Childhood adversities and psychotic symptoms: The potential mediating or moderating role of neurocognition and social cognition

Giovanni Mansueto; Koen Schruers; Fiammetta Cosci; Jim van Os; GROUP Investigators

doi:10.1016/j.schres.2018.11.028

Childhood adversities and psychotic symptoms: The potential mediating or moderating role of neurocognition and social cognition

Schizophr Res. 2019 Apr:206:183-193. doi: 10.1016/j.schres.2018.11.028. Epub 2018 Dec 5.

Authors

Giovanni Mansueto¹, Koen Schruers², Fiammetta Cosci³, Jim van Os⁴; GROUP Investigators

Collaborators

GROUP Investigators:
Behrooz Z Alizadeh⁵, Agna A Bartels-Velthuis⁵, Nico J van Beveren⁶, Richard Bruggeman⁵, Wiepke Cahn⁷, Lieuwe de Haan⁸, Philippe Delespaul⁹, Carin J Meijer⁸, Inez Myin-Germeys¹⁰, Rene S Kahn⁷, Frederike Schirmbeck⁸, Claudia J P Simons¹¹, Neeltje E M van Haren⁷, Ruud van Winkel¹⁰

Affiliations

¹ Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Health Sciences, University of Florence, Florence, Italy. Electronic address: mansuetogiovannipsy@gmail.com.
² Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands.
³ Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Health Sciences, University of Florence, Florence, Italy.
⁴ Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; King's College London, King's Health Partners, Dept. of Psychosis Studies, Institute of Psychiatry, London, United Kingdom.
⁵ University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands.
⁶ Antes Center for Mental Health Care, Rotterdam, the Netherlands; Erasmus MC, Dept of Psychiatry, Dept. of Neuroscience, Rotterdam, the Netherlands.
⁷ University Medical Centre Utrecht, Dept. of Psychiatry, Brain Centre Rudolf Magnus, Utrecht, the Netherlands.
⁸ Academic Medical Centre, University of Amsterdam, Dept. of Psychiatry, Amsterdam, the Netherlands.
⁹ Department of Health Sciences, University of Florence, Florence, Italy.
¹⁰ KU Leuven, Dept. of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium.
¹¹ Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.

PMID: 30527930
DOI: 10.1016/j.schres.2018.11.028

Abstract

Introduction: Childhood abuse and neglect are risk factors for psychotic symptoms. Early adversities may contribute to alterations in neuro/social cognition, which in turn is associated with psychosis. This study explored the possible mediating/moderating role of neuro/social cognition between childhood abuse and neglect on the one hand, and psychotic symptoms on the other.

Method: The sampling frame was 1.119 patients with a psychotic disorder. Childhood adversity was evaluated with the Dutch version of the Childhood Trauma Questionnaire. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Verbal learning-memory, attention-vigilance, working memory, information processing speed, reasoning-problem solving were evaluated as measures of neurocognition using the Word Learning Task, the Continuous Performance Test, the Wechsler Adult Intelligence Scale 3rd. Mentalization was evaluated as a measure of social cognition using the Hinting Task. Correlation, mediation, moderation, 95% Bias Corrected and accelerated (BCaCI) bootstrapped analyses were performed, considering possible sex differences.

Results: In male psychotic patients, attention and vigilance mediated the association between childhood neglect and negative symptoms (indirect effect: 0.18, BCaCI: 0.03-0.54), disorganization (indirect effect: 0.26, BCaCI: 0.05-0.61), excitement (indirect effect: 0.07, BCaCI: 0.004-0.23); mentalization mediated the association between childhood neglect and negative symptoms (indirect effect: 0.21, BCaCI: 0.02-0.51), excitement (indirect effect: 0.07, BCaCI: 0.01-0.20) disorganization (indirect effect: 0.29, BCaCI: 0.02-0.64); working memory mediated the association between childhood abuse and disorganization (indirect effect: 0.28, BCaCI: 0.05-0.57), excitement (indirect effect: 0.08, BCaCI: 0.01-0.20), emotional distress (indirect effect: 0.10, BCaCI: 0.01-0.27).

Discussion: In psychotic disorder, sex-specific mediation of neurocognition and mentalization may exist in the association between childhood adversity and psychotic symptoms.

Keywords: Childhood abuse; Childhood neglect; Neurocognition; Social cognition.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Adverse Childhood Experiences*
Attention / physiology*
Emotions / physiology*
Female
Humans
Longitudinal Studies
Male
Memory, Short-Term / physiology*
Mentalization / physiology*
Middle Aged
Psychological Distress
Psychotic Disorders / physiopathology*
Sex Factors
Social Perception*
Thinking / physiology*
Young Adult