The association between premorbid adjustment and childhood trauma in first-episode schizophrenia spectrum disorders

Smit, Anna Margaretha (2020-12)

Thesis (MA)--Stellenbosch University, 2020.

Thesis

Introduction: Childhood trauma is a worldwide phenomenon that refers to a broad range of adverse experiences occurring during childhood and adolescence, including emotional, sexual and physical abuse, as well as physical and emotional neglect. Childhood trauma is a risk factor for schizophrenia. However, the mechanisms whereby childhood trauma contributes to the risk for schizophrenia remain unclear. One possible mechanism could be that a history of childhood trauma contributes to poorer premorbid adjustment as an indicator of neurodevelopmental compromise and a proxy for those who go on to develop schizophrenia. The objectives of the present study were to examine the associations of childhood trauma type and timing with premorbid functioning in first-episode schizophrenia spectrum disorders (FES). Methods: The present cross-sectional study included 111 individuals with FES. Patients were assessed using the Childhood Trauma Questionnaire, short form (CTQ-SF), the Life Events Checklist (LEC-5), the Premorbid Adjustment Scale (PAS), and the Life Events Timeline. Pearson correlations were calculated to determine the linear associations of different childhood trauma subtypes with specific domains of premorbid adjustment. The initial analyses were used to inform subsequent hierarchical regressions modelling for the effects of childhood trauma on premorbid functioning. Results: Total childhood trauma scores did not demonstrate a significant relationship with overall premorbid adjustment. However, physical neglect showed a significant relationship with poorer premorbid social adjustment in early adolescence. Furthermore, timing of childhood trauma did not moderate the relationship between childhood trauma and premorbid adjustment. Conclusion: Physical neglect could increase the risk for schizophrenia through mechanisms that negatively affect premorbid adjustment. The study highlights the impact of socio-economic circumstances on mental health. This is an important topic for mental health professionals working in South Africa, a country with high levels of poverty. However, the study was cross-sectional in nature, and therefore causality could not be inferred. It would be important to replicate the study findings in a larger representative sample and to conduct a longitudinal study to determine if childhood physical neglect has long-lasting effects on patient outcomes.

Inleiding: Trauma tydens kinderjare kom wêreldwyd voor. Trauma tydens kinderjare verwys na ‘n breë spektrum van ongewenste ervaringe wat gedurende kinderjare en adolossensie plaasvind en sluit in emosionele, seksuele en fisiese mishandeling, asook fisiese en emosionele verwaarlosing. Individue wat gedurende hulle kinderjare trauma ervaar het, het ‘n groter kans om skisofrenie te ontwikkel as diegene wat geen trauma ervaar het nie. Nie te min, presies hoe hierdie trauma bydra tot die ontwikkelling van skisofrenie is steeds onduidelik. Een moontlike meganisme is dat ‘n geskiedenis van kinderjare trauma bydra tot swakker premorbiede aanpassing. Premorbiede aanpassing is ‘n indikasie van neuro-ontwikkelings agterstande en ‘n voorloper vir diegene wat dan later skisofrenie ontwikkel. Die doel van die huidige studie was om die assosiasies van kinderjare trauma, tipe en tydperk met premorbiede aannpassing te bestudeer, in ‘n steekproef van eerste-episode skisofrenie spektrum versteurings (EEV). Metode: Die studie het gebruik gemaak van ‘n kruis-deursnit ontwerp en het 111 individue met EEV ingesluit. Die pasiënte was ge-evalueer met die verkorte weergawe van die Kinderjare Trauma Vraelys (CTQ-SF), die Lewens Gebeurtenisse Kontrole Lys (LEC-5), die Premorbiede Aanpassings Skaal (PAS) en die Lewens Ervaringe Tydlyn. Pearson korrelasies was gedoen om potensieële korrelasies tussen kinderjare trauma veranderlikes en premorbiede aanpassing te identifiseer. Die inisieële analiese was gedoen om ‘n daarop volgende hiërargiese regressie model te lei, in die ondersoek na die effek van kinderjare trauma op premorbiede funksionering. Resultate: Die totale kinderjare trauma telling het nie ‘n beduidende verwantskap met globale premorbiede aanpassing getoon nie. ‘n Beduidende verwantskap tussen fisiese verwaarlosing en swakker sosiale premorbiede aanpassing gedurende vroeë adolossensie was wel bevind. Verder was die tydperk van kinderjare trauma nie ‘n moderator van die verhouding tussen kinderjare trauma en premorbiede aanpassing nie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/109074
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