Unraveling traumatic and adverse childhood experiences (TRACEs): how are they associated with schizophrenia spectrum disorders?
Unraveling traumatic and adverse childhood experiences (TRACEs): how are they associated with schizophrenia spectrum disorders?
Schizophrenia spectrum disorders are severe mental illnesses that arise from complex interactions between genetic vulnerability and environmental exposures. Childhood adversity (e.g., abuse, neglect, or chronic stress in the family), has consistently been linked to an increased risk of psychosis.
This dissertation of Lan Zhou investigates how traumatic and adverse childhood experiences (TRACEs) are associated with the risk, neurobiological correlates, psychosocial mechanisms, and long-term outcomes of psychotic disorders. A large meta-analysis including more than 349,000 participants showed that individuals exposed to childhood adversity have approximately three times higher odds of developing psychosis compared with those without such experiences. Emotional abuse showed the strongest association.
Using neuroimaging and machine-learning approaches, this thesis further demonstrates that childhood adversity, particularly deprivation (emotional or physical neglect), is associated with signs of accelerated brain aging in adulthood. This finding suggests that early-life stress may have long-lasting biological correlates in the brain.
Psychosocial pathways were examined using network analysis. Results indicate that factors such as low self-esteem, reduced perceived social support, and psychological distress may play key roles in linking childhood adversity with psychotic symptoms and functional difficulties. Longitudinal analyses of individuals with first-episode psychosis further showed that those exposed to multiple forms of childhood trauma tend to experience more severe symptoms, poorer functioning, and lower quality of life over time.
Overall, the findings highlight the importance of early identification of childhood adversity and support the integration of trauma-informed approaches in the prevention and treatment of psychotic disorders.