Veling W, Counotte J, Pot-Kolder R, van Os J, van der Gaag M
Department of Psychiatry,University of Groningen, University Medical Center Groningen,Groningen,The Netherlands.
Parnassia Psychiatric Institute,The Hague,The Netherlands.
Psychol Med. 2016 Dec;46(16):3339-3348. doi: 10.1017/S0033291716002208. Epub 2016 Sep 13.
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.
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.
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.
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.
儿童期创伤与包括精神病在内的精神障碍的较高风险相关。对社会压力的高度敏感可能是一种机制。这项虚拟现实研究测试了儿童期创伤对偏执观念水平以及对社会压力反应时的痛苦程度的影响，同时考察了其与精神病易感性和社会压力暴露水平的相互作用。
75名具有较高精神病易感性的个体（55名近期发病的精神病性障碍患者和20名超高危精神病患者）和95名具有较低精神病易感性的个体（42名兄弟姐妹和53名对照）在五个实验中被暴露于一个虚拟咖啡馆，实验中有0至3个社会压力源（拥挤、其他种族和敌意）。每次实验后测量偏执观念。在实验前后对主观痛苦进行自评。采用多水平随机回归分析来测试儿童期创伤的主要效应和相互作用效应。
儿童期创伤在具有较高精神病易感性的个体中更为普遍，并且与较高水平的（亚临床）精神病性和情感症状相关。有儿童期创伤史的个体对虚拟社会压力暴露的主观痛苦反应更大。当虚拟环境压力源的数量增加时，儿童期创伤对偏执和主观痛苦的影响显著增强。较高的精神病易感性增加了儿童期创伤对实验期间峰值主观痛苦和应激反应性的影响。
儿童期创伤与社会压力敏感性增强相关，并且可能通过对社会压力源的偏执和应激反应敏感化，在生命后期导致精神病性和情感失调。
