SA92. Trauma Stress and the Hippocampus in the At-Risk Mental State

摘要

>Background: Childhood trauma may increase the risk of developing psychosis by increasing sensitivity to stressful events later in life. To test this theory, this study investigated associations between childhood trauma and stress sensitivity in daily life and the volume of a stress-related brain structure in people at clinical high risk of psychosis. It was hypothesized that both childhood adversity and greater stress sensitivity would be associated with smaller hippocampal volume. >Methods: Participants were recruited from an At-Risk Mental State service in South London. The Experience Sampling Method (ESM) was used to collect electronic diary data on minor stressful experiences, negative and positive affect, and intensity of psychotic experiences in daily life. Structural MRI data were used to measure the volume of the hippocampus. Childhood abuse was measured used the Childhood Experiences of Care and Abuse questionnaire. Linear mixed models were used to account for the multilevel structure of ESM data, treating multiple observations as nested within subjects. >Results: Smaller hippocampal volume was associated with sexual abuse in childhood but not physical or emotional abuse. Greater affective and psychotic sensitivity to daily stressors were also associated with smaller hippocampal volume. >Conclusion: Smaller hippocampal volume has been consistently reported in people with psychosis. That it is a marker, even before onset of frank psychosis, for both a history of childhood sexual abuse and greater stress sensitivity provides support for the traumagenic neurodevelopmental model of psychosis.