European Child & Adolescent Psychiatry

, Volume 28, Issue 12, pp 1597–1606 | Cite as

Psychotic experiences and trauma predict persistence of psychosocial problems in adolescence

  • Saliha el BouhaddaniEmail author
  • Lieke van Domburgh
  • Barbara Schaefer
  • Theo A. H. Doreleijers
  • Wim Veling
Original Contribution


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.


Psychosocial 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.


  1. 1.
    Kessler RC, Berglund P, Demler O et al (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602. CrossRefPubMedGoogle Scholar
  2. 2.
    Wittchen HU, Nelson CB, Lachner G (1998) Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol Med 28:109–126CrossRefGoogle Scholar
  3. 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. CrossRefPubMedGoogle Scholar
  4. 4.
    McGorry PD, Hickie IB, Yung AR et al (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40:616–622. CrossRefGoogle Scholar
  5. 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. CrossRefPubMedGoogle Scholar
  6. 6.
    MacKie CJ, Castellanos-Ryan N, Conrod PJ (2011) Developmental trajectories of psychotic-like experiences across adolescence: impact of victimization and substance use. Psychol Med 41:47–58. CrossRefPubMedGoogle Scholar
  7. 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. CrossRefPubMedGoogle Scholar
  8. 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. CrossRefGoogle Scholar
  9. 9.
    Jaspers M, De Winter AF et al (2012) Trajectories of psychosocial problems in adolescents predicted by findings from early well-child assessments. JAH 51:475–483. CrossRefGoogle Scholar
  10. 10.
    Ormel J, Raven D, Van Oort F et al (2015) Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders. Psychol Med 45:345–360. CrossRefPubMedGoogle Scholar
  11. 11.
    Lee KW, Chan KW, Chang WC et al (2016) A systematic review on definitions and assessments of psychotic-like experiences. Early Interv Psychiatry 10:3–16. CrossRefPubMedGoogle Scholar
  12. 12.
    Kelleher I, Cannon M (2011) Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychol Med. CrossRefPubMedGoogle Scholar
  13. 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. CrossRefPubMedGoogle Scholar
  14. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Varese F, Smeets F, Drukker M et al (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull 38:661–671. CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Trotta A, Murray RM, Fisher HL (2015) The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis. Psychol Med. CrossRefPubMedGoogle Scholar
  17. 17.
    Vohs KD, Heatherton TF (2001) Self-esteem and threats to self: implications for self-construals and interpersonal perceptions. J Pers Soc Psychol 81:1103–1118. CrossRefPubMedGoogle Scholar
  18. 18.
    Orth U, Robins RW, Trzesniewski KH et al (2009) Low self-esteem is a risk factor for depressive symptoms from young adulthood to old age. J Abnorm Psychol 118:472–478. CrossRefPubMedGoogle Scholar
  19. 19.
    Romm KL, Rossberg JI, Hansen CF et al (2011) Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis. BMC Psychiatry. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Erol RY, Orth U (2011) Self-esteem development from age 14 to 30 years: a longitudinal study. J Pers Soc Psychol 101:607–619. CrossRefPubMedGoogle Scholar
  21. 21.
    Sowislo JF, Orth U (2013) Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol Bull 139:213–240. CrossRefPubMedGoogle Scholar
  22. 22.
    Friberg P, Hagquist C, Osika W (2012) Self-perceived psychosomatic health in Swedish children, adolescents and young adults: an internet-based survey over time. BMJ Open 2:1–6. CrossRefGoogle Scholar
  23. 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. CrossRefPubMedGoogle Scholar
  24. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Nakao M, Yano E (2006) Prediction of major depression in Japanese adults: somatic manifestation of depression in annual health examinations. J Affect Disord 90:29–35. CrossRefPubMedGoogle Scholar
  26. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Stilo SA, Gayer-Anderson C, Beards S et al (2017) Further evidence of a cumulative effect of social disadvantage on risk of psychosis. Psychol Med 47:913–924. CrossRefPubMedGoogle Scholar
  28. 28.
    Raviv T, Taussig HN, Culhane SE, Garrido EF (2010) Cumulative risk exposure and mental health symptoms among maltreated youth placed in out-of-home care. Child Abus Negl 34:742–751. CrossRefGoogle Scholar
  29. 29.
    el Bouhaddani S, van Domburgh L, Schaefer B et al (2018) Peer status in relation to psychotic experiences and psychosocial problems in adolescents: a longitudinal school-based study. Eur Child Adolesc Psychiatry 27:701–710. CrossRefPubMedGoogle Scholar
  30. 30.
    Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586. CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Meltzer H, Gatward R, Goodman R, Ford T (2000) The mental health of children and adolescents in Great Britain. Office for National Statistics (ONS), LondonCrossRefGoogle Scholar
  32. 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. CrossRefPubMedGoogle Scholar
  33. 33.
    Adriaanse M, van Domburgh L, Hoek HW et al (2014) Prevalence, impact and cultural context of psychotic experiences among ethnic minority youth. Psychol Med. CrossRefPubMedGoogle Scholar
  34. 34.
    Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, PrincetonCrossRefGoogle Scholar
  35. 35.
    Franck E, De Raedt R, Barbez C, Rosseel Y (2008) Psychometric properties of the Dutch Rosenberg self-esteem scale. Psychol Belg 48:25. CrossRefGoogle Scholar
  36. 36.
    Ruchkin V, Schwab-Stone M, Vermeiren R (2004) Social and Health Assessment (SAHA); psychometric development summary. Yale University, New HavenGoogle Scholar
  37. 37.
    Kendler KS, Zachar P, Craver C (2011) What kinds of things are psychiatric disorders? Psychol Med 41:1143–1150. CrossRefPubMedGoogle Scholar
  38. 38.
    McGorry P, van Os J (2013) Redeeming diagnosis in psychiatry: timing versus specificity. Lancet 381:343–345. CrossRefPubMedGoogle Scholar
  39. 39.
    van Os J (2013) The dynamics of subthreshold psychopathology: implications for diagnosis and treatment. Am J Psychiatry 170:695–698. CrossRefPubMedGoogle Scholar
  40. 40.
    Thapar A, Heron J, Jones RB et al (2012) Trajectories of change in self-reported psychotic-like experiences in childhood and adolescence. Schizophr Res 140:104–109. CrossRefPubMedGoogle Scholar
  41. 41.
    De Loore E, Drukker M, Gunther N et al (2007) Childhood negative experiences and subclinical psychosis in adolescence: a longitudinal general population study. Early Interv Psychiatry 1:201–207. CrossRefGoogle Scholar
  42. 42.
    Colman I, Kingsbury M, Garad Y et al (2016) Consistency in adult reporting of adverse childhood experiences. Psychol Med 46:543–549. CrossRefPubMedGoogle Scholar
  43. 43.
    Kelleher I, Connor D, Clarke MC et al (2012) Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol Med 42:1857–1863. CrossRefPubMedGoogle Scholar
  44. 44.
    Fusar-Poli P, Nelson B, Valmaggia L et al (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull 40:120–131. CrossRefPubMedGoogle Scholar
  45. 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. CrossRefPubMedPubMedCentralGoogle Scholar
  46. 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. CrossRefPubMedGoogle Scholar
  47. 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. CrossRefPubMedGoogle Scholar
  48. 48.
    De Loore E, Gunther N, Drukker M et al (2011) Persistence and outcome of auditory hallucinations in adolescence: a longitudinal general population study of 1800 individuals. Schizophr Res 127:252–256. CrossRefPubMedGoogle Scholar
  49. 49.
    Yamasaki S, Usami S, Sasaki R et al (2018) The association between changes in depression/anxiety and trajectories of psychotic-like experiences over a year in adolescence. Schizophr Res 195:149–153. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Parnassia Psychiatric InstituteThe HagueThe Netherlands
  2. 2.Department of Research and DevelopmentPluryn-IntermetzoNijmegenThe Netherlands
  3. 3.Department of Child and Adolescent PsychiatryVU Medical CentreAmsterdamThe Netherlands
  4. 4.Department of PsychiatryUniversity Medical Centre Groningen, University of GroningenGroningenThe Netherlands

Personalised recommendations