Understanding the longitudinal course of negative symptoms, especially in relationship to functioning, in the early phase of schizophrenia is crucial to developing intervention approaches. The course ...of negative symptoms and daily functioning was examined over a 1-year period following a recent onset of schizophrenia and at an 8-year follow-up point.
The study included 149 recent-onset schizophrenia patients who had a mean age of 23.7 (SD=4.4)years and mean education of 12.9 (SD=2.2)years. Negative symptom (BPRS and SANS) and functional outcome (SCORS) assessments were conducted frequently by trained raters.
After antipsychotic medication stabilization, negative symptoms during the first outpatient year were moderately stable (BPRS ICC=0.64 and SANS ICC=0.66). Despite this overall moderate stability, 24% of patients experienced at least one period of negative symptoms exacerbation. Furthermore, entry level of negative symptoms was significantly associated with poor social functioning (r=−.34, p<.01) and work/school functioning (r=−.25, p<.05) at 12months, and with negative symptoms at the 8-year follow-up (r=.29, p<.05).
Early negative symptoms are fairly stable during the first outpatient year, are predictors of daily functioning at 12months, and predict negative symptoms 8years later. Despite the high levels of stability, negative symptoms did fluctuate in a subsample of patients. These findings suggest that negative symptoms may be an important early course target for intervention aimed at promoting recovery.
Childhood traumatic experiences have been consistently associated with psychosis risk; however, the specificity of childhood trauma type to interview-based attenuated positive psychotic symptoms has ...not been adequately explored. Further, previous studies examining specificity of trauma to specific positive symptoms have not accounted for co-occurring trauma types, despite evidence of multiple victimization.
We examined the relationship between childhood trauma (Childhood Trauma Questionnaire) with type of attenuated positive symptom, as measured by the Structured Interview for Psychosis-risk Syndromes (SIPS) among a non-clinical, young adult sample (
= 130). Linear regressions were conducted to predict each attenuated positive symptom, with all trauma types entered into the model to control for co-occurring traumas.
Results indicated that childhood sexual abuse was significantly associated with disorganized communication and childhood emotional neglect was significantly associated with increased suspiciousness/persecutory ideas, above and beyond the effect of other co-occurring traumas. These relationships were significant even after removing individuals at clinical high-risk (CHR) for psychosis (
= 14).
Our results suggest that there are differential influences of trauma type on specific positive symptom domains, even in a non-clinical sample. Our results also confirm the importance of controlling for co-occurring trauma types, as results differ when not controlling for multiple traumas.
Abstract
Background
Trauma has been consistently associated with psychosis risk; however, the specificity of childhood trauma to individual attenuated positive psychotic symptoms among ...non-help-seeking individuals has not yet been adequately explored, as only one study to date has examined this relationship among help-seeking individuals and focused only on violent vs. non-violent traumatic events, rather than specific types of traumas.
Methods
We examined the relationship between childhood trauma (Childhood Trauma Questionnaire) with type of positive symptom, as measured by the Structural Interview for Psychosis-risk Syndromes (SIPS) among a sample of non-help-seeking undergraduates at a large, ethnically and socioeconomically diverse urban university (n= 130).
Results
Simple linear regressions revealed that any childhood trauma was significantly associated with increased disorganized communication in young adulthood β = .35, t(128) = 4.15, p < .001. Childhood sexual abuse also predicted increased disorganized communication β = .28, t(128) = 3.34, p =.001. Additionally, childhood emotional neglect was significantly associated with increased suspiciousness/persecutory ideas β = .32, t(128)= 3.76, p <.001.
Discussion
This study is the first to identify specific attenuated positive psychotic symptoms linked to childhood traumas in a non-help-seeking sample. Specifically, our results suggest that there are differential influences of trauma type on specific positive symptom domains, which could be of potential use to future identification and prevention efforts.
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