Universität zu Köln

Albert Porcar, Pilar (2022). Childhood trauma as a transdiagnostic risk factor for major psychiatric conditions: A meta-analysis. PhD thesis, Universität zu Köln.

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Abstract

Background: Childhood trauma (CT) was shown to increase the risk for multiple forms of adult psychiatric disorders, such as bipolar disorder, major depression (MD), and schizophrenia spectrum disorder. Previous research points to general mechanisms linking childhood traumatic experiences and adult psychopathology, which are not specific for psychiatric diagnostic entities. A transdiagnostic approach that cuts across traditional diagnostic categories provides an inclusive picture for understanding research in this field. Transdiagnostic risk factors are factors occurring across multiple disorders that contribute to the aetiology and/ or maintenance of a range of pathologies. This meta-analysis aims to determine if CT can be considered a transdiagnostic risk factor for the development of severe mental disorders: schizophrenia spectrum disorder, bipolar disorder, and major depression (MD); and analysing the role of different CT domains: physical abuse (PA), emotional abuse (EA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). Methods: We conducted a systematic literature search in two bibliographic databases: PubMed and Web of Science. We included articles reporting CT among patients with major psychiatric disorders (schizophrenia spectrum disorder, bipolar disorder, and MD) and healthy controls (HC). We calculated Hedge’s g effect sizes of the CT total scores and the CT domains (PA, EA, SA, EN, and PN) in the three pathologies using random-effects models. To examine the transdiagnostic aspects, we conducted subgroup analyses comparing the effect sizes of CT and its subtypes in the three major psychiatric conditions. Results: In total, 97 studies met our inclusion criteria. We found that the effect sizes of CT total scores were large in schizophrenia spectrum disorder (g=0.83, 95%-CI: 0.70-0.97), bipolar disorder (g=0.84, 95%-CI: 0.69-0.98), and MD (g=0.91, 95%-CI: 0.76-1.05) with no significant transdiagnostic differences in the subgroup analysis. All CT domains had moderate to large effects in the three psychiatric diagnoses compared to healthy controls. In the transdiagnostic comparison, we found significantly higher effect sizes for EA and EN in MD than in schizophrenia spectrum disorder. Conclusions: Our results provide strong evidence of the link between CT and adult psychopathology, identifying CT as a powerful transdiagnostic risk factor for the development of psychiatric disorders. The findings of our meta-analysis bear important implications for future research, clinical practice, and public health approaches.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Albert Porcar, Pilar pilar.albert-porcar@uk-koeln.de UNSPECIFIED UNSPECIFIED
Editors:	Editors Email ORCID ORCID Put Code Albert Porcar, Pilar pilar.albert-porcar@uk-koeln.de UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-647383
Date:	14 November 2022
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Psychiatrie und Psychotherapie > Klinik und Poliklinik für Psychiatrie und Psychotherapie
Subjects:	Psychology Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language childhood trauma UNSPECIFIED
Date of oral exam:	14 November 2022
Referee:	Name Academic Title Kambeitz, Joseph Prof. Dr.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/64738