Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
Castle Peak Hospital, Hong Kong, China.
Asian J Psychiatr. 2024 Nov;101:104211. doi: 10.1016/j.ajp.2024.104211. Epub 2024 Aug 30.
The affective pathway to psychosis implicates affective symptoms and neuroticism as mediating steps between childhood trauma and symptoms of schizophrenia. Prior research seldom examined the interplay between childhood trauma, resilience, personality, social functioning and symptoms in schizophrenia patients. This study recruited 290 schizophrenia patients, and constructed a regularized partial correlation network of childhood trauma, resilience, big-five personality traits, symptoms and social functioning. We further applied flow diagram and shortest path analysis to clarify how different childhood trauma types would contribute to and reach different symptoms. In the network, emotional and physical abuse showed the highest expected influence, and resilience showed the highest strength. In flow diagrams, all nodes together contributed two-thirds of variance of social functioning (which had highest predictability). Among childhood trauma types, emotional abuse contributed most to positive symptoms; physical neglect contributed most to negative, depressive and disorganized symptoms. Childhood abuse reached positive symptoms via neuroticism and depressive symptoms, yet it reached negative symptoms via physical neglect and social functioning. Childhood neglect reached positive symptoms via resilience, conscientiousness, neuroticism and depressive symptoms, yet it reached negative symptoms via social functioning. Our findings support that different childhood trauma types contribute to different symptoms, and interacts with resilience, personality and social functioning.
精神病的情感途径表明,情感症状和神经质是童年创伤与精神分裂症症状之间的中介步骤。先前的研究很少检查精神分裂症患者的童年创伤、适应力、人格、社会功能和症状之间的相互作用。本研究招募了 290 名精神分裂症患者,并构建了一个基于童年创伤、适应力、大五人格特质、症状和社会功能的正则化部分相关网络。我们进一步应用流程图和最短路径分析来阐明不同类型的童年创伤如何导致和到达不同的症状。在网络中,情感和身体虐待显示出最高的预期影响,而适应力则显示出最高的强度。在流程图中,所有节点共同贡献了社会功能三分之二的方差(具有最高的可预测性)。在童年创伤类型中,情感虐待对阳性症状的贡献最大;身体忽视对阴性、抑郁和紊乱症状的贡献最大。童年虐待通过神经质和抑郁症状达到阳性症状,而通过身体忽视和社会功能达到阴性症状。童年忽视通过适应力、尽责性、神经质和抑郁症状达到阳性症状,而通过社会功能达到阴性症状。我们的发现支持不同的童年创伤类型对不同的症状有贡献,并与适应力、人格和社会功能相互作用。