Modelling the interplay between childhood and adult adversity in pathways to psychosis: initial evidence from the AESOP study

Morgan, C., Reininghaus, U., Fearon, P., Hutchinson, G., Morgan, K.D., Dazzan, P., Boydell, J., Kirkbride, J., Doody, G., Jones, P., Murray, R. and Craig, T. 2014. Modelling the interplay between childhood and adult adversity in pathways to psychosis: initial evidence from the AESOP study. Psychological Medicine. 44 (2), pp. 407-419. https://doi.org/10.1017/s0033291713000767

TitleModelling the interplay between childhood and adult adversity in pathways to psychosis: initial evidence from the AESOP study
TypeJournal article
AuthorsMorgan, C., Reininghaus, U., Fearon, P., Hutchinson, G., Morgan, K.D., Dazzan, P., Boydell, J., Kirkbride, J., Doody, G., Jones, P., Murray, R. and Craig, T.
AbstractBACKGROUND:
There is evidence that a range of socio-environmental exposures is associated with an increased risk of psychosis. However, despite the fact that such factors probably combine in complex ways to increase risk, the majority of studies have tended to consider each exposure separately. In light of this, we sought to extend previous analyses of data from the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study on childhood and adult markers of disadvantage to examine how they combine to increase risk of psychosis, testing both mediation (path) models and synergistic effects.
METHOD:
All patients with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK (n = 390) and a series of community controls (n = 391) were included in the AESOP study. Data relating to clinical and social variables, including parental separation and loss, education and adult disadvantage, were collected from cases and controls.
RESULTS:
There was evidence that the effect of separation from, but not death of, a parent in childhood on risk of psychosis was partially mediated through subsequent poor educational attainment (no qualifications), adult social disadvantage and, to a lesser degree, low self-esteem. In addition, there was strong evidence that separation from, but not death of, a parent combined synergistically with subsequent disadvantage to increase risk. These effects held for all ethnic groups in the sample.
CONCLUSIONS:
Exposure to childhood and adult disadvantage may combine in complex ways to push some individuals along a predominantly sociodevelopmental pathway to psychosis.
JournalPsychological Medicine
Journal citation44 (2), pp. 407-419
ISSN0033-2917
Year2014
PublisherCambridge University Press
Digital Object Identifier (DOI)https://doi.org/10.1017/s0033291713000767
PubMed ID23590972
Publication dates
Published online16 Apr 2013
Published in printJan 2014

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Aleman, A., Agrawal, N., Morgan, K.D. and David, A.S. 2006. Insight in psychosis and neuropsychological function: meta-analysis. British Journal of Psychiatry. 189 (3), pp. 204-212. https://doi.org/10.1192/bjp.189.3.204

The structural brain correlates of neurological soft signs in healthy individuals
Dazzan, P., Morgan, K.D., Chitnis, X., Suckling, J., Morgan, C., Fearon, P., McGuire, P.K., Jones, P.B., Leff, J. and Murray, R.M. 2006. The structural brain correlates of neurological soft signs in healthy individuals. Cerebral Cortex. 16 (8), pp. 1225-1231. https://doi.org/10.1093/cercor/bhj063

Insight and cognition
Morgan, K.D. 2006. Insight and cognition. in: Morgan, K.D., David, A.S., Murray, R.M. and Eberhard, J. (ed.) Cognition and schizophrenia: improving real life function Cambridge, UK Cambridge Medical Communication. pp. 37-43

Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the sop first-onset psychosis study
Pariante, C.M., Dazzan, P., Danese, A., Morgan, K.D., Brudaglio, F., Morgan, C., Fearon, P., Orr, K.G., Hutchinson, G., Pantelis, C., Velakoulis, D., Jones, P.B., Leff, J. and Murray, R.M. 2005. Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the sop first-onset psychosis study. Neuropsychopharmacology. 30 (10), pp. 1923-1931. https://doi.org/10.1038/sj.npp.1300766

Pathways to care and ethnicity. 2: source of referral and help-seeking: report from the AESOP study
Morgan, C., Mallett, R.M., Hutchinson, G., Bagalkote, H., Morgan, K.D., Fearon, P., Dazzan, P., Boydell, J., McKenzie, K., Harrison, G., Murray, R.M., Jones, P.B., Craig, T.K.J. and Leff, J. 2005. Pathways to care and ethnicity. 2: source of referral and help-seeking: report from the AESOP study. British Journal of Psychiatry. 186 (4), pp. 290-296.

Pathways to care and ethnicity. 1: sample characteristics and compulsory admission: report from the ÆSOP Study
Morgan, C., Mallett, R.M., Hutchinson, G., Bagalkote, H., Morgan, K.D., Fearon, P., Dazzan, P., Boydell, J., McKenzie, K., Harrison, G., Murray, R.M., Jones, P.B., Craig, T.K.J. and Leff, J. 2005. Pathways to care and ethnicity. 1: sample characteristics and compulsory admission: report from the ÆSOP Study. British Journal of Psychiatry. 186 (4), pp. 281-289.

Different effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the ÆSOP Study
Dazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J., Fearon, P., McGuire, P.K., Mallett, R.M., Jones, P.B., Leff, J. and Murray, R.M. 2005. Different effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the ÆSOP Study. Neuropsychopharmacology. 30 (4), pp. 765-774. https://doi.org/10.1038/sj.npp.1300603

Incidence of bipolar affective disorder in three UK cities: results from the ÆSOP Study
Lloyd, T., Kennedy, N., Fearon, P., Kirkbride, J.B., Mallett, R.M., Leff, J., Holloway, J., Harrison, G., Dazzan, P., Morgan, K.D., Murray, R.M. and Jones, P.B. 2005. Incidence of bipolar affective disorder in three UK cities: results from the ÆSOP Study. British Journal of Psychiatry. 186 (2), pp. 126-131.

A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder
Connor, S.E.J., Ng, V., McDonald, C., Schulze, K., Morgan, K.D., Dazzan, P. and Murray, R.M. 2004. A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder. Neuroradiology. 46 (7), pp. 523-534. https://doi.org/10.1007/s00234-004-1224-0

Neuropsychological studies of insight in psychosis
Morgan, K.D. and David, A.S. 2004. Neuropsychological studies of insight in psychosis. in: Amador, X.S. and David, A.S. (ed.) Insight and psychosis: awareness of illness in schizophrenia and related disorders. 2nd edition Oxford, UK Oxford University Press.

Perception of psychosis in patients
Morgan, K.D. 2004. Perception of psychosis in patients. Epidemiologia e Psichiatria Sociale. 13 (4), pp. 222-226.

Normal cerebral asymmetry in familial and non-familial schizophrenic probands and their unaffected relatives
Chapple, B., Grech, A., Sham, P., Toulopoulou, T., Walshe, M., Schulze, K., Morgan, K.D., Murray, R.M. and McDonald, C. 2004. Normal cerebral asymmetry in familial and non-familial schizophrenic probands and their unaffected relatives. Schizophrenia Research. 67 (1), pp. 33-40. https://doi.org/10.1016/S0920-9964(03)00095-1

The structural brain correlates of neurological soft signs in ÆSOP first-episode psychoses study
Dazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J., Fearon, P., Salvo, J., McGuire, P.K., Mallett, R.M., Jones, P.B., Leff, J. and Murray, R.M. 2003. The structural brain correlates of neurological soft signs in ÆSOP first-episode psychoses study. Brain. 127 (1), pp. 143-153. https://doi.org/10.1093/brain/awh015

A functional magnetic resonance imaging study of overt letter verbal fluency using a clustered acquisition sequence: greater anterior cingulate activation with increased task demand
Fu, C.H.Y., Morgan, K.D., Suckling, J., Williams, S.C.R., Andrew, C., Vythelingum, G.N. and McGuire, P.K. 2002. A functional magnetic resonance imaging study of overt letter verbal fluency using a clustered acquisition sequence: greater anterior cingulate activation with increased task demand. NeuroImage. 17 (2), pp. 871-879. https://doi.org/10.1016/S1053-8119(02)91189-4

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