Offspring Delusions and Hallucinations Linked With Maternal Childhood Adversity

Intergenerational transmission of childhood adversity is relevant in psychosis vulnerability etiology, and is potentially a modifiable risk factor.

Offspring delusional and hallucinatory experiences were associated with a maternal history of childhood adversity and partially mediated through offspring’s contact with childhood adversity, according to findings published in the Schizophrenia Bulletin.

Investigators sought to determine the potential for intergenerational transmission of childhood adversity between mothers and their offspring in association with psychotic experiences of offspring during adolescence.

They conducted a prospective cohort study (embedded in the Generation R Study, a prospective population-based birth cohort study from Rotterdam, the Netherlands) that included 3068 mother/offspring dyads. During pregnancy, maternal history of childhood adversity was evaluated retrospectively using the Childhood Trauma Questionnaire (CTQ). During and after pregnancy, maternal psychopathology was evaluated. When the child was 10 years old, a maternal interview was used to evaluate offspring childhood adversities. Self-report was used when offspring was 14 years old to assess psychotic experiences (nhallucinatory experiences=3068; ndelusional experiences=2560).

Hallucinatory experiences were evaluated using the Youth Self-Report questionnaire consisting of 2 items ([1] I hear sounds or voices that according to other people are not there, [2] I see things that other people think are not there).

Attenuation of these findings following adjustment for preexisting maternal mental health problems suggests that other mechanisms — eg, shared genetic risk, parenting — explain these intergenerational links between childhood adversity and psychotic experiences.

Delusional experiences were evaluated using specific items from the Kiddie Schedule for Affective Disorders and Schizophrenia self-report questionnaire ([1] Have other people ever read your thoughts? [2] Have you ever believed that you were being sent special messages through television or radio? [3] Have you ever thought you were being followed or spied on? [4] Have you ever felt as though your body had been changed in some way that you could not understand? [5] Does somebody have the power to control your mind or body (like a robot)? [6] Have you ever believed you are an important person or have special gifts other people do not have?).

Covariates of analysis included sex (52.7% girls) and child age (mean age 13.58 years at follow-up), maternal age at intake (mean age 31.41 years) and marital status (91.5% married or partnered), national heritage (offspring 77.6% European; mother 75.5% western), and maternal education (low/medium 41.5%).

Investigators found an association between maternal history of childhood adversities and offspring childhood adversities (β=0.12; 95% CI, 0.09-0.16). Maternal and offspring childhood adversity significantly associated with more offspring hallucinatory experiences (odds ratio [OR]=1.41; 95% CI, 1.04-1.90 and OR=1.34; 95% CI, 1.14-1.57, respectively), and to delusional experiences (β=0.04; 95% CI, 0.00-0.08 and β=0.06; 95% CI, 0.02-0.10, respectively).

The association of maternal childhood adversity with offspring hallucinations was mediated by offspring childhood adversity (βindirect effect=0.008; 95% CI, 0.002-0.014, proportion mediated=16.3%). The association of maternal childhood adversity with offspring delusions was mediated by offspring childhood adversity (βindirect effect=0.006; 95% CI, 0.000-0.012, proportion mediated=13.1%).

Study limitations include maternal recall bias, lack of a paternal childhood adversity report, child self-reporting bias, lost to follow-up included mothers with higher CTQ scores and were predominantly from more disadvantaged socioeconomic backgrounds leading to selection bias, and mother-reported offspring childhood adversities may have resulted in misclassification as she may be unaware of all adversities.

Investigators concluded, “Maternal history of childhood adversity was associated with offspring hallucinatory and delusional experiences, which was partially mediated through offspring’s exposure to childhood adversity.” They wrote “Attenuation of these findings following adjustment for preexisting maternal mental health problems suggests that other mechanisms — eg, shared genetic risk, parenting — explain these intergenerational links between childhood adversity and psychotic experiences.” They believe this intergenerational transmission of childhood adversity is relevant in psychosis vulnerability etiology, and is potentially a modifiable risk factor.

References:

Bolhuis K, Steenkamp LR, Tiemeier H, et al. A prospective cohort study on the intergenerational transmission of childhood adversity and subsequent risk of psychotic experiences in adolescence. Schizophr Bull. Published online December 22, 2022. doi:10.1093/schbul/sbac195