Psychotic experiences and trauma predict persistence of psychosocial problems in adolescence
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Psychosocial problems during adolescence are heterogenic, rather common, and unstable. At the same time, they are associated with an elevated risk of developing psychiatric disorders later in life. We aimed to describe the trajectories of psychosocial problems during adolescence and examine potential markers of persistence as compared to remission of these problems. At baseline, 1841 adolescents (51.4% female) were included. Of these adolescents, 1512 (mean age = 12.6 [range 11–14 years]; 52.8% female) completed the first and second self-report questionnaires on psychosocial problems (measured with the Strengths and Difficulties Questionnaire), psychotic experiences, trauma, self-esteem and somatic symptoms at two time points over a 1-year period. Regression analyses were used to examine the association between potential predictors and the trajectory of psychosocial problems (remitting versus persistent). Four trajectories were distinguished: 75.6% of the sample showed no problems (the ‘none’ trajectory), 11.9% were in a ‘remitting’ trajectory, 9.7% were in an ‘incident’ trajectory and 2.8% were in the ‘persistent’ trajectory. Hallucinatory experiences and trauma at baseline were significantly associated with persistence of psychosocial problems compared to those with remitting psychosocial problems. Low rather than high self-esteem was associated with lower risk for persistent problems. Risk of persistence of psychosocial problems increased with accumulation of predictors. Psychotic, especially hallucinatory, experiences and trauma predict persistence of psychosocial problems in adolescents. This underlines the need to assess psychotic experiences and trauma in mental health screening programs.
KeywordsPsychosocial problems Psychotic experiences Trauma Early detection
This work was supported by The Netherlands Organisation for Health Research and Development, Grant number 417100004.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
- 3.McGorry PD, Nelson B, Goldstone S, Yung AR (2010) Clinical staging: a heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Can J Psychiatry 55:486–497. https://doi.org/10.1177/070674371005500803 CrossRefPubMedGoogle Scholar
- 5.McGorry PD, Purcell R, Goldstone S, Amminger GP (2011) Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry 24:301–306. https://doi.org/10.1097/YCO.0b013e3283477a09 CrossRefPubMedGoogle Scholar
- 7.Downs JM, Cullen AE, Barragan M, Laurens KR (2013) Persisting psychotic-like experiences are associated with both externalising and internalising psychopathology in a longitudinal general population child cohort. Schizophr Res 144:99–104. https://doi.org/10.1016/j.schres.2012.12.009 CrossRefPubMedGoogle Scholar
- 8.Lancefield KS, Raudino A, Downs JM, Laurens KR (2016) Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: a prospective population-based cohort study. Dev Psychopathol 28:1–10. https://doi.org/10.1017/S0954579415001108 CrossRefGoogle Scholar
- 13.Linscott RJ, Van Os J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 43:1133–1149. https://doi.org/10.1017/S0033291712001626 CrossRefPubMedGoogle Scholar
- 14.Green JG, McLaughlin KA, Berglund PA et al (2010) Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 67:113–123. https://doi.org/10.1001/archgenpsychiatry.2009.186 CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Barkmann C, Braehler E, Schulte-Markwort M, Richterich A (2011) Chronic somatic complaints in adolescents: prevalence, predictive validity of the parent reports, and associations with social class, health status, and psychosocial distress. Soc Psychiatry Psychiatr Epidemiol 46:1003–1011. https://doi.org/10.1007/s00127-010-0273-4 CrossRefPubMedGoogle Scholar
- 24.Haftgoli N, Favrat B, Verdon F et al (2010) Patients presenting with somatic complaints in general practice: depression, anxiety and somatoform disorders are frequent and associated with psychosocial stressors. BMC Fam Pract 11:67. https://doi.org/10.1186/1471-2296-11-67 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Bohman H, Jonsson U, Paaren A et al (2012) Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers. BMC Psychiatry 12:90. https://doi.org/10.1186/1471-244X-12-90 CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Shaffer D, Fisher P, Lucas CP et al (2000) NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry 39:28–38. https://doi.org/10.1097/00004583-200001000-00014 CrossRefPubMedGoogle Scholar
- 36.Ruchkin V, Schwab-Stone M, Vermeiren R (2004) Social and Health Assessment (SAHA); psychometric development summary. Yale University, New HavenGoogle Scholar
- 45.Karcher NR, Barch DM, Avenevoli S et al (2018) Assessment of the prodromal questionnaire-brief child version for measurement of self-reported psychoticlike experiences in childhood. JAMA Psychiatry 75:853–861. https://doi.org/10.1001/jamapsychiatry.2018.1334 CrossRefPubMedPubMedCentralGoogle Scholar
- 46.de Jong Y, Mulder CL, Boon AE et al (2016) Screening for psychosis risk among adolescents in Child and Adolescent Mental Health Services: a description of the first step with the 16-item version of the Prodromal Questionnaire (PQ-16). Early Interv Psychiatry. https://doi.org/10.1111/eip.12362 CrossRefPubMedGoogle Scholar
- 47.Wigman JTW, van Winkel R, Raaijmakers QAW et al (2011) Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: a 6-year longitudinal general population study. Psychol Med 41:2317–2329. https://doi.org/10.1017/S0033291711000304 CrossRefPubMedGoogle Scholar