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Early life adversity tied to poorer social cognition in psychiatric disorders
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Findings from a systematic review revealed a significant association between early childhood social adversity — including insecure attachment and adversity relating to neglect or abuse — and poorer social cognitive performance in participants with major psychiatric disorders.
These results indicated that early childhood experiences play a crucial role in the development of social cognitive abilities, and may mediate early life adversities and later symptom severity, according to the researchers.
“Deficits in social cognitive function are a hallmark feature of major psychiatric disorders resulting in impaired social and occupational functioning,” Karolina I. Rokita, MSc, PhD student in the department of psychology at the National University of Ireland, and colleagues wrote. “Despite the relevance of early life experience to understanding development of social cognition in those who go on to experience psychiatric disorders, the association between early life experiences and social cognition in psychiatric disorders remains poorly understood.”
The investigators conducted a systematic review of clinical studies identified via electronic and manual searches of the literature to determine the ties between early social environment, early life adversity and social cognition in major psychiatric disorders. They performed quality assessment using the quality evaluation scale employed in earlier systematic reviews.
Researchers included studies examining the direct link between adverse early life experiences (eg, childhood trauma) and/or attachment and social cognition (eg, theory of mind, emotion recognition) in adults with schizophrenia, bipolar disorder, borderline personality disorder, major depressive disorder and/or PTSD.
Overall, 25 studies were included in the review, with scores ranging from 3 to 6 (out of 6) on the quality assessment instrument. Of these, nine studies were conducted in patients with schizophrenia, seven in those with personality disorders, four in patients with affective disorders, three in those with anxiety disorders and two in patients with either affective or personality disorders.
Most of the studies included in the review showed a significant relationship between early childhood experience, including both bad parenting and adversity in childhood related to neglect or abuse, and poorer social cognitive performance. Rokita and colleagues wrote that these data suggest these adverse early life social experiences negatively affect future social cognitive function in patients, and also potentially healthy participants.
The studies showed that emotional and physical abuse, neglect and avoidant attachment were the strongest predictors of theory of mind, issues recognizing emotions and emotional dysregulation. Only three studies did not report this association; however, the researchers explained this was because they used small sample sizes (n = 30), employed a measure of attachment with unknown validity, or used an insufficient task to measure a specific domain of social cognition.
“The studies reviewed suggest a crucial role of early childhood experiences in the development of social cognitive abilities, which may represent a mediator between early life adversities and later symptom severity,” Rokita and colleagues wrote in European Psychiatry.
“Studies to understand the mechanisms by which this occurs at neurocognitive and biological levels remain an important goal for the field,” they continued. “Alongside these research needs, the findings of this review underline the importance of addressing the various types of early childhood social experiences and adversity in clinical assessment and interventions, given the abundant evidence of the later effects of these experiences.” – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.