Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; Department of Clinical and Experimental Medicine, University of Messina, Italy.
Compr Psychiatry. 2024 Aug;133:152496. doi: 10.1016/j.comppsych.2024.152496. Epub 2024 May 3.
Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia.
We approached 241 adults suffering from schizophrenia spectrum disorders (SSDs), who have been in the unit for at least 12 consecutive months, excluding the diagnosis of dementia, and recent substance abuse disorder, and cross-sectional evaluated through the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire Short-Form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). We tested a path-diagram where AS mediated the relationship between CTA and psychosis, after verifying each measure one-dimensionality through confirmatory factor analysis.
The final sample comprised 222 patients (36.9% female), with a mean age of 42.4 (± 13.3) years and an average antipsychotic dose of 453.6 (± 184.2) mg/day (chlorpromazine equivalents). The mean duration of untreated psychosis was 1.8 (± 2.0) years while the mean onset age was 23.9 (± 8.2) years. Significant paths were found from emotional abuse to ASI total score (β = 0.39; p < .001) and from ASI total score to PANSS positive (β = 0.17; p = .019). Finally, a statistically significant indirect association was found from emotional abuse to PANSS positive mediated by ASI total score (β = 0.06; p = .041; CI 95% [0.01, 0.13]).
Emotional abuse has an AS-mediated effect on positive psychotic symptomatology. AS evaluation could allow a better characterization of psychosis as well as explain the presence of positive symptoms in adults with SSDs who experienced CTA.
童年创伤和逆境（CTA）和异常突显（AS）在精神分裂症的发展中起着关键作用，但它们与精神病症状的相互作用仍不清楚。我们探讨了 AS 在精神分裂症中CTA 和精神病症状之间的中介作用。
我们接触了 241 名患有精神分裂症谱系障碍（SSDs）的成年人，他们在单位至少连续 12 个月，排除痴呆和近期物质滥用障碍的诊断，并通过异常突显量表（ASI）、童年创伤问卷短表（CTQ-SF）和阳性和阴性症状量表（PANSS）进行横断面评估。我们通过验证每个措施的一维性，通过验证性因素分析测试了一个路径图，其中 AS 介导了 CTA 和精神病之间的关系。
最终样本包括 222 名患者（36.9%为女性），平均年龄为 42.4（±13.3）岁，平均抗精神病药物剂量为 453.6（±184.2）mg/天（氯丙嗪当量）。未治疗精神病的平均持续时间为 1.8（±2.0）年，平均发病年龄为 23.9（±8.2）岁。发现从情感虐待到 ASI 总分（β=0.39；p<0.001）和从 ASI 总分到 PANSS 阳性（β=0.17；p=0.019）有显著路径。最后，发现从情感虐待到 PANSS 阳性的统计学上显著间接关联，通过 ASI 总分中介（β=0.06；p=0.041；95%CI[0.01, 0.13]）。
情感虐待对阳性精神病症状有 AS 介导的影响。AS 评估可以更好地描述精神病，也可以解释经历 CTA 的 SSD 成年患者出现阳性症状的原因。
