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The relationship between childhood trauma and schizophrenia in the Genomics of Schizophrenia in the Xhosa people (SAX) study in South Africa

Published online by Cambridge University Press:  07 August 2019

Sumaya Mall ,
Jonathan M. Platt ,
Henk Temmingh ,
Eustasius Musenge ,
Megan Campbell ,
Ezra Susser  and
Dan J. Stein
Sumaya Mall*
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Jonathan M. Platt
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Henk Temmingh
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Eustasius Musenge
Affiliation:
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Megan Campbell
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Ezra Susser
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA New York State Psychiatric Institute, New York, USA
Dan J. Stein
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa SU/UCT Medical Research Council Unit on Risk & Resilience in Mental Disorders, South Africa
*
Author for correspondence: Sumaya Mall, E-mail: Sumaya.mall@wits.ac.za
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Abstract

Background

Evidence from high-income countries suggests that childhood trauma is associated with schizophrenia. Studies of childhood trauma and schizophrenia in low and middle income (LMIC) countries are limited. This study examined the prevalence of childhood traumatic experiences among cases and controls and the relationship between specific and cumulative childhood traumatic experiences and schizophrenia in a sample in South Africa.

Methods

Data were from the Genomics of Schizophrenia in the South African Xhosa people study. Cases with schizophrenia and matched controls were recruited from provincial hospitals and clinics in the Western and Eastern Cape regions in South Africa. Childhood traumatic experiences were measured using the Childhood Trauma Questionnaire (CTQ). Adjusted logistic regression models estimated associations between individual and cumulative childhood traumatic experiences and schizophrenia.

Results

Traumatic experiences were more prevalent among cases than controls. The odds of schizophrenia were 2.44 times higher among those who experienced any trauma than those who reported no traumatic experiences (95% CI 1.77–3.37). The odds of schizophrenia were elevated among those who experienced physical/emotional abuse (OR 1.59, CI 1.28–1.97), neglect (OR 1.39, CI 1.16–1.68), and sexual abuse (OR 1.22, CI 1.03–1.45) compared to those who did not. Cumulative physical/emotional abuse and neglect experiences increased the odds of schizophrenia as a dose–response relationship.

Conclusion

Childhood trauma is common in this population. Among many other benefits, interventions to prevent childhood trauma may contribute to a decreasing occurrence of schizophrenia.

Keywords

Case–controlchildhood traumapsychosisSouth Africa
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 9 , July 2020 , pp. 1570 - 1577
Copyright
Copyright © Cambridge University Press 2019

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References

Anda, RF, Felitti, VJ, Bremner, JD, Walker, JD, Whitfield, C, Perry, BD, Dube, SR and Giles, WH (2006) The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience 256, 174–186.CrossRefGoogle ScholarPubMed
Asmal, L, Kilian, S, du Plessis, S, Scheffler, F, Chiliza, B, Fouche, J-P, Seedat, S, Dazzan, P and Emsley, R (2018) Childhood trauma associated white matter abnormalities in first-episode schizophrenia. Schizophrenia Bulletin 45(2), 369–376.CrossRefGoogle Scholar
Baumeister, D, Akhtar, R, Ciufolini, S, Pariante, CM and Mondelli, V (2016) Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α. Molecular Psychiatry 21, 642–649.CrossRefGoogle ScholarPubMed
Beards, S, Gayer-Anderson, C, Borges, S, Dewey, ME, Fisher, HL and Morgan, C (2013) Life events and psychosis: a review and meta-analysis. Schizophrenia Bulletin 39(4), 740–747.CrossRefGoogle ScholarPubMed
Bernstein, DP, Stein, JA, Newcomb, MD, Walker, E, Pogge, D, Ahluvalia, T, Stokes, J, Handelsman, L, Medrano, M, Desmond, D and Zule, W (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse and Neglect 27, 169–190.CrossRefGoogle ScholarPubMed
Bora, E (2015) Neurodevelopmental origin of cognitive impairment in schizophrenia. Psychological Medicine 45, 1–9.CrossRefGoogle Scholar
Campbell, M, Susser, E, Mall, S, Mqulwana, SG, Mndini, MM, Ntola, OA, Nagdee, M, Zingela, Z, Van Wyk, S and Stein, DJ (2017 a) Using iterative learning to improve understanding during the informed consent process in a South African psychiatric genomics study. PLoS ONE 12(11), e0188466. https://doi.org/10.1371/journal.pone.0188466.CrossRefGoogle Scholar
Campbell, MM, Sibeko, G, Mall, S, Baldinger, A, Nagdee, M, Susser, E and Stein, DJ (2017 b) The content of delusions in a sample of South African Xhosa people with schizophrenia. BMC Psychiatry 17, 41.CrossRefGoogle Scholar
Costello, A and Osborne, J (2005) Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation 10, 1–9.Google Scholar
Dantchev, S, Zammit, S and Wolke, D (2018) Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study. Psychological Medicine 48, 2321–2328.CrossRefGoogle ScholarPubMed
Denckla, CA, Consedine, NS, Spies, G, Cherner, M, Henderson, DC, Koenen, KC and Seedat, S (2017) Associations between neurocognitive functioning and social and occupational resilience among South African women exposed to childhood trauma. European Journal of Psychotraumatology 8, 1394146. https://doi.org/10.1080/20008198.2017.1394146.CrossRefGoogle ScholarPubMed
Dunn, TJ, Baguley, T and Brunsden, V (2014) From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology 105, 399–412.CrossRefGoogle ScholarPubMed
Fink, LA, Bernstein, D, Handelsman, L, Foote, J and Lovejoy, M (1995) Initial reliability and validity of the childhood trauma interview: a new multidimensional measure of childhood interpersonal trauma. American Journal of Psychiatry 152, 1329–1335.Google ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M and Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) for DSMIV.Google Scholar
Fisher, HL, McGuffin, P, Boydell, J, Fearon, P, Craig, TK, Dazzan, P, Morgan, K, Doody, GA, Jones, PB, Leff, J, Murray, RM and Morgan, C (2014) Interplay between childhood physical abuse and familial risk in the onset of psychotic disorders. Schizophrenia Bulletin 40, 1443–1451.CrossRefGoogle ScholarPubMed
Gerdner, A and Allgulander, C (2009) Psychometric properties of the Swedish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Nordic Journal of Psychiatry 63, 160–170.CrossRefGoogle Scholar
Gibbs, A, Dunkle, K, Washington, L, Willan, S, Shai, N and Jewkes, R (2018) Childhood traumas as a risk factor for HIV-risk behaviours amongst young women and men living in urban informal settlements in South Africa: a cross-sectional study. PLoS ONE 13(4), e0195369.CrossRefGoogle ScholarPubMed
Gil, A, Gama, CS, de Jesus, DR, Lobato, MI, Zimmer, M and Belmonte-de-Abreu, P (2009) The association of child abuse and neglect with adult disability in schizophrenia and the prominent role of physical neglect. Child Abuse and Neglect 33(9), 618–624.CrossRefGoogle ScholarPubMed
Gunnar, M and Quevedo, K (2007) The neurobiology of stress and development. Annual Review of Psychology 58, 145–173.CrossRefGoogle Scholar
Herniman, SE, Allott, KA, Killackey, E, Hester, R and Cotton, SM (2017) The psychometric validity of the Center for Epidemiological Studies-Depression Scale (CES-D) in first episode schizophrenia spectrum. Psychiatry Research 252, 16–22.CrossRefGoogle Scholar
Hu, L and Bentler, PM (1999) Structural equation modeling: a multidisciplinary journal cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 6, 37–41.CrossRefGoogle Scholar
Jewkes, RK, Dunkle, K, Nduna, M, Jama, PN and Puren, A (2010) Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth. Child Abuse & Neglect 34(11), 833–841.CrossRefGoogle ScholarPubMed
Jewkes, R, Nduna, M, Jama-Shai, N, Chirwa, E and Dunkle, K (2016) Understanding the relationships between gender inequitable behaviours, childhood trauma and socio-economic status in single and multiple perpetrator rape in rural South Africa: structural equation modelling. PLoS ONE 11(5), e0154903.CrossRefGoogle ScholarPubMed
Keefe, RSE and Harvey, PD (2012) Cognitive impairment in schizophrenia. Handbook of Experimental Pharmacology 213, 11–37.CrossRefGoogle Scholar
Kenny, DT, Lennings, CJ and Nelson, PK (2007) The mental health of young offenders serving orders in the community: implications for rehabilitation. Journal of Offender Rehabilitation 45, 123–148.CrossRefGoogle Scholar
Kilian, S, Asmal, L, Chiliza, B, Olivier, M, Phahladira, L, Scheffler, F, Seedat, S, Marder, S, Green, M and Emsley, R (2017 a) Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition. Psychological Medicine 48(13), 2186–2193.CrossRefGoogle ScholarPubMed
Kilian, S, Burns, JK, Seedat, S, Asmal, L, Chiliza, B, du Plessis, M, Olivier, R, Kidd, M and Emsley, R. (2017 b) Factors moderating the relationship between childhood trauma and premorbid adjustment in first-episode schizophrenia. PLoS ONE 12(1), e0170178. https://doi.org/10.1371/journal.pone.0170178.CrossRefGoogle ScholarPubMed
Koen, L, Niehaus, DJH, Wright, G, Warnich, L, de Jong, G, Emsley, RA and Mall, S (2012) Chromosome 22q11 in a Xhosa schizophrenia population. South African Medical Journal 102, 165–166.CrossRefGoogle Scholar
Kraan, T, Velthorst, E, Smit, F, de Haan, L and van der Gaag, M (2015) Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis. Schizophrenia Research 161, 143–149.CrossRefGoogle ScholarPubMed
Lochner, C, Seedat, S, Allgulander, C, Kidd, M, Stein, D and Gerdner, A (2010) Childhood trauma in adults with social anxiety disorder and panic disorder: a cross-national study. African Journal of Psychiatry 13, 376–381.Google ScholarPubMed
MacDonald, K, Thomas, ML, MacDonald, TM and Sciolla, AF (2014) A perfect childhood? Clinical correlates of minimization and denial on the childhood trauma questionnaire. Journal of Interpersonal Violence 30, 988–1009.CrossRefGoogle ScholarPubMed
Mandelli, L, Petrelli, C and Serretti, A (2015) The role of specific early trauma in adult depression: a meta-analysis of published literature. Childhood trauma and adult depression. European Psychiatry 30, 665–680.CrossRefGoogle ScholarPubMed
Martin, L, Viljoen, M, Kidd, M and Seedat, S (2014) Are childhood trauma exposures predictive of anxiety sensitivity in school attending youth? Journal of Affective Disorders 168, 5–12.CrossRefGoogle ScholarPubMed
Matheson, SL, Shepherd, AM, Pinchbeck, RM, Laurens, KR and Carr, VJ (2012) Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 1–13.Google ScholarPubMed
McCrory, E, De Brito, SA and Viding, E (2011) The impact of childhood maltreatment: a review of neurobiological and genetic factors. Frontiers in Psychiatry 43.Google Scholar
McGrath, RE, Mitchell, M, Kim, BH and Hough, L (2010) Evidence for response bias as a source of error variance in applied assessment. Psychological Bulletin 136, 450–470.CrossRefGoogle ScholarPubMed
Menon, B, Cherkil, S, Aswathy, S, Unnikrishnan, A and Rajani, G (2012) The process and challenges in the translation of World health organization quality of Life (WHOQOL-BREF) to a regional language; Malayalam. Indian Journal of Psychological Medicine 34, 149.CrossRefGoogle ScholarPubMed
Morgan, C and Fisher, H (2007) Environmental factors in schizophrenia: childhood trauma – a critical review. Schizophrenia Bulletin 33, 3–10.CrossRefGoogle ScholarPubMed
Pearce, N (2016) Analysis of matched case-control studies. BMJ (Clinical Research Ed.) http://dx.doi.org/10.1136/bmj.i969.Google ScholarPubMed
Peralta, V and Cuesta, MJ (2009) Characterization of affective domains within the nonaffective psychotic disorders. Schizophrenia Research 111(1-3), 61–69.CrossRefGoogle ScholarPubMed
Powers, A, Fani, N, Cross, D, Ressler, KJ and Bradley, B (2016) Childhood trauma, PTSD, and psychosis: findings from a highly traumatized, minority sample. Child Abuse and Neglect 58, 111–118.CrossRefGoogle ScholarPubMed
Read, J, Van Os, J, Morrison, AP and Ross, CA (2005) Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.CrossRefGoogle ScholarPubMed
Rössler, W, Joachim Salize, H, Van Os, J and Riecher-Rössler, A (2005) Size of burden of schizophrenia and psychotic disorders. European Neuropsychopharmacology 15, 399–409.CrossRefGoogle ScholarPubMed
Rubin, DB (1987) Multiple Imputation for Nonresponse in Surveys Donald B. Rubin. Wiley Series in Probability and Statistics.CrossRefGoogle Scholar
Seaman, JB, Terhorst, L, Gentry, A, Hunsaker, A, Parker, LS and Lingler, JH (2015) Psychometric properties of a decisional capacity screening tool for individuals contemplating participation in Alzheimer's disease research. Journal of Alzheimer's Disease 46, 1–9.CrossRefGoogle ScholarPubMed
Sideli, L, Fisher, HL, Murray, RM, Sallis, H, Russo, M, Stilo, SA, Paparelli, A, Wiffen, BDR, O'Connor, JA, Pintore, S, Ferraro, L, La Cascia, C, La Barbera, D, Morgan, C and Di Forti, M (2018) Interaction between cannabis consumption and childhood abuse in psychotic disorders: preliminary findings on the role of different patterns of cannabis use. Early Intervention in Psychiatry 12, 135–142.CrossRefGoogle ScholarPubMed
Spies, G and Seedat, S (2014) Depression and resilience in women with HIV and early life stress: does trauma play a mediating role? A cross-sectional study. BMJ Open 4, e004200.CrossRefGoogle ScholarPubMed
Spies, G, Ahmed-Leitao, F, Fennema-Notestine, C, Cherner, M and Seedat, S (2016) Effects of HIV and childhood trauma on brain morphometry and neurocognitive function. Journal of NeuroVirology 22, 149–158.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JBW, Gibbon, M and First, MB (1992) The Structured Clinical Interview for DSM-III-R (SCID): I: history, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle ScholarPubMed
Susser, E and Widom, CS (2012) Still searching for lost truths about the bitter sorrows of childhood. Schizophrenia Bulletin 38, 672–675.CrossRefGoogle ScholarPubMed
Trotta, A, Di Forti, M, Mondelli, V, Dazzan, P, Pariante, C, David, A, Mulè, A, Ferraro, L, Formica, I, Murray, RM and Fisher, HL (2013) Prevalence of bullying victimisation amongst first-episode psychosis patients and unaffected controls. Schizophrenia Research 150, 169–175.CrossRefGoogle ScholarPubMed
Trotta, A, Murray, RM and Fisher, HL (2015) The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis. Psychological Medicine 150, 1–18.Google Scholar
Tsigebrhan, R, Shibre, T, Medhin, G, Fekadu, A and Hanlon, C (2014) Violence and violent victimization in people with severe mental illness in a rural low-income country setting: a comparative cross-sectional community study. Schizophrenia Research 152, 275–282.CrossRefGoogle Scholar
Tucci, AM, Kerr-Corrêa, F and Souza-Formigoni, MLO (2010) Childhood trauma in substance use disorder and depression: an analysis by gender among a Brazilian clinical sample. Child Abuse & Neglect 34, 95–104.CrossRefGoogle ScholarPubMed
van Dam, DS, van der Ven, E, Velthorst, E, Selten, JP, Morgan, C and de Haan, L (2012) Childhood bullying and the association with psychosis in non-clinical and clinical samples: a review and meta-analysis. Psychological Medicine 42, 2463–2474.CrossRefGoogle ScholarPubMed
van Os, J, Rutten, BP and Poulton, R (2008) Gene-environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophrenia Bulletin 34, 1066–1082.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, Van Os, J and Bentall, RP (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671.CrossRefGoogle ScholarPubMed
Wall, MM and Amemiya, Y (2000) Estimation for polynomial structural equation models. Journal of the American Statistical Association 95, 929–940.CrossRefGoogle Scholar
Widom, CS, Czaja, SJ and DuMont, KA (2015) Intergenerational transmission of child abuse and neglect: real or detection bias? Science 347, 1480–1485.CrossRefGoogle ScholarPubMed
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