Childhood Trauma and Social Cognition Deficits in Early Psychosis: Evidence from the PREGAP Study
B. Pedruzo, C. Aymerich, L. Madaria, G. Acasuso, M. Á. Gonzalez-Torres, A. CatalánIntroduction
Adverse childhood experiences (ACEs) are disproportionately prevalent in early psychosis and may contribute to impairments in social cognition, a core predictor of functional outcomes. However, it remains unclear whether trauma explains unique variance in social cognition beyond the effects of psychosis itself.
Objectives
To examine whether ACE exposure contributes independently to deficits in social cognition across individuals with first-episode psychosis (FEP), clinical high risk for psychosis (CHR-P), and healthy controls (HC).
Methods
In this cross-sectional study, 107 participants were included (39 FEP, 35 CHR-P, 33 HC). ACEs were assessed with the Childhood Trauma Questionnaire (CTQ). Social cognition was measured using a comprehensive battery covering theory of mind (MASC, Hinting, Faux Pas), facial emotion recognition (PERE), and general socio-cognitive functioning (GEOPTE). Linear regression models adjusted for age, sex, and IQ were performed. Three nested models were compared: Model A (ACE), Model B (clinical group), and Model C (combined). Interaction terms tested stage-dependent effects.
Results
Higher ACE exposure was significantly associated with worse performance in specific social cognition domains. Emotional abuse predicted greater socio-cognitive difficulties (GEOPTE; β=0.62, p=0.01), physical and sexual abuse were linked to impaired disgust recognition (β=-0.06 and -0.05, both p=0.02), and emotional neglect was related to reduced Hinting performance (β=-0.11, p=0.02) and recognition of neutral expressions (β=-0.09, p<0.01). Physical neglect was associated with both reduced recognition of neutrality (β=-0.14, p<0.01) and increased recognition of joy (β=0.06, p=0.05). Nested model comparisons showed that adding ACEs improved model fit beyond clinical status, particularly for neutral expressions (ΔR
2
up to 0.18, p<0.01). ACE-by-group interactions indicated that negative effects of abuse on disgust recognition were stronger in FEP and CHR-P than in HC.
Image 1: Long description.