Original Research

Associations of premorbid adjustment with type and timing of childhood trauma in first-episode schizophrenia spectrum disorders

Anna M. Smit, Sanja Kilian, Robin A. Emsley, Hilmar K. Luckhoff, Leslie Swartz, Soraya Seedat, Laila Asmal
South African Journal of Psychiatry | Vol 27 | a1639 | DOI: https://doi.org/10.4102/sajpsychiatry.v27i0.1639 | © 2021 Anna M. Smit, Sanja Kilian, Robin A. Emsley, Hilmar K. Luckhoff, Leslie Swartz, Soraya Seedat, Laila Asmal | This work is licensed under CC Attribution 4.0
Submitted: 06 October 2020 | Published: 22 June 2021

About the author(s)

Anna M. Smit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
Sanja Kilian, Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
Robin A. Emsley, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Hilmar K. Luckhoff, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Leslie Swartz, Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
Soraya Seedat, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Laila Asmal, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

Background: Childhood trauma may contribute to poorer premorbid social and academic adjustment which may be a risk factor for schizophrenia.

Aim: We explored the relationship between premorbid adjustment and childhood trauma, timing of childhood trauma’s moderating role as well as the association of clinical and treatment-related confounders with premorbid adjustment.

Setting: We conducted a secondary analysis in 111 patients with first-episode schizophrenia (FES) disorders that formed part of two parent studies, EONKCS study (n =73) and the Shared Roots study (n =38).

Methods: Type of childhood trauma was assessed with the Childhood Trauma Questionnaire, short-form and premorbid adjustment using the Premorbid Adjustment Scale. Timing of childhood trauma was assessed using the Life Events Checklist and life events timeline. Linear regression analyses were used to assess the moderating effect of timing of childhood trauma. Clinical and treatment-related confounders were entered into sequential hierarchical regression models to identify independent predictors of premorbid adjustment across key life stages.

Results: Childhood physical neglect was associated with poorer premorbid academic functioning during childhood and early adolescence, and poorer premorbid social functioning during early and late adolescence. By hierarchical regression modelling (r2 = 0.13), higher physical neglect subscale scores (p = 0.011) independently predicted poorer premorbid social adjustment during early adolescence. Timing of childhood trauma did not moderate the relationship between childhood trauma and premorbid functioning.

Conclusion: In patients with FES, childhood physical neglect may contribute to poorer premorbid social functioning during early adolescence. This may provide us with an opportunity to identify and treat at-risk individuals earlier.


Keywords

childhood trauma; premorbid adjustment; first episode schizophrenia spectrum disorders; academic and social functioning; early adolescence

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