A systematic review of biopsychosocial mediators and moderators of the association between childhood adversity and psychosis

Childhood adversity is a major public health problem that has long lasting adverse consequences for mental health, including the development of depression, post-traumatic stress disorder, suicide, and substance misuse. In addition, childhood maltreatment and neglect are associated with an increased risk for subclinical psychosis and diagnosable psychotic disorders (OR 2.78, 95% CI 2.34-3.31) and account for up to 33% of the population affected with psychosis (Varese et al., 2012). Given the complex aetiology of psychosis, it is important to understand how childhood abuse and neglect increase the risk for psychosis in some individuals, but not in others. In view of that, this paper aims to systematically review potential mediating and moderating factors of the relationship between childhood adversity and psychosis. Specifically, we have systematically reviewed the literature on the effect of genes, substance use, adult life events and prolonged social stress, cognitive schema and reasoning biases, attachment styles, and non-psychotic psychopathology (depression, anxiety, post-traumatic stress disorder, and dissociation) in the association between childhood adversity and psychosis.