Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Schizophr Bull. 2024 Jul 27;50(4):903-912. doi: 10.1093/schbul/sbae023.
Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood.
We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula.
In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results.
Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.
童年逆境常被描述为发生精神病性体验的潜在原因，但潜在机制尚不清楚。我们旨在研究认知和精神病理学因素在童年逆境与成年早期发生精神病性体验之间的关系中的中介作用。
我们分析了来自父母与子女纵向研究（Avon Longitudinal Study of Parents and Children）的数据，这是一项大型基于人群的队列研究。童年逆境从出生到 11 岁前瞻性测量，中介因素（焦虑、抑郁、外部心理控制[LoC]、负性症状）在大约 16 岁时评估，成年早期在 18 岁和 24 岁时评估发生精神病性体验。通过反事实 g 计算公式来检验中介作用。
总共有 7%的参与者在成年早期发生疑似或明确的精神病性体验。童年逆境与更多的精神病性体验相关（调整后的 OR=1.34，95%CI=1.21；1.49），这种关联部分通过所有检查的中介因素来介导（介导比例：19.9%）。在每个中介因素的单独分析中，焦虑、抑郁、外部 LoC 和负性症状都被发现介导了逆境与精神病性体验之间的联系。考虑到潜在的混杂因素并没有改变我们的结果。
我们的研究表明，认知偏差以及情绪症状可能是早期生活逆境与精神病性体验发展之间的因果途径。未来的研究应该确定哪些中介因素最容易改变，最有可能降低发生精神病性体验的风险。
