Redman Samantha L, Corcoran Cheryl M, Kimhy David, Malaspina Dolores
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Arch Psychol (Chic). 2017 Dec 15;1(3). Epub 2017 Dec 18.
Early trauma (ET), though broadly and inconsistently defined, has been repeatedly linked to numerous psychological disturbances, including various developmental stages of psychotic disorders. The prodromal phase of psychosis highlights a unique and relevant population that provides insight into the critical periods of psychosis development. As such, a relatively recent research focus on individuals at clinical high risk (CHR) for psychosis reveals robust associations of early life trauma exposures with prodromal symptoms and function in these cohorts. While prevalence rates of ET in CHR cohorts remain consistently high, methodological measures of traumatic experiences vary across studies, presenting potential problems for reliability and validity of results. This review aims to 1) highlight the existing evidence identifying associations of ET, of multiple forms, with both symptom severity and transition rates to psychosis in CHR individuals, 2) present data on the variability among trauma assessments and its implications for conclusions about its relationship with clinical variables, 3) describe cognitive deficits common in CHR cohorts, including perceptual and neurocognitive impairments, and their neural correlates, that may modify the relationship of ET to symptoms, and 4) propose future directions for standardization of trauma assessment in CHR cohorts to better understand its clinical and cognitive correlates.
早期创伤（ET），尽管定义宽泛且不一致，但已多次与多种心理障碍相关联，包括精神障碍的各个发展阶段。精神病的前驱期突出了一个独特且相关的人群，这为洞察精神病发展的关键时期提供了线索。因此，最近对临床高危（CHR）精神病个体的研究重点揭示了这些队列中早年创伤暴露与前驱症状及功能之间的强烈关联。虽然CHR队列中ET的患病率一直居高不下，但创伤经历的方法学测量在不同研究中存在差异，这给结果的可靠性和有效性带来了潜在问题。本综述旨在：1）强调现有证据，确定多种形式的ET与CHR个体的症状严重程度及向精神病转变率之间的关联；2）呈现创伤评估之间变异性的数据及其对ET与临床变量关系结论的影响；3）描述CHR队列中常见的认知缺陷，包括感知和神经认知障碍及其神经关联，这些可能会改变ET与症状之间的关系；4）为CHR队列中创伤评估的标准化提出未来方向，以更好地理解其临床和认知关联。
