Early Adversity And Psychotic Experiences: Bio-psycho-social Pathways And Resiliencies

Principal investigator: Dr Helen Fisher

Location: UK

Funding Period: 2015-2018

1 in 10 children will experience psychotic symptoms, such as hearing voices or seeing things that others don’t.

A number of major studies have explored this area, and found that if these symptoms continue into adolescence, it can be a sign of future schizophrenia. And if young people have been bullied, abused or experienced other traumatic events, the chance of developing the condition increases.

But understanding of exactly how trauma can lead to psychosis remains limited – so Dr Helen Fisher and her team analysed data collected over many years, to pinpoint potential clues.

The project

The project investigated how early adversity influences the development of psychotic experiences in children and adolescents. The research aimed to identify bio-psycho-social pathways and resilience factors, using data from three large longitudinal cohorts: ALSPAC, CHADS, and E-Risk.

The overarching goal was to understand why some children with troubled childhoods develop psychotic experiences and to identify those at risk for long-term mental health disorders

The process

The research addressed three main objectives:

To determine if locus of control and self-esteem mediate the link between early adversity and adolescent psychotic experiences.
To explore whether DNA methylation patterns differ between children exposed and not exposed to adversity, and among those with different psychotic experience trajectories.
To investigate whether social support, self-control, coping style, and cognitive flexibility moderate the association between adversity and psychotic experiences.

To do this, Helen and her team looked at data from existing studies that describe exposure to traumatic events, alongside information on potential psychological and social mechanisms and the nature of psychotic symptoms across childhood.

They also studied DNA samples that were taken during the studies, to explore whether changes in gene behaviour after traumatic experiences could provide clues to the causes of psychosis.

The outcome

The project resulted in a prolific output of scientific publications, the findings from which have contributed to the development of early interventions and improved understanding of risk and resilience in adolescent mental health.

- Children who experienced post-traumatic stress symptoms after adversity were found to be at greater risk of developing psychotic experiences.
- Biological analyses revealed differences in gene regulation between children with and without psychotic experiences, especially among those with persistent symptoms. However, no clear links to childhood victimisation were found.

Papers published

Olesya Ajnakina, Antonella Trotta, Valeria Mondelli, Robin M. Murray, Helen L. Fisher Et Al Different types of childhood adversity and 5-year outcomes in a longitudinal cohort of first-episode psychosis patients Discovery UCL 2015
Hosang GM, Fisher HL, Hodgson K, Maughan B, Farmer AE. Childhood maltreatment and adult medical morbidity in mood disorders: comparison of unipolar depression with bipolar disorder. Br J Psychiatry. 2018
Aylott A, Zwicker A, MacKenzie LE, Cumby J, Propper L, Abidi S, Bagnell A, Fisher HL, Pavlova B, Alda M, Uher R. Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring. J Dev Orig Health Dis. 2019
Roberts S, Arseneault L, Barratt B, Beevers S, Danese A, Odgers CL, Moffitt TE, Reuben A, Kelly FJ, Fisher HL. Exploration of NO₂ and PM_2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study. Psychiatry Res. 2019
Roberts S, Suderman M, Zammit S, Watkins SH, Hannon E, Mill J, Relton C, Arseneault L, Wong CCY, Fisher HL. Longitudinal investigation of DNA methylation changes preceding adolescent psychotic experiences. Transl Psychiatry. 2019
Riches S, Khan F, Kwieder S, Fisher HL. Impact of an auditory hallucinations simulation on trainee and newly qualified clinical psychologists: A mixed-methods cross-sectional study. Clin Psychol Psychother. 2019
Crush E, Arseneault L, Danese A, Jaffee SR, Fisher HL. Using discordant twin methods to investigate an environmentally mediated pathway between social support and the reduced likelihood of adolescent psychotic experiences. Psychol Med. 2020

The impact

The research has the potential to inform early interventions to prevent the onset and persistence of psychotic phenomena in young people, thereby reducing the risk of serious mental illnesses and suicide attempts.

The findings from this study have already contributed to public information resources such as through ChildLine.

The findings are being utilised in further research, including an NSPCC-ESRC funded project and the MQ-funded IDEA consortium, which seeks to improve early identification of adolescent depression internationally.

“I think that being an MQ Fellow has given me the confidence, solid data, and international profile to secure additional funding to extend my research into epigenetic mechanisms of adolescent psychosocial stress (awarded in 2015) and the involvement of wider environmental factors (particularly neighborhood social processes and pollution – awarded in 2015 & 2016) in the development of psychopathology.” Dr Helen Fisher

Dr Helen Fisher

Dr Helen Fisher is a psychologist and Professor at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London. Her focus is on the causes and treatment of psychosis in young adults.

Since completing her MQ Fellowship Helen ahs joined the MQ Science Council.