Storvestre Guttorm Breivik, Jensen Arvid, Bjerke Espen, Tesli Natalia, Rosaeg Cato, Friestad Christine, Andreassen Ole Andreas, Melle Ingrid, Haukvik Unn Kristin
Department of Psychiatry, Ostfold Hospital Trust, Grålum, Norway.
NORMENT, Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.
Front Psychiatry. 2020 May 5;11:383. doi: 10.3389/fpsyt.2020.00383. eCollection 2020.
Childhood trauma is a risk factor for psychosis as well for violent behavior and offending later in life. Childhood trauma comprises subdomains of abuse and neglect that may be differently related to later violence among patients with schizophrenia. The aim of this study was to map the subdomains of childhood trauma associated with violent offending in schizophrenia.
Information on childhood trauma from predominantly male patients with a DSM-IV diagnosis of schizophrenia and a history of violent offending (interpersonal violence) (SCZ-V, n = 19), schizophrenia patients without a history of violence (SCZ-NV, n = 34), and healthy controls (HC, n = 66) was obtained with the Childhood Trauma Questionnaire (CTQ). Differences between groups in total maltreatment scores and the five subdomains including physical, emotional, and sexual abuse, as well as physical and emotional neglect were analyzed.
SCZ-V had the highest median CTQ scores for all sub-domains. SCZ-V reported significantly higher total CTQ scores than SCZ-NV and HC. SCZ-V had significantly higher scores than HC on all subdomains, and significantly higher than SCZ-NV on physical and emotional neglect. SCZ-NV had higher scores on all domains except sexual abuse compared to HC.
SCZ-V patients had higher exposure to childhood trauma than SCZ-NV, and both schizophrenia groups had higher exposure than HC. The results suggest that childhood physical and emotional neglect may be of specific importance to later violence in schizophrenia.
童年创伤是导致精神病以及日后暴力行为和犯罪的一个风险因素。童年创伤包括虐待和忽视等子领域，在精神分裂症患者中，这些子领域与日后暴力行为的关联可能有所不同。本研究的目的是梳理出与精神分裂症暴力犯罪相关的童年创伤子领域。
使用儿童创伤问卷（CTQ）获取了主要为男性的患者的童年创伤信息，这些患者被诊断为DSM-IV精神分裂症且有暴力犯罪史（人际暴力）（SCZ-V组，n = 19）、无暴力史的精神分裂症患者（SCZ-NV组，n = 34）以及健康对照者（HC组，n = 66）。分析了各组在总虐待得分以及包括身体虐待、情感虐待、性虐待以及身体忽视和情感忽视在内的五个子领域方面的差异。
SCZ-V组在所有子领域的CTQ中位数得分最高。SCZ-V组报告的CTQ总得分显著高于SCZ-NV组和HC组。SCZ-V组在所有子领域的得分均显著高于HC组，在身体忽视和情感忽视方面显著高于SCZ-NV组。与HC组相比，SCZ-NV组在除性虐待外的所有领域得分更高。
SCZ-V组患者比SCZ-NV组遭受更多的童年创伤，且两个精神分裂症组比HC组遭受的童年创伤更多。结果表明，童年期的身体和情感忽视可能对精神分裂症患者日后的暴力行为具有特殊重要性。
