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

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posted on 2020-03-26, 16:05 authored by Y Liu, M Mendoncą, S Johnson, H O'Reilly, P Bartmann, N Marlow, D Wolke
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.MethodsTwo 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.ResultsThere 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.ConclusionsExposure 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.


Ms Liu has a funded Ph.D. studentship by the Department of Psychology at the University of Warwick. BLS received funding from the German Federal Ministry of Education and Science (grants PKE24, JUG14, 01EP9504 and 01ER0801), and EPICure from Medical Research Council Programme (grant ref no. MR/J01107X/1). Prof Marlow receives part funding from the Department of Health’s NIHR Biomedical Research Centre’s funding scheme at UCLH/UCL, and Prof Wolke, Prof Bartmann, Dr Mendonca and Prof Johnson from European Union’s Horizon 2020 research and innovation programme (RECAP-Preterm) under grant agreement: 733280.



Psychological Medicine, 2019

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Department of Health Sciences


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Psychological Medicine


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Cambridge University Press (CUP)





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