psychosis in children -- 4/8/14

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Today's selection -- Psychosis in children comes from parenting, not genetics:

"In an astonishing admission in the Guardian last month, Robert Plomin, the country's leading genetic psychologist, admitted of the Human Genome Project's quest for genes for psychological traits of all kinds: 'I've been looking for these genes for 15 years and I don't have any.'

"On the other side of the equation, the evidence for the role of maltreatment in causing emotional distress in general, and emotional abuse and neglect in particular, has become overwhelming. This applies as much to the extreme disturbance of psychosis (mostly schizophrenia and bipolar disorder) as to more common problems such as depression and anxiety.

"A definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. It broke down the role of different kinds of maltreatment. Emotional abuse meant exposure to behaviour such as harshness and name-calling from parents. Emotional neglect meant lack of love and responsiveness. Overall, in order of impact, emotional abuse increased the risk of psychosis the most (by 3.4 times, physical abuse and emotional neglect did so by 2.9, sexual abuse and bullying by peers by 2.4).

"That emotional abuse is more damaging than sexual and physical abuse may seem surprising, although they tend to go together. One study found that the emotionally abused were 12 times more likely to be schizophrenic than the general population (compared with six times for the physically abused and twice as likely for the sexually abused). Another study followed adolescents for 15 years and found that over a third became schizophrenic if both parents were hostile, critical and intrusive, compared with none where only one parent was or neither were. In his definitive book, Models of Madness, John Read, a clinical psychologist at Liverpool University, shows that in the 10 studies testing the matter, the more extreme the childhood adversity, the greater the risk of adult psychosis. The results are similar for the number of adversities. In one large study, those subjected to five or more adversities were 193 times more likely to suffer psychosis than those with none.

"Similar findings come from studies of less extreme emotional distress. In the definitive one, which followed 180 children from infancy to the age of 18, 90% of those who suffered early maltreatment qualified for a mental illness. Emotional neglect under the age of two was a critical predictor."

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