individual ACE components were independently associated with several CVD risk factors. ConclusionACEs are common and associated with CVD risk factors in adult Mexican women.

Teaching Note—Understanding the Impact of Childhood Adversity on Social Work Students

ABSTRACT Social work students often come to the profession with their own history of childhood difficulty and adversity. Although these experiences frequently motivate students to become social workers, they can also impede a professional’s ability to practice effectively. This teaching note presents the literature regarding the impact of the attachment category and childhood history of adversity on helping professionals. We describe classroom activities that can be used in educating social work students about the potential impact of their history on social work practice.

27.1 NEURAL STRUCTURE IS INDEPENDENTLY PREDICTED BY DEPRIVATION AND THREAT IN EARLY CHILDHOOD

The impact of childhood adversity on risk for psychopathology is commonly examined using a cumulative risk model. In a recently proposed alternative approach, the dimensional model of adversity and psychopathology (DMAP), different dimensions of adversity are hypothesized to impact health and well-being through different neural pathways. We expect deprivation to impact thickness in areas of cortex involved in higher-order cognition such as the prefrontal cortex. In contrast, we expect threat to selectively impact subcortical structures associated with increased reactivity to emotional stimuli.

The Impact of Childhood Adversity on Cognitive Development in Schizophrenia.

Childhood adversity, such as physical, sexual, and verbal abuse, as well as neglect and family conflict, is a risk factor for schizophrenia. Such adversity can lead to disruptions of cognitive function during development, undermining intellectual capabilities and academic achievement. Schizophrenia is a neurodevelopmental disorder that is associated with cognitive impairments that may become evident during childhood. The Australian Schizophrenia Research Bank database comprises a large community cohort (N = 1169) in which we previously identified 3 distinct cognitive groups among people with schizophrenia: (1) Compromised, current, and estimated premorbid cognitive impairment; (2) Deteriorated, substantial decline from estimated premorbid function; and (3) Preserved, performing in the normal cognitive range without decline. The compromised group displayed the worst functional and symptom outcomes. Here, we extend our previous work by assessing the relationship among these categories of cognitive abilities and reported childhood adversity in 836 patients and healthy controls. Exploratory factor analysis of the Childhood Adversity Questionnaire revealed 3 factors (lack of parental involvement; overt abuse; family breakdown and hardship). People with schizophrenia reported significantly more childhood adversity than healthy controls on all items and factors. People with schizophrenia in the compromised group reported significantly more lack of parental involvement and family breakdown and hardship and lower socioeconomic status than those in the deteriorated group. The cognitive groups were not related to family history of psychosis. These findings identify specific social and family factors that impact cognition, highlighting the important role of these factors in the development of cognitive and functional abilities in schizophrenia.

Impact of childhood adversity on corticolimbic volumes in youth at clinical high-risk for psychosis

Childhood adversity is among the strongest risk factors for psychosis-spectrum disorders, though the nature and specificity of the biological mechanisms underlying this association remains unclear. Previous research reveals overlaps in the volumetric alterations observed in both adversity-exposed individuals and in psychosis-spectrum populations, highlighting the possibility that deviations in corticolimbic gray matter development may be one mechanism linking adversity and psychosis. Given that childhood adversity encompasses a wide range of adverse experiences, there is also a critical need to examine whether these different types of experiences have unique effects on corticolimbic regions. This study examined the association between childhood adversity and cortical, hippocampal, and amygdalar volume in a large sample of youth at clinical-high risk (CHR) for psychosis. We utilized a novel differentiated adversity approach that distinguishes exposures along dimensions of threat (e.g., abuse) and deprivation (e.g., poverty, neglect) to test for differential associations. Participants were drawn from the North American Prodromal Longitudinal Study (NAPLS) and completed an MRI scan and a retrospective assessment of childhood adversity at baseline. We found that deprivation exposure, but not threat, was uniquely associated with smaller cortical volume and smaller right hippocampal volume in CHR youth. These associations were masked in a generalized risk model that utilized a total adversity score. The findings suggest that deprivation exposures during childhood contribute to the subtle volumetric reductions observed in clinical high-risk samples and highlight the importance of disentangling different dimensions of adversity.

Decoding the impact of adverse childhood experiences on the progression of schizophrenia

Adverse childhood experiences are frequently present in patients with mental disorders, including those with schizophrenia. Whereas an impact of childhood adversities on psychopathology and potential neuroendocrine/biological mediators has been reported for posttraumatic stress disorder, depression, and anxiety disorders, the relationships in schizophrenia remain to be clarified. The present study compared amount and types of adverse childhood experiences (screened by interview) between individuals at risk for psychosis (n = 29), early schizophrenia patients with 1–2 admissions (n = 34), chronic schizophrenia patients with multiple admissions (n = 24), and healthy comparison participants (n = 38). It was expected that at-risk individuals and early-stage as well as chronic patients report more childhood adversities than controls, and that adversity load predicts psychotic symptom severity and altered neuroendocrine regulation based on hair cortisol concentration. Results confirmed more childhood adversities in clinical groups than in controls, and relationships between total childhood adversities and increased positive symptom severity. Hair cortisol concentration did not differ between groups, but early abuse experiences predicted lower hair cortisol concentration, and the latter predicted severity of specific psychotic symptoms in the clinical sample. In conclusion, individuals at risk and with manifest schizophrenia experienced substantial childhood maltreatment, as reported for other diagnoses. The present findings suggest childhood adversities as sensitizing (environmental) factor in vulnerable individuals. Lower hair cortisol concentration may indicate lasting effects of past stress experiences on stress axis function in schizophrenia, which might modulate unfolding psychopathology.