The work being done by European researchers, particularly Jim van Os, fits very well with my hypothesis on the role of experience and psychosocial factors in not only the course and outcome of these disorders, but in their initiation as well. In cancer research, epigenetic factors as well as randomness are being taken much more seriously. Likewise in our field, the role of experience is highly significant.
Brian Koehler
Abstract:
Bak M, Krabbendam L, Janssen I, de Graaf R, Vollebergh W, van Os J. Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control. Acta Psychiatr Scand 2005: 112: 360–366. © 2005 Blackwell Munksgaard.
Objective:
Exposure to early trauma may increase the risk of dysfunctional responses to anomalous psychotic experiences resulting in psychotic symptom formation.
Method:
In a three-wave longitudinal general population study, 4045 never-psychotic individuals exposed and non-exposed to trauma before the age of 16 years, according to baseline interview, were interviewed for the onset of psychotic experiences 3 years later (T2). In 36 individuals with incident psychosis at T2, assessments were made, for each psychotic experience, of i) the amount of distress associated with and ii) the degree of coping and subjective control over the experience.
Results:
In the 16 observations of an incident psychotic experience, in the absence of distress, the baseline rate of early trauma was low (6%), whereas it was much higher in the 21 observations of an incident psychotic experience with distress [43%; odds ratio = 10.0, 95% confidence interval (CI): 1.04, 96.3; P = 0.046]. Similarly, coping attempts in the context of early trauma was associated with less control (reduction of 2 points on a seven-point scale, 95% CI: -4.0, -0.07).
Conclusion:
Early experience of trauma may create lasting cognitive and affective vulnerabilities to develop clinical symptoms arising out of early, non-clinical psychotic experiences.
Affiliations: 1: Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht 2: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
