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Testing the neurodevelopmental, trauma and developmental risk factor models of psychosis using a naturalistic experiment

Published online by Cambridge University Press:  09 December 2019

Yiwen Liu
Affiliation:
Department of Psychology, University of Warwick, Coventry, UK
Marina Mendonça
Affiliation:
Department of Psychology, University of Warwick, Coventry, UK
Samantha Johnson
Affiliation:
Department of Health Sciences, Centre for Medicine, University of Leicester, Leicester, UK
Helen O'Reilly
Affiliation:
Department of Psychology, University College Dublin, Dublin, Ireland
Peter Bartmann
Affiliation:
Department of Neonatology, University Hospital Bonn, Bonn, Germany
Neil Marlow
Affiliation:
University College London Institute of Women's Health, University College London, London, UK
Dieter Wolke*
Affiliation:
Department of Psychology, University of Warwick, Coventry, UK Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
*
Author for correspondence: Dieter Wolke, E-mail: D.Wolke@warwick.ac.uk

Abstract

Background

The neurodevelopmental and trauma theories are two widely cited models of psychosis. A third – the developmental risk factor model (DRFM) – recognises the combined role of neurodevelopmental risks and trauma. Our objective was to test these theories using preterm populations as a natural experiment, given the high prevalence of neurodevelopmental deficits and exposure to trauma.

Methods

Two population-based preterm birth cohorts, the Bavarian Longitudinal Study (BLS; N = 399) and EPICure Study (N = 184), were included with term-born controls. Peer victimisation in childhood was assessed by parent and child report and psychotic experiences (PE) were assessed in early adulthood. Different models of psychosis were tested using regression and mediation analyses.

Results

There was support for the trauma and DRFM in the BLS. Peer victimisation increased the risk of PE for preterm and term-born participants equally [odds ratio = 4.87, 95% confidence interval (CI) 1.96–12.08]. There was an indirect effect where preterm children were more likely to be victimised, which subsequently increased risk of PE [β = 1.12 (s.e. = 0.61), 95% CI 0.11–2.48]. The results were replicated in EPICure.

Conclusions

Exposure to trauma which is experienced more often by neurodevelopmental risk children rather than neurodevelopmental risk per se increases the risk of PE. The findings are consistent with the trauma model and DRFM. Interventions focused on reducing trauma may reduce the development of PE.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2019

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