The relationship between childhood trauma, psychotic symptoms, and cognitive schemas in patients with schizophrenia, their siblings, and healthy controls: results from the EU-GEI study

Alp Üçok*, Handan Noyan, Sinan Gülöksüz, Meram Can Saka, Köksal Alptekin, Cem Atbaşoğlu, Elçin Akturan, Gülşah Karadayı, Zeynep Baran Tatar, Berna Akdede, Tolga Binbay, Vesile Altınyazar, Halis Ulaş, Berna Yalınçetin, Güvem Gümüş-Akay, Burçin Cihan, Haldun Soygür, Eylem Şahin Cankurtaran, Semra Ulusoy Kaymak, Bart P F RuttenJim van Os

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The relationship between childhood trauma (CT) and psychotic symptoms in patients with schizophrenia (SCZ), and subthreshold psychotic experiences in non-clinical populations is well-established. However, little is known about the relationship between subtypes of trauma and specific symptoms in patients, their siblings, and controls. It is also not clear which variables mediate the relationship between trauma and psychotic symptoms.

METHODS: Seven hundred and forty-two patients with SCZ, 718 of their unaffected siblings and 1039 controls from three EU-GEI sites were assessed for CT, symptom severity, and cognitive schemas about self/others. CT was assessed with the Childhood Trauma Questionnaire, and cognitive schemas were assessed by The Brief Core Schema Scale.

RESULTS: Patients with psychosis were affected by CT more than their siblings and controls in all domains. Childhood emotional abuse and neglect were more common in siblings than controls. CT was related to negative cognitive schemas toward self/others in patients, siblings, and controls. We found that negative schemas about self-mediated the relationship between emotional abuse and thought withdrawal and thought broadcasting. Approximately 33.9% of the variance in these symptoms was explained by the mediator. It also mediated the relationship between sexual abuse and persecutory delusions in SCZ.

CONCLUSIONS: Our findings suggest that childhood abuse and neglect are more common in patients with schizophrenia than their siblings and healthy controls, and have different impacts on clinical domains which we searched. The relationship between CT and positive symptoms seems to be mediated by negative cognitive schemas about self in schizophrenia.

Original languageEnglish
Pages (from-to)2414-2425
Number of pages12
JournalPsychological medicine
Volume54
Issue number10
Early online date12 Apr 2024
DOIs
Publication statusPublished - Jul 2024

Keywords

  • childhood trauma
  • cognitive schemas
  • psychotic symptoms
  • schizophrenia
  • unaffected siblings

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