School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia.
Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Br J Clin Psychol. 2022 Jun;61(2):444-464. doi: 10.1111/bjc.12349. Epub 2021 Nov 24.
Risk for psychosis in the general population is characterized by a set of multidimensional traits that are referred to as schizotypy. Higher levels of schizotypy are associated with socioeconomic disadvantage and childhood trauma, just as these risk factors are associated with schizophrenia and bipolar disorder. Here, we set out to investigate whether cumulative sociodemographic disadvantage mediates associations between childhood trauma and schizotypy in adulthood.
A sociodemographic cumulative risk (SDCR) score was derived from six risk indices spanning employment, education, income, socioeconomic status, marital, and living circumstances for 197 participants that included both healthy (n = 57) and clinical samples with schizophrenia or schizoaffective disorder (n = 65) or bipolar disorder (n = 75). A series of multiple linear regressions was used to examine the direct and indirect associations among childhood trauma (measured with the Childhood Trauma Questionnaire), the SDCR index, and levels of schizotypy (measured with the Schizotypal Personality Questionnaire).
Schizotypy was independently associated with trauma and the SDCR index. In addition, the SDCR index partially mediated associations between trauma and schizotypy.
These findings in a mixed sample of healthy and clinical participants represent the full spectrum of schizotypy across health and illness and suggest that effects of childhood trauma on schizotypal personality organization may operate via cumulative socioeconomic disadvantage in adulthood.
The strong associations between trauma and schizotypy suggest that systematic health screening of children exposed to early life trauma may assist to identify those at risk of developing psychosis. Clinicians should pay attention to various indicators of sociodemographic disadvantage in patients prone to psychosis, in addition to any exposure to trauma during childhood.
一般人群的精神病风险特征是一组多维特质，称为精神分裂症特质。较高水平的精神分裂症特质与社会经济劣势和儿童创伤有关，就像这些风险因素与精神分裂症和双相情感障碍有关一样。在这里，我们着手研究童年创伤与成年期精神分裂症特质之间的关联是否受到累积社会人口劣势的影响。
从跨越就业、教育、收入、社会经济地位、婚姻和生活环境的六个风险指数中得出一个社会人口累积风险（SDCR）评分，该评分包括 197 名参与者，其中包括健康组（n=57）和临床组，临床组包括精神分裂症或分裂情感障碍（n=65）或双相情感障碍（n=75）。使用一系列多元线性回归来检验童年创伤（用儿童期创伤问卷测量）、SDCR 指数和精神分裂症特质水平（用精神分裂症人格问卷测量）之间的直接和间接关联。
精神分裂症特质与创伤和 SDCR 指数独立相关。此外，SDCR 指数部分中介了创伤与精神分裂症特质之间的关联。
在健康和临床参与者的混合样本中，这些发现代表了健康和疾病中精神分裂症特质的全貌，并表明童年创伤对精神分裂症人格组织的影响可能通过成年后累积的社会经济劣势起作用。
创伤与精神分裂症特质之间的强烈关联表明，对暴露于早期生活创伤的儿童进行系统的健康筛查可能有助于识别那些有发展精神病风险的人。临床医生除了关注儿童时期的任何创伤暴露外，还应注意易患精神病的患者中各种社会人口劣势的指标。
