Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis

  • Jacqueline Stowkowy
  • Lu Liu
  • Kristin S. Cadenhead
  • Tyrone D. Cannon
  • Barbara A. Cornblatt
  • Thomas H. McGlashan
  • Diana O. Perkins
  • Larry J. Seidman
  • Ming T. Tsuang
  • Elaine F. Walker
  • Scott W. Woods
  • Carrie E. Bearden
  • Daniel H. Mathalon
  • Jean Addington
Original Paper



There is evidence to suggest that both early traumatic experiences and perceived discrimination are associated with later onset of psychosis. Less is known about the impact these two factors may have on conversion to psychosis in those who are at clinical high risk (CHR) of developing psychosis. The purpose of this study was to determine if trauma and perceived discrimination were predictors of conversion to psychosis.


The sample consisted of 764 individuals who were at CHR of developing psychosis and 280 healthy controls. All participants were assessed on past trauma, bullying and perceived discrimination.


Individuals at CHR reported significantly more trauma, bullying and perceived discrimination than healthy controls. Only perceived discrimination was a predictor of later conversion to psychosis.


Given that CHR individuals are reporting increased rates of trauma and perceived discrimination, these should be routinely assessed, with the possibility of offering interventions aimed at ameliorating the impact of past traumas as well as improving self-esteem and coping strategies in an attempt to reduce perceived discrimination.


Clinical high risk Psychosis Trauma Perceived discrimination Prodrome Risk 



The authors thank the NAPLS group: T Raedler, L McGregor, D Marulanda, L Legere, L Marshall, E Falukozi, E Fitton, K Smith, (University of Calgary). T Alderman, K Shafer, I Domingues, A Hurria, H Mirzakhanian (UCSD). B Walsh, J Saksa, N Santamauro, A Carlson, J Kenney, B Roman (Yale University). K Woodberry, AJ Giuliano, W Stone, JM Rodenhiser, L Tucker, R Serur, G Min, R Szent-Imrey (Beth Israel Deaconess Medical Center/Harvard). C Bearden, P Bachman, J Zinberg, S DeSilva, A Andaya, S Uguryan (UCLA). J Brasfield, H Trotman, (Emory University). A Pelletier, K Lansing, H Mates, J Nieri, B Landaas, K Graham, E Rothman, J Hurta, Y Sierra (University of North Carolina). A Auther, R Carrion, M McLaughlin, R Olsen (Zucker Hillside Hospital).

Compliance with ethical standards

Funding source

This study was supported by the National Institute of Mental Health (Grant U01MH081984 to Dr Addington; Grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to Dr Seidman; Grants R01 MH60720, U01 MH082022 and K24 MH76191 to Dr Cadenhead; Grant U01MH081902 to Dr Cannon; Grant U01MH082004-01A1 to Dr Perkins; Grant U01MH081988 to Dr Walker; Grant U01MH082022 to Dr Woods; and UO1 MH081857-05 Grant to Dr Cornblatt. The NIMH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jacqueline Stowkowy
    • 1
  • Lu Liu
    • 1
  • Kristin S. Cadenhead
    • 2
  • Tyrone D. Cannon
    • 4
  • Barbara A. Cornblatt
    • 3
  • Thomas H. McGlashan
    • 4
  • Diana O. Perkins
    • 5
  • Larry J. Seidman
    • 6
  • Ming T. Tsuang
    • 2
  • Elaine F. Walker
    • 7
  • Scott W. Woods
    • 4
  • Carrie E. Bearden
    • 8
  • Daniel H. Mathalon
    • 9
  • Jean Addington
    • 1
  1. 1.Department of Psychiatry, Mathison Centre for Mental Health Research and EducationUniversity of CalgaryCalgaryCanada
  2. 2.Department of PsychiatryUCSDLa JollaUSA
  3. 3.Department of PsychiatryZucker Hillside HospitalLong IslandUSA
  4. 4.Department of PsychiatryYale UniversityNew HavenUSA
  5. 5.Department of PsychiatryUniversity of North CarolinaChapel HillUSA
  6. 6.Department of PsychiatryHarvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General HospitalBostonUSA
  7. 7.Departments of Psychology and PsychiatryEmory UniversityAtlantaUSA
  8. 8.Departments of Psychology and Psychiatry and Biobehavioral SciencesUCLALos AngelesUSA
  9. 9.Department of PsychiatryUCSFSan FranciscoUSA

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