Childhood trauma and childhood urbanicity in relat

Authors: Aleida Frissen Ritsaert Lieverse Marjan Drukker Ruud van Winkel Philippe Delespaul GROUP Investigators

Publish Date: 2015/04/21

Volume: 50, Issue: 10, Pages: 1481-1488

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Abstract

Urban upbringing and childhood trauma are both associated with psychotic disorders However the association between childhood urbanicity and childhood trauma in psychosis is poorly understood The urban environment could occasion a background of social adversity against which any effect of childhood trauma increases Also any impact of the urban environment on likelihood of exposure to childhood trauma could be stronger in children who later develop psychotic disorder The aim of this study was twofold 1 to investigate whether childhood urbanicity moderates the effect of childhood trauma in a model predicting psychotic disorder 2 to investigate whether there is an association between the urban environment and childhood trauma and whether this is moderated by genetic liability for psychotic disorderPatients with a diagnosis of nonaffective psychotic disorder n = 1119 and 589 healthy controls from the Netherlands and Belgium were studied Childhood trauma was assessed with the Dutch version of the Childhood Trauma Questionnaire Short Form Urban exposure was defined at four levels considering the population density using data from Statistics Netherlands and the equivalent database in BelgiumThere was a significant interaction between childhood urbanicity on the one hand and childhood trauma on the other indicating that trauma was significantly associated with psychotic disorder with increasing odds ratios for higher levels of childhood urbanicity In addition there was weak evidence that childhood urbanicity was associated with childhood trauma in the patient group higher levels of childhood urbanicity were associated with higher trauma scoresUrban birth and urban upbringing 1 2 3 4 and childhood trauma 5 6 7 8 9 are both associated with psychotic disorder The dynamics underlying the triangular association between childhood urbanicity childhood trauma and psychosis remains poorly understood but is of considerable interest in the prevention and management of risk given childhood exposure to adversityThere is evidence that the incidence of childhood trauma is linked to aspects of the urban environment neighbourhood factors such as impoverishment and child care burden ratio of children to adults and the ratio of males to females significantly increase child abuse 10 Lower levels of social capital inherent to higher levels of urbanicity have been found to increase the odds of neglectful parenting psychologically harsh parenting and domestic violence 11Childhood urbanicity moderates the association between childhood trauma and psychotic disorder Childhood urbanicity is associated with social adversity which is associated with stress Any effect of childhood trauma on psychotic disorder in the urban environment may increase because of higher background levels of stress

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