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童年逆境对精神分裂症认知发展的影响。

The Impact of Childhood Adversity on Cognitive Development in Schizophrenia.

机构信息

School of Psychiatry, University of New South Wales, Sydney, Australia.

Neuroscience Research Australia, Randwick, Sydney, Australia.

出版信息

Schizophr Bull. 2020 Jan 4;46(1):140-153. doi: 10.1093/schbul/sbz033.

Abstract

Childhood adversity, such as physical, sexual, and verbal abuse, as well as neglect and family conflict, is a risk factor for schizophrenia. Such adversity can lead to disruptions of cognitive function during development, undermining intellectual capabilities and academic achievement. Schizophrenia is a neurodevelopmental disorder that is associated with cognitive impairments that may become evident during childhood. The Australian Schizophrenia Research Bank database comprises a large community cohort (N = 1169) in which we previously identified 3 distinct cognitive groups among people with schizophrenia: (1) Compromised, current, and estimated premorbid cognitive impairment; (2) Deteriorated, substantial decline from estimated premorbid function; and (3) Preserved, performing in the normal cognitive range without decline. The compromised group displayed the worst functional and symptom outcomes. Here, we extend our previous work by assessing the relationship among these categories of cognitive abilities and reported childhood adversity in 836 patients and healthy controls. Exploratory factor analysis of the Childhood Adversity Questionnaire revealed 3 factors (lack of parental involvement; overt abuse; family breakdown and hardship). People with schizophrenia reported significantly more childhood adversity than healthy controls on all items and factors. People with schizophrenia in the compromised group reported significantly more lack of parental involvement and family breakdown and hardship and lower socioeconomic status than those in the deteriorated group. The cognitive groups were not related to family history of psychosis. These findings identify specific social and family factors that impact cognition, highlighting the important role of these factors in the development of cognitive and functional abilities in schizophrenia.

摘要

儿童时期的逆境经历,如身体、性和言语虐待,以及忽视和家庭冲突,是精神分裂症的一个风险因素。这种逆境可能导致认知功能在发育过程中受到干扰,从而削弱智力能力和学业成绩。精神分裂症是一种神经发育障碍,与认知障碍有关,这些障碍可能在儿童时期就表现出来。澳大利亚精神分裂症研究银行数据库包含一个大型社区队列(N=1169),我们之前在其中确定了精神分裂症患者中的 3 个不同认知群体:(1)受损、当前和估计的发病前认知障碍;(2)恶化,从估计的发病前功能显著下降;(3)保存,在正常认知范围内没有下降。受损组的功能和症状结果最差。在这里,我们通过评估这些认知能力类别与 836 名患者和健康对照组报告的儿童期逆境之间的关系,扩展了我们之前的工作。童年逆境问卷的探索性因素分析显示出 3 个因素(父母参与度不足;公然虐待;家庭破裂和困难)。与健康对照组相比,精神分裂症患者在所有项目和因素上都报告了更多的儿童期逆境。在受损组中,与恶化组相比,认知障碍组的精神分裂症患者报告了更多的父母参与度不足、家庭破裂和困难以及较低的社会经济地位。认知组与精神病家族史无关。这些发现确定了影响认知的具体社会和家庭因素,突出了这些因素在精神分裂症认知和功能能力发展中的重要作用。

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