Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA 30322, USA.
Psychiatry Res. 2011 Aug 15;188(3):343-9. doi: 10.1016/j.psychres.2011.05.019. Epub 2011 Jun 12.
Associations among maltreatment and traumatic experiences in childhood and adolescence, later substance use, and subsequent mental health outcomes for individuals with schizophrenia-spectrum disorders have been initially explored in previous studies; however, research on these factors in socially disadvantaged patients with first-episode psychosis is unavailable. This exploratory, correlational analysis examined associations between maltreatment and trauma-related variables (e.g., traumatic experiences, parental harsh discipline, violence exposure) and: social variables (years of education attained and extent of Axis IV psychosocial problems at initial hospitalization), substance abuse (age at initiation of alcohol and cannabis use, as well as estimates of lifetime intake of both), and positive and negative symptom severity. Rates of childhood abuse and traumatic events were remarkably high in the sample. Years of educational attainment and number of Axis IV psychosocial problems were substantially correlated with several domains of childhood abuse/traumatic events. Age at initiation of alcohol and cannabis use, and lifetime alcohol and cannabis intake, were correlated with a number of trauma domains. Whereas positive symptom severity was correlated with four of the trauma variables, negative symptom severity was correlated only with prior emotional neglect. These results provide insights into the relations among childhood traumatic events, substance use, and clinical features of first-episode psychosis, creating hypotheses for future research.
先前的研究初步探讨了儿童和青少年时期受虐待和创伤经历、随后的物质使用以及精神分裂症谱系障碍患者随后的心理健康结果之间的关联;然而,对于首次出现精神病的社会劣势患者,这些因素的研究尚属空白。本探索性相关性分析检查了虐待和与创伤相关的变量(例如,创伤经历、父母严厉管教、暴力暴露)之间的关联:社会变量(接受教育的年限和初次住院时的轴 IV 心理社会问题的严重程度)、物质滥用(开始使用酒精和大麻的年龄,以及两者的终生摄入量估计),以及阳性和阴性症状的严重程度。在样本中,儿童期受虐待和创伤事件的发生率非常高。受教育年限和轴 IV 心理社会问题的数量与儿童期虐待/创伤事件的多个领域密切相关。酒精和大麻使用的起始年龄以及终生的酒精和大麻摄入量与多个创伤领域相关。阳性症状的严重程度与四个创伤变量相关,而阴性症状的严重程度仅与先前的情感忽视相关。这些结果深入了解了首发精神病中儿童期创伤事件、物质使用和临床特征之间的关系,为未来的研究提供了假设。