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neuropsychiatrie

, Volume 27, Issue 1, pp 21–37 | Cite as

Trauma und Psychose – Teil 2

Zur Assoziation frühkindlicher Traumatisierungen und Psychoserisiko in der Allgemeinbevölkerung
  • Hans-Peter KapfhammerEmail author
übersicht
  • 330 Downloads

Zusammenfassung

Epidemiologische Studien eignen sich in besonderer Weise, den potentiellen Zusammenhang von frühkindlichen Traumatisierungen und nachfolgender psychotischer Symptombildung zu untersuchen. Als primäres Outcome-Kriterium fungiert bei diesem Ansatz die Prävalenz von nicht-klinischen psychotischen Symptomen bei traumaexponierten Personen im Vergleich zu nicht traumatisierten Kontrollgruppen aus der Allgemeinbevölkerung. Mittlerweile existiert eine Fülle von methodisch guten epidemiologischen Studien, die diesen Zusammenhang für Populationen in der Kindheit, in der Adoleszenz und im Erwachsenenalter überzeugend belegen. Im Anschluss hieran stellen sich einerseits Fragen, über welche psychologischen, psychosozialen und neurobiologischen Mechanismen ein erhöhtes Psychoserisiko früher Traumatisierungen vermittelt werden kann, und andererseits Fragen, welche Faktoren den Übergang dieser mehrheitlich subklinischen psychotischen Symptome in klinisch relevante Formen psychotischer Störungen bestimmen. Sowohl theoretische Modelle als auch empirische Daten aus ersten Studien werden dargestellt.

Schlüsselwörter

Trauma Frühkindlicher Missbrauch Psychotische Symptome Epidemiologisch Allgemeinbevölkerung Vermittlungsmechanismus Psychose-Kontinuum 

Trauma and psychosis—part 2 – On the association of early childhood maltreatment and risk of psychosis in general population

Summary

Any association of early childhood maltreatment and later risk of psychosis may be favourably investigated by epidemiological studies in the general population. Primary outcome variable in these studies is the prevalence of subclinical psychotic symptoms (hallucinations, delusions) in early trauma-exposed groups compared to control groups without any significant trauma in childhood. A systematic literature search underlines a significant association of early childhood trauma and later non-clinical psychotic symptoms in representative samples of the general population both during childhood, adolescence and adulthood. Important questions deal with the issues, which psychological, psychosocial and neurobiological mechanisms may mediate the risk of early trauma in respect of later psychotic symptoms on the one side, and which factors may determine the transition from non-clinical psychotic symptoms to major psychotic disorders cared for within mental health services. Both theoretical models and first data derived from empirical studies will be presented.

Keywords

Trauma Early childhood abuse Psychotic symptoms Epidemiological General population Mechanism of mediation Transition over psychosis continuum 

Notes

Interessenkonflikt

Es besteht kein Interessenkonflikt.

Literatur

  1. 1.
    Aas M, Djurovic S, Athanasiu L, et al. Serotonin transporter gene polymorphism, childhood trauma, and cognition in patients with psychotic disorders. Schizophr Bull. 2012;38:15–22.PubMedCrossRefGoogle Scholar
  2. 2.
    Armando M, Nelson B, Yung AR, Ross M, et al. Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophr Res. 2010;119:258–65.PubMedCrossRefGoogle Scholar
  3. 3.
    Arseneault L, Cannon M, Fisher HL, Polanczyk G, Moffitt TE, Caspi A. Childhood trauma and children’s emerging psychotic symptoms: a genetically sensitive longitudinal cohort study. Am J Psychiatry. 2011;168:65–72.PubMedCrossRefGoogle Scholar
  4. 4.
    Bak M, Krabbendam L, Janssen I, et al. Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control. Acta Psychiatr Scand. 2005;112:360–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Bebbington P. Childhood sexual abuse and psychosis: aetiology and mechanism. Epidemiol Psichiatr Soc. 2009;18:284–93.PubMedGoogle Scholar
  6. 6.
    Bebbington P, Jonas S, Kuipers E, et al. Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England. Br J Psychiatry. 2011b;199:29–37.CrossRefGoogle Scholar
  7. 7.
    Bebbington PE. Why psychiatry has to be social. In: Morgan C, Bhugra D, Herausgeber. Principles of social psychiatry. 2. Aufl. Chichester: Wiley; 2010. S. 13–29.Google Scholar
  8. 8.
    Bebbington PE, Bhugra D, Brugha T, et al. Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. Br J Psychiatry. 2004;185:220–26.PubMedCrossRefGoogle Scholar
  9. 9.
    Bentall RP, Fernyhough C. Social predictors of psychotic experiences: specificity and psychological mechanisms. Schizophr Bull. 2008;34:1012–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Binder PE. At the verge of unthinkable anxiety: on the relevance of a neurophysiologically informed relational perspective on meaning making in psychosis. Int For Psychoanal. 2006;15:201–11.CrossRefGoogle Scholar
  11. 11.
    Birchwood M. Pathways to emotional dysfunction in first-episode psychosis. Br J Psychiatry. 2003;182:373–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Brewin CR, Gregory JD, Lipton M, Burgess N. Intrusive images in psychiatric disorders: Characteristics, neural mechanisms, and treatment implications. Psychol Rev. 2010;117:210–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Collip D, van Winkel R, Peerbooms O, et al. COMT Val158Met-stress interaction in psychosis: role of background psychosis risk. CNS Neurosci Ther. 2011;17:612–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Cougnard A, Marcelis M, Myin-Germeys I, et al. Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model. Psychol Med. 2007;37:513–27.PubMedCrossRefGoogle Scholar
  15. 15.
    Cutajar MC, Mullen PE, Ogloff JR, et al. Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Arch Gen Psychiatry. 2010;67:1114–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Delima J, Vimpani G. The neurobiological effects of childhood maltreatment. An often overlooked narrative related to the long-term effects of early childhood trauma? Fam Matters. 2011;89:42–52.Google Scholar
  17. 17.
    Famularo R, Kinscherff R, Fenton T. Psychiatric diagnoses of maltreated children: preliminary findings. J Am Acad Child Adolesc Psychiatry. 1992;31:863–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Famularo R, Kinscherff R, Fenton T. Psychiatric diagnoses of abusive mothers. A preliminary report. J Nerv Ment Dis. 1992;180:658–61.PubMedCrossRefGoogle Scholar
  19. 19.
    Fisher H, Craig T. Childhood adversity and psychosis. In: Morgan C, McKenzie K, Fearon P, Herausgeber. Society and psychosis. Cambridge: Cambridge University Press; 2008. S. 95–111.Google Scholar
  20. 20.
    Fowler D, Freeman D, Steel C, et al. The catastrophic interaction hypothesis. How do trauma, stress, emotion and information processing abnormalities lead to psychosis. In: Larkin W, Morrison AP, Herausgeber. Trauma and psychosis: new directions of theory and therapy. London: Routledge, Taylor & Francis; 2006. S. 101–24.Google Scholar
  21. 21.
    Freeman D, Fowler D. Routes to psychotic symptoms: trauma, anxiety and psychosis-like experiences. Psychiatry Res. 2009;169:107–12.PubMedCrossRefGoogle Scholar
  22. 22.
    Galletly C, Van Hooff M, McFarlane A. Psychotic symptoms in young adults exposed to childhood trauma – a 20 year follow-up study. Schizophr Res. 2011;127:76–82.PubMedCrossRefGoogle Scholar
  23. 23.
    Gould F, Clarke J, Heim C, et al. The effects of child abuse and neglect on cognitive functioning in adulthood. J Psychiatr Res. 2012;46:500–6.Google Scholar
  24. 24.
    Gracie A, Freeman D, Green S, et al. The association between traumatic experience, paranoia and hallucinations: a test of the predictions of psychological models. Acta Psychiatr Scand. 2007;116:280–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Gumley A, Schwannauer W. Staying well after psychosis: a cognitive interpersonal approach to recovery and relapse prevention. Chichester: Wiley; 2006.Google Scholar
  26. 26.
    Hardy A, Fowler D, Freeman D, et al. Trauma and hallucinatory experience in psychosis. J Nerv Ment Dis. 2005;193:501–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Harley M, Kelleher I, Clarke M, et al. Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence. Psychol Med. 2010;40:1627–34.PubMedCrossRefGoogle Scholar
  28. 28.
    Heim C, Shugart M, Craighead WE, Nemeroff CB. Neurobiological and psychiatric consequences of child abuse and neglect. Dev Psychobiol. 2010;52:671–90.PubMedCrossRefGoogle Scholar
  29. 29.
    Holtzman CW, Shapiro DI, Trotman HD, Walker EF. Stress and the prodromal phase of psychosis. Curr Pharm Des. 2012;18:527–33.Google Scholar
  30. 30.
    Houston JE, Murphy J, Adamson G, et al. Childhood sexual abuse, early cannabis use, and psychosis: testing an interaction model based on the National Comorbidity Survey. Schizophr Bull. 2008;34:580–5.PubMedCrossRefGoogle Scholar
  31. 31.
    Houston JE, Murphy J, Shevlin M, Adamson G. Cannabis use and psychosis: re-visiting the role of childhood trauma. Psychol Med. 2011;18:1–10.Google Scholar
  32. 32.
    Hoy K, Barrett S, Shannon C, et al. Childhood Trauma and Hippocampal and Amygdalar Volumes in First-Episode Psychosis. Schizophr Bull 2011. Epub ahead of print.Google Scholar
  33. 33.
    Janssen I, Krabbendam L, Bak M, et al. Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand. 2004;109:38–45.PubMedCrossRefGoogle Scholar
  34. 34.
    Janssen I, Krabbendam L, Hanssen M, et al. Are apparent associations between parental representations and psychosis risk mediated by early trauma? Acta Psychiatr Scand. 2005;112:372–5.PubMedCrossRefGoogle Scholar
  35. 35.
    Kapfhammer HP. Zur Psychodynamik der Paranoia: Ein psychoanalytischer Beitrag zum Verständnis paranoider Persönlichkeiten. Psyche. 2001;55:435–503.Google Scholar
  36. 36.
    Kapfhammer HP. Zur Entwicklungspsychologie psychotischer Zustände. In: Schwarz F, Tabbert-Haugg C, Hering W, Wendl-Kempmann G, Kapfhammer HP, Herausgeber. Psychodynamik und Psychotherapie der Psychosen. Stuttgart: Kohlhammer; 2006. S. 120–47.Google Scholar
  37. 37.
    Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. 2003;160:13–23.PubMedCrossRefGoogle Scholar
  38. 38.
    Kelleher I, Harley M, Lynch F, et al. Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. Br J Psychiatry. 2008;193:378–82.PubMedCrossRefGoogle Scholar
  39. 39.
    Kilcommons AM, Morrison A. Relationships between trauma and psychosis: an exploration of cognitive and dissociative factors. Acta Psychiatr Scand. 2006;112:351–9.CrossRefGoogle Scholar
  40. 40.
    Kilcommons AM, Morrison AP, Knight A, Lobban F. Psychotic experiences in people who have been sexually assaulted. Soc Psychiatry Psychiatr Epidemiol. 2008;43:602–11.PubMedCrossRefGoogle Scholar
  41. 41.
    Konings M, Stefanis N, Kuepper R, et al. Replication in two independent population-based samples that childhood maltreatment and cannabis use synergistically impact on psychosis risk. Psychol Med. 2012;42:149–59.PubMedCrossRefGoogle Scholar
  42. 42.
    Kramer IM, Simons CJ, Myin-Germeys I, et al. Evidence that genes for depression impact on the pathway from trauma to psychotic-like symptoms by occasioning emotional dysregulation. Psychol Med. 2011. Epub ahead of print.Google Scholar
  43. 43.
    Kuepper R, van Os J, Lieb R, Wittchen HU, Henquet C. Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study. Psychol Med. 2011;41:2121–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Lardinois M, Lataster T, Mengelers R, Van Os J, Myin-Germeys I. Childhood trauma and increased stress sensitivity in psychosis. Acta Psychiatr Scand. 2011;123:28–35.PubMedCrossRefGoogle Scholar
  45. 45.
    Larkin W, Morrison AP. Relationships between trauma and psychosis: From theory to therapy. In: Larkin W, Morrison AP, Herausgeber. Trauma and psychosis: new directions of theory and therapy. London: Routledge, Taylor & Francis; 2006. S. 259–82.Google Scholar
  46. 46.
    Larkin W, Read J. Childhood trauma and psychosis: evidence, pathways, and implications. J Postgrad Med. 2008;54:287–93.PubMedCrossRefGoogle Scholar
  47. 47.
    Lataster J, Myin-Germeys I, Lieb R, et al. Adversity and psychosis: a 10-year prospective study investigating synergism between early and recent adversity in psychosis. Acta Psychiatr Scand. 2012;125:388–99.Google Scholar
  48. 48.
    Lataster T, van Os J, Drukker M, et al. Childhood victimisation and developmental expression of non-clinical delusional ideation and hallucinatory experiences: victimisation and non-clinical psychotic experiences. Soc Psychiatry Psychiatr Epidemiol. 2006;41:423–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Linscott RJ, van Os J. Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annu Rev Clin Psychol. 2010;27:391–419.CrossRefGoogle Scholar
  50. 50.
    McCarthy-Jones S. Voices from the storm: a critical review of quantitative studies of auditory verbal hallucinations and childhood sexual abuse. Clin Psychol Rev. 2011;31:983–92.PubMedCrossRefGoogle Scholar
  51. 51.
    Morrison AP. A cognitive behavioural perspective on the relationship between childhood trauma and psychosis. Epidemiol Psichiatr Soc. 2009;18:294–8.PubMedGoogle Scholar
  52. 52.
    Moskowitz A, Read J, Farelly S, et al. Are psychotic symptoms traumatic in origin and dissociative in kind? In: Dell PE, O’Neill JA, Herausgeber. Dissociation and dissociative disorders. DSM-V and beyond. New York: Routledge, Taylor & Francis; 2009. S. 521–34.Google Scholar
  53. 53.
    Murphy J, Shevlin M, Adamson G, Houston JE. From sexual abuse to psychosis: a pilot study exploring the social deafferentiation hypothesis and the mediating role of avoidance. Psychos Psychol Soc Integr Approaches. 2011. Epub ahead of print.Google Scholar
  54. 54.
    Myin-Germeys I, van Os J. Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clin Psychol Rev. 2007;27:409–24.PubMedCrossRefGoogle Scholar
  55. 55.
    Pierre JM. Hallucinations in nonpsychotic disorders: toward a differential diagnosis of „hearing voices“. Harv Rev Psychiatry. 2010;18:22–35.PubMedCrossRefGoogle Scholar
  56. 56.
    Read J, Gumley A. Can attachment theory help to explain the relationship between childhood adversity and psychosis? Attachment New Perspect PsychotherRelat Psychoanal. 2008;2:1–35.Google Scholar
  57. 57.
    Read J, Bentall RP, Fosse R. Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms. Epidemiol Psichiatr Soc. 2009;18:299–310.PubMedGoogle Scholar
  58. 58.
    Reif M, Castille DM, Muenzenmaier K, Link B. Childhood abuse and the content of adult psychotic symptoms. Psychol Trauma Theor Res Pract Policy. 2011;1–14.Google Scholar
  59. 59.
    Saha S, Varghese D, Slade T, et al. The association between trauma and delusional-like experiences. Psychiatry Res. 2011;189:259–64.PubMedCrossRefGoogle Scholar
  60. 60.
    Schäfer I, Ross CA, Read J. Childhood trauma in psychotic and dissociative disorders. In: Moskowitz A, Schäfer I, Dorahy MJ, Herausgeber. Psychosis, trauma and Dissociation. Chichester: Wiley; 2008. S. 137–50.Google Scholar
  61. 61.
    Schreier A, Wolke D, Thomas K, et al. Prospective study of peer victimization in childhood and psychotic symptoms in a nonclinical population at age 12 years. Arch Gen Psychiatry. 2009;66:527–36.PubMedCrossRefGoogle Scholar
  62. 62.
    Scott J, Chant D, Andrews G, et al. Association between trauma exposure and delusional experiences in a large community-based sample. Br J Psychiatry. 2007;190:339–43.PubMedCrossRefGoogle Scholar
  63. 63.
    Shannon C, Douse K, McCusker C, et al. The association between childhood trauma and memory functioning in schizophrenia. Schizophr Bull. 2011;37:531–7.PubMedCrossRefGoogle Scholar
  64. 64.
    Shevlin M, Dorahy M, Adamson G. Childhood traumas and hallucinations: an analysis of the National Comorbidity Survey. J Psychiatr Res. 2007a;41:222–8.CrossRefGoogle Scholar
  65. 65.
    Shevlin M, Dorahy MJ, Adamson G. Trauma and psychosis: an analysis of the National Comorbidity Survey. Am J Psychiatry. 2007b;164:166–9.CrossRefGoogle Scholar
  66. 66.
    Shevlin M, Murphy J, Dorahy MJ, Adamson G. The distribution of positive psychosis-like symptoms in the population: a latent class analysis of the National Comorbidity Survey. Schizophr Res. 2007c;89:101–9.CrossRefGoogle Scholar
  67. 67.
    Shevlin M, Houston JE, Dorahy MJ, Adamson G. Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British Psychiatric Morbidity Survey. Schizophr Bull. 2008;34:193–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Shevlin M, Murphy J, Read J, Mallett J, Adamson G, Houston JE. Childhood adversity and hallucinations: a community-based study using the National Comorbidity Survey Replication. Soc Psychiatry Psychiatr Epidemiol. 2011;46:1203–10.PubMedCrossRefGoogle Scholar
  69. 69.
    Spataro J, Mullen PE, Burgess PM, et al. Impact of child sexual abuse on mental health: prospective study in males and females. Br J Psychiatry. 2004;184:416–21.PubMedCrossRefGoogle Scholar
  70. 70.
    Spauwen J, Krabbendam L, Lieb R, et al. Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness. Br J Psychiatry. 2006;188:527–33.PubMedCrossRefGoogle Scholar
  71. 71.
    Stefanis NC, Henquet C, Avramopoulos D, et al. COMT Val158Met moderation of stress-induced psychosis. Psychol Med. 2007;37:1651–6.PubMedCrossRefGoogle Scholar
  72. 72.
    Stein JA, Goldring JM, Siegel JM, et al. Long-term psychological sequelea of childhood abuse. The Epidemiological Catchment Area study. In: Wyatt GE, Powell GJ, Herausgeber. Lastuing effects of child sexual abuse. Newbury Park: Sage; 1988. S. 135–54.Google Scholar
  73. 73.
    Teicher MH, Anderson CM, Polcari A. Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum. Proc Natl Acad Sci USA. 2012;109:E563–72.PubMedCrossRefGoogle Scholar
  74. 74.
    van Os J, Kapur S. Schizophrenia. Lancet. 2009;374:635–45.PubMedCrossRefGoogle Scholar
  75. 75.
    van Os J, Kenis G, Rutten BP. The environment and schizophrenia. Nature. 2010;468:203–12.PubMedCrossRefGoogle Scholar
  76. 76.
    van Rossum I, Dominguez MD, Lieb R, Wittchen HU, van Os J. Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophr Bull. 2011;37:561–71.Google Scholar
  77. 77.
    van Winkel R, Stefanis NC, Myin-Germeys .I. Psychosocial stress and psychosis. A review of the neurobiological mechanisms and the evidence for gene-stress interaction. Schizophr Bull. 2008;34:1095–105.Google Scholar
  78. 78.
    Whitfield CL, Dube SR, Felitti VJ, Anda RF. Adverse childhood experiences and hallucinations. Child Abuse Negl. 2005;29:797–810.PubMedCrossRefGoogle Scholar
  79. 79.
    Wigman JT, van Winkel R, Jacobs N, et al. A twin study of genetic and environmental determinants of abnormal persistence of psychotic experiences in young adulthood. Am J Med Genet B Neuropsychiatr Genet. 2011;156B:546–52.Google Scholar

Copyright information

© Springer-Verlag Wien 2012

Authors and Affiliations

  1. 1.Universitätsklinik für PsychiatrieMedizinische Universität GrazGrazÖsterreich

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