Psychosocial functioning as a mediator between childhood trauma and symptom severity in patients with schizophrenia

Eva Neumann; Jacqueline Rixe; Martin Driessen; Georg Juckel

doi:10.1016/j.chiabu.2023.106372

Psychosocial functioning as a mediator between childhood trauma and symptom severity in patients with schizophrenia

Child Abuse Negl. 2023 Oct:144:106372. doi: 10.1016/j.chiabu.2023.106372. Epub 2023 Jul 25.

Authors

Eva Neumann¹, Jacqueline Rixe², Martin Driessen³, Georg Juckel⁴

Affiliations

¹ Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital of the Ruhr University, Bochum, Germany; Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital of the Heinrich Heine University, Düsseldorf, Germany. Electronic address: eva.neumann@uni-duesseldorf.de.
² Department of Psychiatry and Psychotherapy, University Hospital OWL of the Bielefeld University, Bielefeld, Germany; Institute for Health and Nursing Science, International Graduate Academy, Martin Luther University Halle-Wittenberg, Germany.
³ Department of Psychiatry and Psychotherapy, University Hospital OWL of the Bielefeld University, Bielefeld, Germany.
⁴ Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital of the Ruhr University, Bochum, Germany.

PMID: 37499307
DOI: 10.1016/j.chiabu.2023.106372

Abstract

Background: There is empirical evidence that childhood trauma is associated with symptom severity and psychosocial functioning in schizophrenia.

Objective: The present study aimed to further elucidate these associations by examining which subdomains of schizophrenic symptoms and psychosocial functioning are associated with childhood trauma. In addition, it should be tested whether the association between childhood trauma and schizophrenic symptoms is mediated by psychosocial functioning.

Participants and setting: Participants of this study were 253 inpatients of five psychiatric hospitals diagnosed with schizophrenia. Clinical interviews were conducted with these patients towards the end of therapy.

Methods: Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ), a retrospective self-report scale. Schizophrenic symptoms were measured with the Positive and Negative Syndrome Scale (PANSS) and psychosocial functioning with the Personal and Social Performance Scale (PSP), two measures for ratings by experts.

Results: Most participants were affected by childhood trauma, with 91.7 % reporting at least one trauma. Childhood trauma showed small but significant correlations with positive symptoms and general psychopathology, and also with psychosocial functioning in the occupational and social area and in control over aggressive behavior. Psychosocial functioning was shown to mediate the association between childhood trauma and symptom severity, whereby full mediation was found with regard to positive symptoms and partial mediation with regard to general psychopathology.

Conclusions: The findings suggest that good psychosocial functioning mitigates the negative impact of childhood trauma on illness severity in schizophrenic patients. Therapeutic interventions that promote personal and social resources are therefore useful in the treatment of schizophrenia.

Keywords: Childhood trauma; Emotional abuse; Emotional neglect; Mediation analysis; Psychosocial functioning; Schizophrenia.

Publication types

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

MeSH terms

Adverse Childhood Experiences*
Aggression
Humans
Psychosocial Functioning
Retrospective Studies
Schizophrenia*