Childhood adversities and psychotic symptoms: The potential mediating or moderating role of neurocognition and social cognition

Introduction: Childhood abuse and neglect are risk factors for psychotic symptoms. Early adversities may contribute to alterations in neuro/social cognition, which in turn is associated with psychosis. This study explored the possible mediating/moderating role of neuro/social cognition between childhood abuse and neglect on the one hand, and psychotic symptoms on the other. Method: The sampling frame was 1.119 patients with a psychotic disorder. Childhood adversity was evaluated with the Dutch version of the Childhood Trauma Questionnaire. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Verbal learning-memory, attention-vigilance, working memory, information processing speed, reasoning-problem solving were evaluated as measures of neurocognition using the Word Learning Task, the Continuous Performance Test, the Wechsler Adult Intelligence Scale 3rd. Mentalization was evaluated as a measure of social cognition using the Hinting Task. Correlation, mediation, moderation, 95% Bias Corrected and accelerated (BCaCI) bootstrapped analyses were performed, considering possible sex differences. Results: In male psychotic patients, attention and vigilance mediated the association between childhood neglect and negative symptoms (indirect effect: 0.18, BCaCI: 0.03–0.54), disorganization (indirect effect: 0.26, BCaCI: 0.05–0.61), excitement (indirect effect: 0.07, BCaCI: 0.004–0.23); mentalization mediated the association between childhood neglect and negative symptoms (indirect effect: 0.21, BCaCI: 0.02–0.51), excitement (indirect effect: 0.07, BCaCI: 0.01–0.20) disorganization (indirect effect: 0.29, BCaCI: 0.02–0.64); working memory mediated the association between childhood abuse and disorganization (indirect effect: 0.28, BCaCI: 0.05–0.57), excitement (indirect effect: 0.08, BCaCI: 0.01–0.20), emotional distress (indirect effect: 0.10, BCaCI: 0.01–0.27). Discussion: In psychotic disorder, sex-specific mediation of neurocognition and mentalization may exist in the association between childhood adversity and psychotic symptoms.

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