Childhood trauma, psychopathy, and psychopathology
Today, I examine two studies of childhood trauma. First, Garofalo, Delvecchio, Bogaerts, Sellbom & Mazzeschi (2024) published “Childhood Trauma and Psychopathy: The moderating role of resilience” in Psychological Trauma: Theory, Research, Practice, and Policy. Here are the edited abstract and impact statements:
Despite accumulating evidence of significant albeit moderate associations between childhood trauma and psychopathy, little is known about the potential moderators of these associations. To advance knowledge in this area, the present study investigated the moderating role of resilience in the childhood trauma–psychopathy link. A community sample of 521 adult participants from the Netherlands (40.1% men; Mage = 35.27 years, SD = 15.99) completed two self-report questionnaires measuring psychopathic personality traits: a self-report measure of resilience and a retrospective measure of childhood traumatic experiences. Correlation analyses were employed to investigate bivariate associations among study variables. Moderated multiple regression analyses with bootstrapping followed by simple slope analyses were employed to examine Childhood Trauma × Resilience interactions in predicting scores of psychopathy subscales. Childhood trauma had small positive associations with psychopathic traits across the board, with the exception of a small negative association with boldness traits, as well as a small negative association with resilience. Resilience was strongly and positively related to boldness, and negatively related to affective (callousness, meanness) and behavioral (antisocial, disinhibition) traits of psychopathy. Resilience moderated six out of seven associations between childhood trauma and psychopathic traits. Resilience appeared to represent a significant buffer in the associations between childhood traumatic experiences and psychopathic traits, such that these associations became weaker and nonsignificant (and even negative for boldness) at higher levels compared to lower levels of resilience.
The findings of this study offer valuable insights into the relationship between childhood trauma and psychopathic personality traits, emphasizing the clinical significance of resilience as a protective factor against the development and manifestation of psychopathic traits in adults who have experienced childhood trauma. Among individuals who experienced childhood trauma, more resilient individuals show lower levels of psychopathic traits than those who are less resilient. Interventions aimed at enhancing resilience in individuals with a history of childhood trauma may be effective in buffering the emergence of psychopathic traits, contributing to improved mental health outcomes and decreased societal risks associated with psychopathy.
This is not at all surprising but suggests interventions related to resilience may have payoffs for children who experience childhood trauma. Next, Williams et al. (2024) published “The Hierarchical Taxonomy of Psychopathology in Clinical High Risk for Psychosis: Validation and extension in Journal of Psychopathology and Clinical Science. The edited abstract and impact statements follow:
The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium’s transdiagnostic dimensional model of psychopathology has considerable support; however, this model has been underresearched in individuals at clinical high risk for psychosis (CHR-P), a population that may advance the model. CHR-P individuals not only have attenuated psychotic symptoms that vary in severity, but also have many comorbid diagnoses and varied clinical outcomes, including disorders with uncertain relations to HiTOP (e.g., obsessive-compulsive disorder). The present study used self-report and interview data from North American Prodrome Longitudinal Study-3 (710 CHR, 96 controls) to replicate the HiTOP model and test specific hypotheses regarding disorders with uncertain relations to its dimensions. Additionally, the present study examined the HiTOP model in relation to childhood trauma, declines in social functioning, and development of full psychosis. Confirmatory factor analysis indicated that the HiTOP model’s fit was nearly adequate (e.g., comparative fit index = .89), though several theory-relevant modifications were indicated. Additionally, specific tests were conducted to gain a more fine-grained perspective on how disorders with less clear prior evidence were related to the HiTOP model. Notable findings from these analyses include bipolar spectrum disorders relating to the psychosis super spectrum (i.e., .39 loading), and obsessive-compulsive disorder showing a complex pattern of loadings (e.g., internalizing and psychosis). The final model parsimoniously accounted for childhood trauma (e.g., super spectra rs = .22–.32), associations with current functioning, and predicted future conversion to a psychotic disorder (e.g., super spectra R² = .13). Overall, these results inform the HiTOP model and suggest its promise for CHR-P research.
Individuals at risk of developing psychosis often have multiple psychiatric diagnoses; however, existing diagnostic frameworks poorly describe the reality of the symptoms experienced by individuals at risk for psychosis. The present study supported the validity and utility of an alternative framework for describing psychiatric symptoms—the Hierarchical Taxonomy of Psychopathology—by showing its relevance to both psychosis risk factors and clinical outcomes.
The HiTOP model identifies six spectra: somatoform, internalizing, thought disorder, externalizing disinhibited, externalizing antagonistic, and detachment. It then moves down to subfactors, syndromes and disorders, signs and symptoms, and traits with links between each level in the hierarchy. It’s clear that childhood trauma is again a major predictor, this time of risks of psychosis. The bipolar-psychosis relationship is not at all surprising, but I like the OCD loading on internalizing and psychosis. As we see more and more spectrum disorders, this HiTOP model may be increasingly helpful.