Longitudinal Impact of Trauma in the North American Prodrome Longitudinal Study (NAPLS-3)

• Type of Material: Article
• Authors: Megan S. Farris, University of Calgary; Amy Braun, University of Calgary; Lu Liu, University of Calgary; Carrie E. Bearden, University of California, Los Angeles; Kristin S. Cadenhead, University of California, San Diego; Barbara A. Cornblatt, Zucker Hillside Hospital; Matcheri Keshavan, Harvard University; Daniel H. Mathalon, University of California, San Francisco; Thomas H. McGlashan, Yale University; Diana O. Perkins, University of North Carolina, Chapel Hill; William S. Stone, Harvard University; Ming T. Tsuang, University of California, San Diego; Elaine Walker, Emory University; Scott W. Woods, Yale University; Tyrone D. Cannon, Yale University; Jean Addington, University of Calgary
• Language: English
• Date: 2022-02-13
• Publisher: John Wiley and Sons
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 John Wiley & Sons Australia, Ltd.
• Final Published Version (URL): https://doi.org/10.1111/eip.13270
• Title of Journal or Parent Work: Early Intervention in Psychiatry
• Volume: 16
• Issue: 11
• Start Page: 1211
• End Page: 1216
• Grant/Funding Information: This worked was supported by the National Institute of Mental Health (grant U01MH081984 to Dr. Addington; grant U01MH081928 to Dr. Stone; grant U01MH081944 to Dr. Cadenhead; grant U01MH081902 to Drs Cannon and Bearden; grant U01MH082004 to Dr. Perkins; grant U01MH081988 to Dr. Walker; grant U01MH082022 to Dr. Woods; grant U01MH076989 to Dr. Mathalon; grant UO1MH081857 to Dr. Cornblatt).
• Keywords: depression; trauma; clinical outcomes; clinical high risk; transition to psychosis
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Mental Health

Abstract

Aim: individuals at clinical high risk (CHR) for psychosis have been shown to experience more trauma than the general population. However, although the effects of trauma appear to impact some symptoms it does not seem to increase the risk of transition to psychosis. The aim of this paper was to examine the prevalence of trauma, and its association with longitudinal clinical and functional outcomes in a large sample of CHR individuals. Methods: From the North American Prodrome Longitudinal Study-3 (NAPLS-3) 690 CHR individuals and 91 healthy controls from nine study sites between 2015–2018 were assessed. Historical trauma experiences were captured at baseline. Participants completed longitudinal assessments measuring clinical outcomes including positive and negative symptoms, depression, social and role functioning and assessing transition to psychosis. Results: From the 690 CHR participants and 9 6 healthy controls, 343 (49.6%) and 15 (15.6%), respectively, reported a history of trauma (p<0.001). Emotional neglect (70.3%) was the most commonly reported type of trauma, followed by psychological abuse (57.4%). Among CHR participants, time to transition to psychosis was not associated with trauma. Baseline depression and suspiciousness/persecutory ideas were statistically significantly different between CHR individuals who did or did not experience trauma. However, when examining clinical and functional outcomes over 12-months of follow-up, there were no differences between those who experienced trauma and those who did not. Conclusion: Overall, trauma is a significantly prevalent among CHR individuals. The effects of trauma on transition and longitudinal clinical and functional outcomes were not significant.