June 26, 2006

Trauma Link to Schizophrenia is Strengthened by New Research

Following a number of stories that have come out in the past few weeks - a new research study out of The Netherlands further strengthens the evidence that suggests that Trauma is a causal factor in psychosis and likely in schizophrenia (that includes psychosis as one of the key symptoms). In a broader sense this study also provides confirmation of the consensus view in the scientific community that schizophrenia is caused by a genetic or biological prediposition, and then later environmental insults, or stresses that further increase the risk or trigger the disorder.

The Schizophrenia Research Forum reports:

Does exposure to psychological trauma in childhood—war, natural disasters, child abuse—cause schizophrenia? A new study that assessed childhood trauma, then prospectively measured the appearance of psychotic symptoms, doesn’t answer that question directly, but it suggests that for at least a subset of schizophrenia symptoms, the answer is yes. The work, from Jim van Os at the University of Maastricht, the Netherlands, with Roselind Lieb and Hans-Ulrich Wittchen at Max Planck Institute, Munich, showed a dose-response relationship between the severity of self-reported childhood trauma and later psychoses in a large group of young Germans. The effect of trauma was enhanced in subjects who measured high on a scale of psychotic proneness at the beginning of the study. The results, appearing in the June issue of the British Journal of Psychiatry, support the idea that childhood trauma can promote psychosis later in life, and in particular may bring out or exacerbate symptoms in a subset of susceptible people. ...

A dose response effect supported the idea that trauma played a causal role in the psychotic symptoms. The odds ratio for psychosis increased with an increasing number of trauma events. The effect of trauma appeared specific for psychosis, as the researchers found no association between self-reported trauma and the occurrence of bipolar disorder or major depression.

Experiencing traumatic events was significantly more likely to produce psychoses in people who scored in the top quartile on tests of psychosis proneness, compared to those in the lower three quarters. The effect size for trauma in those without psychosis proneness was 1.8 percent, while in those with proneness, it was 7 percent. The difference was statistically significant, and showed a synergistic rather than additive effect of childhood trauma on later psychoses in this susceptible group. Of course, the authors concede, childhood abuse itself could affect psychosis proneness, and they did detect a weak interaction between reported trauma at baseline and signs of psychosis proneness." ...

It remains to be seen, however, if the association between trauma and psychotic symptoms also applies to psychotic disorders, including schizophrenia. ...

More work will be necessary to sort out the mechanisms by which trauma increases the risk of psychosis, but several likely hypotheses exist. Childhood stress affects early brain development...

Read the Full story: Trauma Link to Psychosis Is Strengthened

Research Paper Abstract: Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness

We'd like to see much more work in this area - and with better classifications of types of emotional trauma - including neglect.

More information on the Causes of Schizophrenia


Comments

I am seing a disturbing trend in that there seems to be a resurrgence in the theory of environment causality in schizophrenia. I think this is a terrible regression.
I simply believe that there are too many people who are predisposed to this type of thinking that are attracted to the field of psychiatry and research in this area. The enviroment factor is often a failed analysis of a dynamic where a child of a schizophrenic parent is more likely to be raised in a chaotic or sifunctional environment because the same genetics that eventully made the child sick are directly responsible for the parents behaviors. Put a child without the damaged genetics in the same disfunctional environment and the child will not get sick. Why is it so extremely difficult for people to comprehend the nearly unfathomable complexity of biology and genetics.

Whatever one believes in, intelligent engineering or evolution, the fact is the "creator" of the brain as we know it just made thought look easy. Maybe some people just lack the cognitive capacity to understand and accept genetics as a predominant factor in schizophrenia.

If this is where research is headed, it is a very unfortunate direction.

Posted by: jenbailey99@peplepc.com at June 27, 2006 07:51 PM

Hi Jen,

Actually - the consensus view amoung schizophrenia researchers is that "environment" is an important factor (if a person has the "genes" or biological disposition) in the development of schizophrenia - this is why in the case of identical twins, only 50% of the twins develop schizophrenia. If the issue was only one of genes - you would see 100% of identical twins develop schizophrenia. I encourage you to read our section on the causal factors that have been identified for schizophrenia - to understand the interplay of genes and environment and how they are proving to inter-relate in schizophrenia (and most other disorders):
http://www.schizophrenia.com/hypo.php

More importantly there is some recent research that suggests a situation opposite to what you are proposing. Increasingly researchers are viewing the "social environment" as an exciting and promising area of research because certain interpersonal learning and social skills (which few people think are genetically based) may play a significant role in whether the genetically/biologically predisposed people actually develop schizophrenia. This is exciting news because it MAY be relatively easy (compared to genetic engineering) to modify people's learning and social skills so as to make them much more resilient - and thus greatly reduce the risk of schizophrenia.

Studies have indicated that when babies are adopted from mothers diagnosed with schizophrenia (that is, children with an increased risk of a biological predisposition towards schizophrenia) and are raised in "healthy" families they have over a 86% lower risk of developing schizophrenia - which suggests that the social skills and stress-management skills learned in a positive family environment can be important protective agent against mental illness.(Source: British Journal of Psychiatry).

See this page for details:
http://www.schizophrenia.com/prevention/stress1.html

A good analogy might be obesity - there is no question in the research community that some people have a genetic predisposition for becoming obese. At the same time - if you take the average thin person off the street and put them in a room with a TV and stuff them full of pies and cokes and other high-calorie food, eventually the thin people will become obese.

Similarly - simple laws of physics suggest that if an obese person limits his or her intake of calories and excercises that eventually they will lose weight and become thin.

The take home message here is that if you have the gene for obesity - it doesn't mean that you automatically become fat (afterall, a very large percentage of American genes come (via immigration) from Europe and Asia and Mexico - where people are much thinner than in America) - so the Environment in the USA is obviously greatly contributing to obesity in the US (because the genes in people don't change just by moving them across the Atlantic or Pacific ocean).

Similarly, runs the dominant theory in schizophrenia today - that just because you have the genes that predispose you to schizophrenia doesn't mean you'll get schizophrenia. The environment that you are exposed to seems to frequently be the determining factor. As we learn more about what precisely the environmental factors are - the better people can avoid them. This seems like exciting news towards the goal of preventing schizophrenia!

Posted by: Sz Administrator at June 28, 2006 10:07 AM

you may have found a study that shows that 'dysfunctional' families have a higher rate of schizophrenia in adopted children - there are a large number of studies that show exactly the opposite - that children from at risk parents develop schizophrenia at EXACTLY the same rate no matter where they are adopted to.

you can back any point of view if you choose unjuried, unreviewed studies, or ignore the other half of the studies that are showing exactly the opposite of the studies you quote.

slc

Posted by: slc at June 28, 2006 03:57 PM

i think you are working with an extremely distorted idea of what 'research today' and 'environmental factors' means.

I think you have no idea what 'environmental factors' mean.I suggest you buy a dictionary and learn the correct meaning of the word.

Posted by: Tim at June 30, 2006 02:00 PM

basically I'm speaking from experience I was diagnosed with schizaphreia 12 years ago and I must agree that even though I was predisposed to this illness so were my siblings and one parent. I have encountered many environmental factors that brought the onset of this illness the first being abuse that resulted in the post abuse diagnosis of post traumatic stress after the initial symptoms of schizophrenia I indulged in marijuana which of course in me only heightened the oncoming of psychosis. I must say that even though at first it was thought genetics and drugs were the cause of these subsequent times of psychosis it is now realized that I have improved my environment and this is the obvious reason for my many years of much improved though not perfect health. i am thus very interested in your comments as it is a debate theyve waged on me since the first

Posted by: ness at July 4, 2006 06:50 PM

i think people are in favor of the environmental cause or mixed causality because it seems more reversible or treatable than a biochemical or purely biochemical root of an illness. it seems something more un-do-able.

we may be talking about semantics - i agree that drug use, upbringing and conditions have a huge effect on the outcome of the illness. but to me cause and outcome are very different things.

Posted by: slc2 at July 11, 2006 12:04 PM

While doing research for a paper in research methods I stumbled across this page. I'm amazed that such a page exists and that I found it. My husband was diagnosed w/ schizophrenia 5 years ago and it's been quite a roller coaster ride ever since. While I love him deeply I am concerned for his healt since he has gained 50+ pounds and sleeps nearly all of the time. Is this merely a side effect from the seroquel or is he being over medicated?

Posted by: Debbie at July 18, 2006 10:38 PM

We adopted a girl from Romania at 3 yrs. of age from one of the "worst" (according to US Embassy there) orphanages. She was recovering from a broken femur. They all had the "orphans salute". She developed signs of schizophrenia around 14 yrs. of age and was put on medication at 16 yrs. This goes along with the theory of abuse. Her birth mother kept her about 3 mos. prior to releasing her to the home, but even she was abusive to the child. I see glimpses of the girl she could have been. This is so sad.

Posted by: B.Walker at November 4, 2006 11:10 PM

As a sufferer of psychosis, of which the main symptoms were delusions, I can say that the feelings of fear that I got during the psychosis were definitely the same as the feelings I got as a young person while I experienced periodic violence. The feeling of fear and dread surfaced years later without the stimulus being present. I think that when a child experiences trauma such as violence directed at them it may lead to feelings of persecution in years to come because it sets up a negative mindset in the sufferer of how people act in general and changes their expectations in life.

Posted by: horsensei at December 12, 2006 03:55 PM

I was abused sexually in childhood from 4 to 10 years old and later on was also abused sexually from 14 to 18 years old. I was started to feeling stressed out and feeling depressed when I was 15 years old and consulted the doctor and it was diagnosed as psychiatric problems. I strongly feel that childhood sexual abuse and trauma later on might be the cause for my psychiatric problems as I was very normal before I started feeling depressed at age 15. I always thought that my childhood incest and sexual abuse is the cause for psychiatric problems

Posted by: Kavitha at February 15, 2007 08:48 PM

I belive genetics, environment etc. all can more or less contribute to schizophrenia.

Personally I've had bad childhood experiences with bad parents etc. I was always afraid at home.
My twinbrother developed schizophrenia and I was more fortunate, just showed signs of psychosis at some periods. No one in the family except me know he has schizophrenia. He and I have broken contact with the rest of the family.
I am convinced that we would have turned out as healthy individuals under good circumstances. It is sad.

Alex
Sweden

Posted by: Alexander at March 6, 2008 04:52 PM


My daughter was traumatized by people who abused her. She was seventeen when she left home and took drugs.I could not get her back for a year and a half.She came home, but she suffers from fear and anxiety even though she is on alot of medicine! She has Schizo/Affective disorder. Nobody in my family has a mental illness and she grew up in a happy, loving home.

Posted by: Mary at April 24, 2008 09:00 AM

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