Childhood Adversity Linked to Cognitive Impairment in Schizophrenia

People with schizophrenia and cognitive impairment reported significant childhood adversity, especially the lack of parental involvement and family hardships.

Exposure to childhood adversity may be tied to distinct cognitive impairment patterns in individuals with schizophrenia, according to a study published in Schizophrenia Bulletin.

Investigators evaluated 836 individuals from the Australian Schizophrenia Research Bank database who either had schizophrenia or were healthy control individuals. All the individuals completed the Childhood Adversity Questionnaire, which assessed lack of parental affection, not having needs met, parental emotional trouble and substance use, financial hardship, family conflict and divorce or separation, neglect, and abuse. In addition, individuals with schizophrenia were separated into 3 cognitive subgroups: compromised (current and estimated premorbid cognitive impairment), deteriorated (substantial decline from estimated premorbid function), and preserved (performing in the normal cognitive range without decline).

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Overall, individuals with schizophrenia reported more adverse events than healthy control individuals (6.0 vs 2.8; t[834] = 14.46; P <.001), and the compromised group had the worst functional and symptom outcomes. Within the 3 subgroups, investigators found significantly more adversity in individuals with compromised cognition compared with deteriorated cognition (t[243] = 3.3; P =.009); specifically, more lack of parental involvement and family breakdown and hardship, and lower socioeconomic status. There were no other significant differences between groups.

The study relied on self-report of adverse childhood events, and the Childhood Adversity Questionnaire does not capture the timing or frequency of trauma, both of which may mediate effects on cognitive development.

The investigators concluded, “[Programs] to prevent or ameliorate these childhood adversities may positively alter trajectories of cognitive and functional outcomes for those who develop schizophrenia and may possibly prevent development of schizophrenia for others.”


Wells R, Jacomb I, Swaminathan V, et al. The impact of childhood adversity on cognitive development in schizophrenia [published online May 3, 2019]. Schizophr Bull. doi:10.1093/schbul/sbz033