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Childhood trauma, psychosis liability and social stress reactivity: a virtual reality study

  • W. Veling (a1) (a2) (a3), J. Counotte (a2), R. Pot-Kolder (a2) (a4), J. van Os (a3) (a5) and M. van der Gaag (a2) (a4)...
Abstract
Background

Childhood trauma is associated with higher risk for mental disorders, including psychosis. Heightened sensitivity to social stress may be a mechanism. This virtual reality study tested the effect of childhood trauma on level of paranoid ideations and distress in response to social stress, in interaction with psychosis liability and level of social stress exposure.

Method

Seventy-five individuals with higher psychosis liability (55 with recent onset psychotic disorder and 20 at ultra-high risk for psychosis) and 95 individuals with lower psychosis liability (42 siblings and 53 controls) were exposed to a virtual café in five experiments with 0–3 social stressors (crowded, other ethnicity and hostility). Paranoid ideation was measured after each experiment. Subjective distress was self-rated before and after experiments. Multilevel random regression analyses were used to test main effects of childhood trauma and interaction effects.

Results

Childhood trauma was more prevalent in individuals with higher psychosis liability, and was associated with higher level of (subclinical) psychotic and affective symptoms. Individuals with a history of childhood trauma responded with more subjective distress to virtual social stress exposures. The effects of childhood trauma on paranoia and subjective distress were significantly stronger when the number of virtual environmental stressors increased. Higher psychosis liability increased the effect of childhood trauma on peak subjective distress and stress reactivity during experiments.

Conclusions

Childhood trauma is associated with heightened social stress sensitivity and may contribute to psychotic and affective dysregulation later in life, through a sensitized paranoid and stress response to social stressors.

Copyright
Corresponding author
*Address for correspondence: Dr W. Veling, Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. (Email: w.veling@umcg.nl)
References
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Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615623.
Bernstein, DP, Fink, L (1998). Childhood Trauma Questionnaire: A Retrospective Self-report Manual. The Psychological Corporation: San Antionio, TX.
Bernstein, DP, Stein, JA, Newcomb, MD, Walker, E, Pogge, D, Ahluvalia, T, Stokes, J, Handelsman, L, Medrano, M, Desmond, D, Zule, W (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse and Neglect 27, 169190.
Collip, D, Geschwind, N, Peeters, F, Myin-Germeys, I, van Os, J, Wichers, M (2013). Putting a hold on the downward spiral of paranoia in the social world: a randomized controlled trial of mindfulness-based cognitive therapy in individuals with a history of depression. PLoS ONE 8, e66747.
Collip, D, Myin-Germeys, I, Van Os, J (2008). Does the concept of ‘sensitization’ provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophrenia Bulletin 34, 220225.
Collip, D, Oorschot, M, Thewissen, V, Van Os, J, Bentall, R, Myin-Germeys, I (2011). Social world interactions: how company connects to paranoia. Psychological Medicine 41, 911921.
Elsey, J, Coates, A, Lacadie, CM, McCrory, EJ, Sinha, R, Mayes, LC, Potenza, MN (2015). Childhood Trauma and Neural Responses to Personalized Stress, Favorite-Food and Neutral-Relaxing Cues in Adolescents. Neuropsychopharmacology 40, 15801589.
Fornells-Ambrojo, M, Barker, C, Swapp, D, Slater, M, Antley, A, Freeman, D (2008). Virtual reality and persecutory delusions: safety and feasibility. Schizophrenia Research 104, 228236.
Fornells-Ambrojo, M, Freeman, D, Slater, M, Swapp, D, Antley, A, Barker, C (2015). How do people with persecutory delusions evaluate threat in a controlled social environment? A qualitative study using virtual reality. Behavioural and Cognitive Psychotherapy 43, 89107.
Freeman, D, Dunn, G, Fowler, D, Bebbington, P, Kuipers, E, Emsley, R, Jolley, S, Garety, P (2013). Current paranoid thinking in patients with delusions: the presence of cognitive-affective biases. Schizophrenia Bulletin 39, 12811287.
Freeman, D, Emsley, R, Dunn, G, Fowler, D, Bebbington, P, Kuipers, E, Jolley, S, Waller, H, Hardy, A, Garety, P (2015). The stress of the street for patients with persecutory delusions: a test of the symptomatic and psychological effects of going outside into a busy urban area. Schizophrenia Bulletin 41, 971979.
Freeman, D, Gittins, M, Pugh, K, Antley, A, Slater, M, Dunn, G (2008). What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine 38, 11211132.
Freeman, D, Pugh, K, Green, C, Valmaggia, L, Dunn, G, Garety, P (2007). A measure of state persecutory ideation for experimental studies. Journal of Nervous and Mental Disease 195, 781784.
Freeman, D, Pugh, K, Vorontsova, N, Antley, A, Slater, M (2010). Testing the continuum of delusional beliefs: an experimental study using virtual reality. Journal of Abnormal Psychology 119, 8392.
Fusar-Poli, P, Borgwardt, S, Bechdolf, A, Addington, J, Riecher-Rössler, A, Schultze-Lutter, F, Keshavan, M, Wood, S, Ruhrmann, S, Seidman, LJ, Valmaggia, L, Cannon, T, Velthorst, E, De Haan, L, Cornblatt, B, Bonoldi, I, Birchwood, M, McGlashan, T, Carpenter, W, McGorry, P, Klosterkötter, J, McGuire, P, Yung, A (2013). The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry 70, 107120.
Garety, Pa, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E (2007). Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine 37, 13771391.
Glaser, JP, van Os, J, Portegijs, PJM, Myin-Germeys, I (2006). Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. Journal of Psychosomatic Research 61, 229236.
Gottesman, II (1991). Schizophrenia Genesis: The Origins of Madness. New York: W. H. Freeman.
Green, CEL, Freeman, D, Kuipers, E, Bebbington, P, Fowler, D, Dunn, G, Garety, Pa (2008). Measuring ideas of persecution and social reference: the Green et al. Paranoid Thought Scales (GPTS). Psychological Medicine 38, 101111.
Heim, C, Nemeroff, CB (2001). The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies. Biological Psychiatry 49, 10231039.
Hovens, JGFM, Wiersma, JE, Giltay, EJ, Van Oppen, P, Spinhoven, P, Penninx, BWJH, Zitman, FG (2010). Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders v. controls. Acta Psychiatrica Scandinavica 122, 6674.
Howes, OD, Murray, RM (2014). Schizophrenia: an integrated sociodevelopmental-cognitive model. Lancet 383, 16771687.
Kapur, S, Mizrahi, R, Li, M (2005). From dopamine to salience to psychosis-linking biology, pharmacology and phenomenology of psychosis. Schizophrenia Research 79, 5968.
Kirschbaum, C, Pirke, KM, Hellhammer, DH (1993). The ‘Trier Social Stress Test’ – a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 7681.
Konings, M, Bak, M, Hanssen, M, van Os, J, Krabbendam, L (2006). Validity and reliability of the CAPE: a self-report instrument for the measurement of psychotic experiences in the general population. Acta Psychiatrica Scandinavica 114, 5561.
Kramer, IMA, Simons, CJP, Myin-Germeys, I, Jacobs, N, Derom, C, Thiery, E, van Os, J, Wichers, M (2012). Evidence that genes for depression impact on the pathway from trauma to psychotic-like symptoms by occasioning emotional dysregulation. Psychological Medicine 42, 283294.
Lardinois, M, Lataster, T, Mengelers, R, Van Os, J, Myin-Germeys, I (2011). Childhood trauma and increased stress sensitivity in psychosis. Acta Psychiatrica Scandinavica 123, 2835.
Lederbogen, F, Kirsch, P, Haddad, L, Streit, F, Tost, H, Schuch, P, Wüst, S, Pruessner, JC, Rietschel, M, Deuschle, M, Meyer-Lindenberg, A (2011). City living and urban upbringing affect neural social stress processing in humans. Nature 474, 498501.
Mattick, RP, Clarke, JC (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy 36, 455470.
Myin-Germeys, I, Oorschot, M, Collip, D, Lataster, J, Delespaul, P, van Os, J (2009). Experience sampling research in psychopathology: opening the black box of daily life. Psychological Medicine 39, 15331547.
Myin-Germeys, I, van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409424.
Opriş, D, Pintea, S, García-Palacios, A, Botella, C, Szamosközi, Ş, David, D (2012). Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depression and Anxiety 29, 8593.
Phillips, LJ, Francey, SM, Edwards, J, McMurray, N (2007). Stress and psychosis: towards the development of new models of investigation. Clinical Psychology Review 27, 307317.
Reininghaus, U, Kempton, MJ, Valmaggia, L, Craig, TKJ, Garety, P, Onyejiaka, A, Gayer-Anderson, C, So, SH, Hubbard, K, Beards, S, Dazzan, P, Pariante, C, Mondelli, V, Fisher, HL, Mills, JG, Viechtbauer, W, McGuire, P, van Os, J, Murray, RM, Wykes, T, Myin-Germeys, I, Morgan, C (2016). Stress sensitivity, aberrant salience, and threat anticipation in early psychosis: an experience sampling study. Schizophrenia Bulletin 42, 712722.
Selten, J-P, van der Ven, E, Rutten, BPF, Cantor-Graae, E (2013). The social defeat hypothesis of schizophrenia: an update. Schizophrenia Bulletin 39, 11801186.
Valmaggia, L, Freeman, D, Green, C, Garety, P, Swapp, D, Antley, A, Prescott, C, Fowler, D, Kuipers, E, Bebbington, P, Slater, M, Broome, M, McGuire, PK (2007). Virtual reality and paranoid ideations in people with an ‘at-risk mental state’ for psychosis. British Journal of Psychiatry 1, 6368.
Valmaggia, LR, Day, F, Garety, P, Freeman, D, Antley, A, Slater, M, Swapp, D, Myin-Germeys, I, McGuire, P (2015 a). Social defeat predicts paranoid appraisals in people at high risk for psychosis. Elsevier B.V. Schizophrenia Research 168, 1622.
Valmaggia, LR, Day, FL, Kroll, J, Laing, J, Byrne, M, Fusar-Poli, P, McGuire, P (2015 b). Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis. Schizophrenia Research 168, 6873.
van den Berg, DPG, de Bont, PaJM, van der Vleugel, BM, de Roos, C, de Jongh, A, Van Minnen, A, van der Gaag, M (2015). Prolonged exposure v. eye movement desensitization and reprocessing v. waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry 72, 259267.
van Os, J, Kenis, G, Rutten, BPF (2010). The environment and schizophrenia. Nature 468, 203212.
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179195.
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, Van Os, J, Bentall, RP (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661671.
Veling, W, Brinkman, W-P, Dorrestijn, E, van der Gaag, M (2014 a). Virtual reality experiments linking social environment and psychosis: a pilot study. Cyberpsychology, Behavior and Social Networking 17, 191195.
Veling, W, Moritz, S, Van Der Gaag, M (2014 b). Brave new worlds – review and update on virtual reality assessment and treatment in psychosis. Schizophrenia Bulletin 40, 11941197.
Veling, W, Pot-Kolder, R, Counotte, J, van Os, J, van der Gaag, M (2016). Environmental social stress, paranoia and psychosis liability: a virtual reality study. Schizophrenia Bulletin. Published online: 2 April 2016. doi:10.1093/schbul/sbw031.
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589593.
Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M, Francey, SM, Cosgrave, EM, Killackey, E, Stanford, C, Godfrey, K, Buckby, J (2005). Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Australian and New Zealand Journal of Psychiatry 39, 964971.
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