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Childhood abuse and psychotic experiences – evidence for mediation by adulthood adverse life events

Published online by Cambridge University Press:  09 October 2017

V. Bhavsar ,
J. Boydell ,
P. McGuire ,
V. Harris ,
M. Hotopf ,
S. L. Hatch ,
J. H. MacCabe  and
C. Morgan
V. Bhavsar*
Affiliation:
Department of Psychosis Studies, King's College London, IOPPN, London, UK
J. Boydell
Affiliation:
Cornwall NHS Foundation Trust, Saint Austell, UK
P. McGuire
Affiliation:
Department of Psychosis Studies, King's College London, IOPPN, London, UK
V. Harris
Affiliation:
Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
M. Hotopf
Affiliation:
Department of Psychological Medicine, King's College London, IOPPN and South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
S. L. Hatch
Affiliation:
Department of Psychological Medicine, King's College London, IOPPN and South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
J. H. MacCabe
Affiliation:
Department of Psychosis Studies, King's College London, IOPPN, London, UK
C. Morgan
Affiliation:
Department of Health Services and Population Research, King's College London, IOPPN, London, UK
*
*Address for correspondence: V. Bhavsar, Department of Psychosis Studies, King's College London, IOPPN, London, UK. (Email: vishal.2.bhavsar@kcl.ac.uk)
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Abstract

Aims.

We have previously reported an association between childhood abuse and psychotic experiences (PEs) in survey data from South East London. Childhood abuse is related to subsequent adulthood adversity, which could form one pathway to PEs. We aimed to investigate evidence of mediation of the association between childhood abuse and PEs by adverse life events.

Methods.

Data were analysed from the South East London Community Health Study (SELCoH, n = 1698). Estimates of the total effects on PEs of any physical or sexual abuse while growing up were partitioned into direct (i.e. unmediated) and indirect (total and specific) effects, mediated via violent and non-violent life events.

Results.

There was strong statistical evidence for direct (OR 1.58, 95% CI: 1.19–2.1) and indirect (OR 1.51, 95% CI: 1.32–1.72) effects of childhood abuse on PEs after adjustment for potential confounders, indicating partial mediation of this effect via violent and non-violent life events. An estimated 47% of the total effect of abuse on PEs was mediated via adulthood adverse life events, of which violent life events made up 33% and non-violent life events the remaining 14%.

Conclusions.

The association between childhood abuse and PEs is partly mediated through the experience of adverse life events in adulthood. There is some evidence that a larger proportion of this effect was mediated through violent life events than non-violent life events.

Keywords

Child abusepopulation surveypsychosistraumaviolence
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 3 , June 2019 , pp. 300 - 309
Copyright
Copyright © Cambridge University Press 2017 

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References

Alemany, S, Arias, B, Aguilera, M, Villa, H, Moya, J, Ibáñez, MI, Vossen, H, Gastó, C, Ortet, G, Fañanás, L (2011). Childhood abuse, the BDNF-Val66Met polymorphism and adult psychotic-like experiences. The British Journal of Psychiatry 199, 38–42.Google Scholar
Alemany, S, Goldberg, X, Van Winkel, R, Gastó, C, Peralta, V, Fañanás, L (2013). Childhood adversity and psychosis: examining whether the association is due to genetic confounding using a monozygotic twin differences approach. European Psychiatry 28, 207–212.Google Scholar
Arseneault, L, Cannon, M, Fisher, HL, Polanczyk, G, Moffitt, TE, Caspi, A (2011 a). Childhood trauma and children's emerging psychotic symptoms: a genetically sensitive longitudinal cohort study. American Journal of Psychiatry 168, 65–72.Google Scholar
Arseneault, L, Cannon, M, Fisher, HL, Polanczyk, G, Moffitt, TE, Caspi, A (2011 b). Childhood trauma and children's emerging psychotic symptoms: a genetically sensitive longitudinal cohort study. American Journal of Psychiatry 168, 65–72.Google Scholar
Baron, RM, Kenny, DA (1986). The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 1173.Google Scholar
Bebbington, P, Nayani, T (1995). The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research 5, 11–19.Google Scholar
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004 a). Psychosis, victimisation and childhood disadvantage evidence from the second British national survey of psychiatric morbidity. The British Journal of Psychiatry 185, 220–226.Google Scholar
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004 b). Psychosis, victimisation and childhood disadvantage: evidence from the second British national survey of psychiatric morbidity. The British Journal of Psychiatry 185, 220–226.Google Scholar
Bhavsar, V, Maccabe, J, Hatch, SL, Hotopf, M, Boydell, J, Mcguire, P (2017). Subclinical psychotic experiences and subsequent contact with mental health services. British Journal of Psychiatry Open 3, 64–70.Google Scholar
Bonoldi, I, Simeone, E, Rocchetti, M, Codjoe, L, Rossi, G, Gambi, F, Balottin, U, Caverzasi, E, Politi, P, Fusar-Poli, P (2013). Prevalence of self-reported childhood abuse in psychosis: a meta-analysis of retrospective studies. Psychiatry Research 210, 8–15.Google Scholar
Borges, S, Gayer-Anderson, C, Mondelli, V (2013). A systematic review of the activity of the hypothalamic–pituitary–adrenal axis in first episode psychosis. Psychoneuroendocrinology 38, 603–611.Google Scholar
Briere, J, Runtz, M (1987). Post sexual abuse trauma data and implications for clinical practice. Journal of Interpersonal Violence 2, 367–379.Google Scholar
Carr, CP, Martins, CMS, Stingel, AM, Lemgruber, VB, Juruena, MF (2013). The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes. The Journal of Nervous and Mental Disease 201, 1007–1020.Google Scholar
Chu, JA, Dill, DL (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. The American Journal of Psychiatry 147, 887.Google Scholar
Collip, D, Nicolson, N, Lardinois, M, Lataster, T, Van Os, J, Myin-Germeys, I (2011). Daily cortisol, stress reactivity and psychotic experiences in individuals at above average genetic risk for psychosis. Psychological Medicine 41, 2305–2315.Google Scholar
Das-Munshi, J, Becares, L, Boydell, JE, Dewey, ME, Morgan, C, Stansfeld, SA, Prince, MJ (2012). Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). British Journal of Psychiatry 201, 282–290.Google Scholar
Devylder, JE, Oh, HY, Corcoran, CM, Lukens, EP (2014). Treatment seeking and unmet need for care among persons reporting psychosis-like experiences. Psychiatric Services 65, 774–780.Google Scholar
Finkelhor, D (1979). Sexually Victimized Children. Free Press: New York.Google Scholar
Fisher, H, Schreier, A, Zammit, S, Lewis, G, Maughan, B, Munafo, M, Harrison, G, Wolke, D (2011). Prospective investigation of psychological and affective pathways from childhood trauma to psychosis-like experiences in a UK birth cohort. Comprehensive Psychiatry 52, E6.Google Scholar
Fisher, HL, Caspi, A, Poulton, R, Meier, MH, Houts, R, Harrington, H, Arseneault, L, Moffitt, TE (2013 a). Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study. Psychological Medicine 43, 2077–2086.Google Scholar
Fisher, HL, Schreier, A, Zammit, S, Maughan, B, Munafo, MR, Lewis, G, Wolke, D (2013 b). Pathways between childhood victimization and psychosis-like symptoms in the ALSPAC birth cohort. Schizophrenia Bulletin 39, 1045–1055.Google Scholar
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, P (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.Google Scholar
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, 1377–1391.Google Scholar
Hatch, SL, Frissa, S, Verdecchia, M, Stewart, R, Fear, NT, Reichenberg, A, Morgan, C, Kankulu, B, Clark, J, Gazard, B (2011). Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community health (SELCoH) study. BMC Public Health 11, 861.Google Scholar
Hatch, SL, Woodhead, C, Frissa, S, Fear, NT, Verdecchia, M, Stewart, R, Reichenberg, A, Morgan, C, Bebbington, P, Mcmanus, S, Brugha, T, Kankulu, B, Clark, JL, Gazard, B, Medcalf, R, Hotopf, M, TEAM, S. E. S. (2012). Importance of thinking locally for mental health: data from cross-sectional surveys representing South East London and England. PLoS ONE 7, e48012.Google Scholar
Howes, OD, Kapur, S (2009). The dopamine hypothesis of schizophrenia: version III – the final common pathway. Schizophrenia Bulletin 35, 549–562.Google Scholar
Iverson, KM, Litwack, SD, Pineles, SL, Suvak, MK, Vaughn, RA, Resick, PA (2013). Predictors of intimate partner violence revictimization: the relative impact of distinct PTSD symptoms, dissociation, and coping strategies. Journal of Traumatic Stress 26, 102–110.Google Scholar
Johns, LC, Nazroo, JY, Bebbington, P, Kuipers, E (2002). Occurrence of hallucinatory experiences in a community sample and ethnic variations. The British Journal of Psychiatry 180, 174–178.Google Scholar
Johns, LC, Cannon, M, Singleton, N, Murray, RM, Farrell, M, Brugha, T, Bebbington, P, Jenkins, R, Meltzer, H (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. The British Journal of Psychiatry 185, 298–305.Google Scholar
Kaymaz, N, Drukker, M, Lieb, R, Wittchen, HU, Werbeloff, N, Weiser, M, Lataster, T, Van Os, J (2012). Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychological Medicine 42, 2239–2253.Google Scholar
Kelleher, I, Lynch, F, Harley, M, Molloy, C, Roddy, S, Fitzpatrick, C, Cannon, M (2012). Psychotic symptoms in adolescence index risk for suicidal behavior: findings from 2 population-based case-control clinical interview studies. Archives of General Psychiatry 69, 1277–1283.Google Scholar
Kelleher, I, Corcoran, P, Keeley, H, Wigman, JT, Devlin, N, Ramsay, H, Wasserman, C, Carli, V, Sarchiapone, M, Hoven, C (2013 a). Psychotic symptoms and population risk for suicide attempt: a prospective cohort study. JAMA Psychiatry 70, 940–948.Google Scholar
Kelleher, I, Keeley, H, Corcoran, P, Ramsay, H, Wasserman, C, Carli, V, Sarchiapone, M, Hoven, C, Wasserman, D, Cannon, M (2013 b). Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality. American Journal of Psychiatry 170, 734–741.Google Scholar
Krieger, N (1994). Epidemiology and the web of causation: has anyone seen the spider? Social Science and Medicine 39, 887–903.Google Scholar
Kuijpers, KF, Van Der Knaap, LM, Winkel, FW (2012). PTSD symptoms as risk factors for intimate partner violence revictimization and the mediating role of victims’ violent behavior. Journal of Traumatic Stress 25, 179–186.Google Scholar
Linscott, RJ, Van Os, J (2013). An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine 43, 1133–1149.Google Scholar
Mäkikyrö, T, Sauvola, A, Moring, J, Veijola, J, Nieminen, P, Järvelin, MR, Isohanni, M (1998). Hospital-treated psychiatric disorders in adults with a single-parent and two-parent family background: a 28-year follow-up of the 1966 Northern Finland birth cohort. Family Process 37, 335–344.Google Scholar
Mayall, A, Gold, SR (1995). Definitional issues and mediating variables in the sexual revictimization of women sexually abused as children. Journal of Interpersonal Violence 10, 26–42.Google Scholar
Mcmanus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (2009). Adult psychiatric morbidity in England, 2007: results of a household survey. London: The NHS Information Centre for Health and Social Care.Google Scholar
Morgan, C, Kirkbride, J, Hutchinson, G, Craig, T, Morgan, K, Dazzan, P, Boydell, J, Doody, GA, Jones, PB, Murray, RM, Leff, J, Fearon, P (2008). Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychological Medicine 38, 1701–1715.Google Scholar
Morgan, C, Charalambides, M, Hutchinson, G, Murray, RM (2010). Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophrenia Bulletin 36, 655–664.Google Scholar
Morgan, C, Frissa, S, Verdecchia, M, Stewart, R, Fear, NT, Reichenberg, A, Hotopf, M, Hatch, SL (2013). Trauma, life events and psychosis: evidence of synergistic effects from the selcoh study. Schizophrenia Bulletin 39, S71–S72.Google Scholar
Morgan, C, Reininghaus, U, Fearon, P, Hutchinson, G, Morgan, K, Dazzan, P, Boydell, J, Kirkbride, J, Doody, GA, Jones, PB (2014 a). Modelling the interplay between childhood and adult adversity in pathways to psychosis: initial evidence from the AESOP study. Psychological Medicine 44, 407–419.Google Scholar
Morgan, C, Reininghaus, U, Reichenberg, A, Frissa, S, Hotopf, M, Hatch, SL, SELCoH study team (2014 b). Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects. The British Journal of Psychiatry 204, 346.Google Scholar
Morrison, AP, Frame, L, Larkin, W (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology 42, 331–353.Google Scholar
Mueser, KT, Rosenberg, SD, Goodman, LA, Trumbetta, SL (2002). Trauma, PTSD, and the course of severe mental illness: an interactive model. Schizophrenia Research 53, 123–143.Google Scholar
Muthén, L, Muthén, B (1998). Mplus Version 7 [Statistical Software]. Muthén & Muthén: Los Angeles, CA.Google Scholar
Myin-Germeys, I, Van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409–424.Google Scholar
Pantazis, C, Gordon, D, Levitas, R (2006). Poverty and Social Exclusion in Britain: The Millennium Survey. Policy Press: Bristol.Google Scholar
Reininghaus, U, Priebe, S, Bentall, RP (2013). Testing the psychopathology of psychosis: evidence for a general psychosis dimension. Schizophrenia Bulletin 39, 884–895.Google Scholar
Reuben, A, Moffitt, TE, Caspi, A, Belsky, DW, Harrington, H, Schroeder, F, Hogan, S, Ramrakha, S, Poulton, R, Danese, A (2016). Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. Journal of Child Psychology and Psychiatry 57, 1103–1112.Google Scholar
Rottenberg, J, Yaroslavsky, I, Carney, RM, Freedland, KE, George, CJ, Baji, I, Dochnal, R, Gádoros, J, Halas, K, Kapornai, K (2014). The association between major depressive disorder in childhood and risk factors for cardiovascular disease in adolescence. Psychosomatic Medicine 76, 122.Google Scholar
Russell, DE (1983). The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children. Child Abuse and Neglect 7, 133–146.Google Scholar
Schofield, P, Das-Munshi, J, Bécares, L, Morgan, C, Bhavsar, V, Hotopf, M, Hatch, S (2016). Minority status and mental distress: a comparison of group density effects. Psychological Medicine 46, 3051.Google Scholar
Schreier, A, Wolke, D, Thomas, K, Horwood, J, Hollis, C, Gunnell, D, Lewis, G, Thompson, A, Zammit, S, Duffy, L (2009). Prospective study of peer victimization in childhood and psychotic symptoms in a nonclinical population at age 12 years. Archives of General Psychiatry 66, 527–536.Google Scholar
Sheinbaum, T, Ros, A, Kwapil, TR, Ballespi, S, Mitjavila, M, Barrantes-Vidal, N (2012). Insecure attachment style mediates the association between childhood adversity and subclinical psychotic symptoms in a non-clinical sample. Early Intervention in Psychiatry 6, 124.Google Scholar
Siegel, JM, Sorenson, SB, Golding, JM, Burnam, MA, Stein, JA (1987). The prevalence of childhood sexual assault The Los Angeles epidemiologic catchment area project. American Journal of Epidemiology 126, 1141–1153.Google Scholar
Van Nierop, M, Lataster, T, Smeets, F, Gunther, N, Van Zelst, C, De Graaf, R, Ten Have, M, Van Dorsselaer, S, Bak, M, Myin-Germeys, I, Viechtbauer, W, Van Os, J, Van Winkel, R (2014). Psychopathological mechanisms linking childhood traumatic experiences to risk of psychotic symptoms: analysis of a large, representative population-based sample. Schizophrenia Bulletin 40, S123–S130.Google Scholar
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, 661–671.Google Scholar
Werbeloff, N, Drukker, M, Dohrenwend, BP, Levav, I, Yoffe, R, Van Os, J, Davidson, M, Weiser, M (2012). Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Archives of General Psychiatry 69, 467–475.Google Scholar