Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder

Jim van Os; Anne Marsman; GROUP investigators; Daniela van Dam; Claudia J.P. Simons; Berhooz Z. Alizadeh; Agna A. Bartels-Velthuis; Nico J. van Beveren; Richard Bruggeman; Wiepke Cahn; Lieuwe de Haan; Philippe Delespaul; Carin J. Meijer; Inez Myin-Germeys; Rene S. Kahn; Frederike Schirmbeck; Neeltje E. van Haren; Ruud van Winkel

doi:10.1093/schbul/sbw177

Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder

Jim van Os^*, Anne Marsman, GROUP investigators, Daniela van Dam, Claudia J.P. Simons, Berhooz Z. Alizadeh, Agna A. Bartels-Velthuis, Nico J. van Beveren, Richard Bruggeman, Wiepke Cahn, Lieuwe de Haan, Philippe Delespaul, Carin J. Meijer, Inez Myin-Germeys, Rene S. Kahn, Frederike Schirmbeck, Neeltje E. van Haren, Ruud van Winkel

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

33 Citations (Scopus)

Abstract

Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80-1.92, P<.001)thanthenonexposed(b=2.31,95%CI:1.92-2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups.

Original language	English
Pages (from-to)	316-324
Number of pages	9
Journal	Schizophrenia Bulletin
Volume	43
Issue number	2
DOIs	https://doi.org/10.1093/schbul/sbw177
Publication status	Published - 1 Mar 2017
Externally published	Yes

Bibliographical note

Funding Information:
The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid,

Funding Information:
Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community’s Seventh Framework Program under grant agreement No. HEALTH-F2-2009–241909 (Project EU-GEI).

Funding Information:
The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community's Seventh Framework Program under grant agreement No. HEALTH-F2-2009-241909 (Project EU-GEI). We are grateful for the generosity, in terms of time and effort, shown by the patients, their families and the HCSs, and for the continuing collaboration with all the researchers who make the GROUP project possible. Furthermore, we would like to thank all research personnel involved in the GROUP project, in particular: Joyce van Baaren, Erwin Veermans, Ger Driessen, Truda Driesen, Karin Pos, Erna van 't Hag, Jessica de Nijs, Atiqul Islam, Wendy Beuken and Debora Op 't Eijnde.

Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

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10.1093/schbul/sbw177

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van Os, J., Marsman, A., GROUP investigators, van Dam, D., Simons, C. J. P., Alizadeh, B. Z., Bartels-Velthuis, A. A., van Beveren, N. J., Bruggeman, R., Cahn, W., de Haan, L., Delespaul, P., Meijer, C. J., Myin-Germeys, I., Kahn, R. S., Schirmbeck, F., van Haren, N. E., & van Winkel, R. (2017). Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder. Schizophrenia Bulletin, 43(2), 316-324. https://doi.org/10.1093/schbul/sbw177

@article{9002d716642f4aa598618768a8ba488e,

title = "Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder",

abstract = "Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80-1.92, P<.001)thanthenonexposed(b=2.31,95%CI:1.92-2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups.",

author = "{van Os}, Jim and Anne Marsman and {GROUP investigators} and {van Dam}, Daniela and Simons, {Claudia J.P.} and Alizadeh, {Berhooz Z.} and Bartels-Velthuis, {Agna A.} and {van Beveren}, {Nico J.} and Richard Bruggeman and Wiepke Cahn and {de Haan}, Lieuwe and Philippe Delespaul and Meijer, {Carin J.} and Inez Myin-Germeys and Kahn, {Rene S.} and Frederike Schirmbeck and {van Haren}, {Neeltje E.} and {van Winkel}, Ruud",

note = "Funding Information: The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Funding Information: Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community{\textquoteright}s Seventh Framework Program under grant agreement No. HEALTH-F2-2009–241909 (Project EU-GEI). Funding Information: The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community's Seventh Framework Program under grant agreement No. HEALTH-F2-2009-241909 (Project EU-GEI). We are grateful for the generosity, in terms of time and effort, shown by the patients, their families and the HCSs, and for the continuing collaboration with all the researchers who make the GROUP project possible. Furthermore, we would like to thank all research personnel involved in the GROUP project, in particular: Joyce van Baaren, Erwin Veermans, Ger Driessen, Truda Driesen, Karin Pos, Erna van 't Hag, Jessica de Nijs, Atiqul Islam, Wendy Beuken and Debora Op 't Eijnde. Publisher Copyright: {\textcopyright} The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.",

year = "2017",

month = mar,

day = "1",

doi = "10.1093/schbul/sbw177",

language = "English",

volume = "43",

pages = "316--324",

journal = "Schizophrenia Bulletin",

issn = "0586-7614",

publisher = "Oxford University Press",

number = "2",

}

van Os, J, Marsman, A, GROUP investigators, van Dam, D, Simons, CJP, Alizadeh, BZ, Bartels-Velthuis, AA, van Beveren, NJ, Bruggeman, R, Cahn, W, de Haan, L, Delespaul, P, Meijer, CJ, Myin-Germeys, I, Kahn, RS, Schirmbeck, F, van Haren, NE & van Winkel, R 2017, 'Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder', Schizophrenia Bulletin, vol. 43, no. 2, pp. 316-324. https://doi.org/10.1093/schbul/sbw177

TY - JOUR

T1 - Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder

AU - van Os, Jim

AU - Marsman, Anne

AU - GROUP investigators

AU - van Dam, Daniela

AU - Simons, Claudia J.P.

AU - Alizadeh, Berhooz Z.

AU - Bartels-Velthuis, Agna A.

AU - van Beveren, Nico J.

AU - Bruggeman, Richard

AU - Cahn, Wiepke

AU - de Haan, Lieuwe

AU - Delespaul, Philippe

AU - Meijer, Carin J.

AU - Myin-Germeys, Inez

AU - Kahn, Rene S.

AU - Schirmbeck, Frederike

AU - van Haren, Neeltje E.

AU - van Winkel, Ruud

N1 - Funding Information: The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Funding Information: Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community’s Seventh Framework Program under grant agreement No. HEALTH-F2-2009–241909 (Project EU-GEI). Funding Information: The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZON-MW, grant number 10-000-1001), and matching funds from participating industry (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag), universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGZ Eindhoven en De Kempen, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Mondriaan, Zuyderland, MetGGZ, Riagg-Virenze Maastricht, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal, Riagg Amersfoort and Delta). This study was funded in part by the European Community's Seventh Framework Program under grant agreement No. HEALTH-F2-2009-241909 (Project EU-GEI). We are grateful for the generosity, in terms of time and effort, shown by the patients, their families and the HCSs, and for the continuing collaboration with all the researchers who make the GROUP project possible. Furthermore, we would like to thank all research personnel involved in the GROUP project, in particular: Joyce van Baaren, Erwin Veermans, Ger Driessen, Truda Driesen, Karin Pos, Erna van 't Hag, Jessica de Nijs, Atiqul Islam, Wendy Beuken and Debora Op 't Eijnde. Publisher Copyright: © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80-1.92, P<.001)thanthenonexposed(b=2.31,95%CI:1.92-2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups.

AB - Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80-1.92, P<.001)thanthenonexposed(b=2.31,95%CI:1.92-2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups.

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U2 - 10.1093/schbul/sbw177

DO - 10.1093/schbul/sbw177

M3 - Article

C2 - 28177077

AN - SCOPUS:85026320042

SN - 0586-7614

VL - 43

SP - 316

EP - 324

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - 2

ER -

Evidence that the impact of childhood trauma on IQ is substantial in controls, moderate in siblings, and absent in patients with psychotic disorder

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