CHICAGO – Children who are consistently victimized by peers appear
more likely to develop psychotic symptoms in early adolescence,
according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Some
psychosis-like symptoms such as hallucinations and delusions are
commonly experienced in childhood and adulthood, according to
background information in the article. Children with these symptoms are
at increased risk of developing psychosis in adulthood. "Recent studies
have demonstrated an association between traumatic events such as abuse
in childhood and psychosis in adults," the authors write.
Andrea
Schreier, Ph.D., of Warwick Medical School, University of Warwick,
Coventry, England, and colleagues studied 6,437 individuals in early
adolescence (average age 12.9) who were part of the Avon Longitudinal
Study of Parents and Children (ALSPAC). Parents had completed regular
mailed questionnaires about their child's health and development since
birth, and the children underwent yearly physical and psychological
assessments from age 7.
At each visit, trained interviewers
rated the children on whether they had experienced psychotic symptoms
(hallucinations, delusions or thought disorders) during the previous
six months. Children, parents and teachers reported on whether the
child had experienced peer victimization, defined as negative actions
by one of more other students with the intention to hurt.
A
total of 46.2 percent of participants were categorized as victims and
53.8 percent were not victimized at either ages 8 or 10. At follow-up,
13.7 percent had broad psychosis-like symptoms (one or more symptoms
suspected or definitely present), 11.5 percent had intermediate
symptoms (one or more of the symptoms was suspected or present at times
other than going to sleep, waking from sleep, fever or after substance
use) and 5.6 percent had narrow symptoms (one or more symptoms
definitely present).
The risk of psychotic symptoms was
approximately doubled among children who were victims of bullying at
age 8 or 10, independent of other psychiatric illness, family adversity
or the child's IQ. The association was stronger when victimization was
chronic or severe.
"A range of mechanisms has been proposed
to explain the link between traumatic events, such as victimization,
and psychotic symptoms," the authors write. For instance, chronic
stress from bullying may act on a genetic predisposition to
schizophrenia to trigger symptoms.
"Whether repeated
victimization experiences alter cognitive and affective processing or
reprogram stress response or whether psychotic symptoms are more likely
due to genetic predisposition still needs to be determined in further
research," the authors conclude. "A major implication is that chronic
or severe peer victimization has non-trivial, adverse, long-term
consequences. Reduction of peer victimization and of the resulting
stress caused to victims could be a worthwhile target for prevention
and early intervention efforts for common mental health problems and
psychosis."
###
(Arch Gen Psychiatry. 2009;66[5]:527-536. Available pre-embargo to the media at www.jamamedia.org.)
Editor's
Note: The UK Medical Research Council, the Wellcome Trust and the
University of Bristol provide core support for ALSPAC. This study was
funded by a grant from the Wellcome Trust. Please see the article for
additional information, including other authors, author contributions
and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.
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