A report in the May issue of Archives of General Psychiatry (one of the JAMA/Archives journals) indicates that children who have been mistreated over and over again by peers seem more prone to suffer from psychotic symptoms in early adolescence.

Background facts sustained in the report demonstrate that hallucinations and delusions are common in childhood and adulthood and are characteristic symptoms of psychosis. Children experiencing these symptoms have a greater probability of developing psychosis in later life. The researchers say: “Recent studies have demonstrated an association between traumatic events such as abuse in childhood and psychosis in adults.”

A study including 6,437 early adolescents with an average age of 12.9 was carried out by Andrea Schreier, Ph.D., and his colleagues of The Warwick Medical School, University of Warwick, Coventry, England. The children participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Questionnaires were regularly sent by mail to parents concerning their child’s physical condition and progress since birth. Beginning at the age of seven, the children were submitted to physical and psychological evaluations on a yearly basis.

During the yearly visits, they were rated by skilled interviewers on whether during the preceding six months they had experienced hallucinations, delusions, thought disorders or any other psychotic symptoms. Peer victimization is defined as harmful actions and unfair treatment by one or several other students with purpose to harm. Children, parents and teachers were required to account on whether the child had suffered such oppression.

The study concluded that a total of 46.2 percent of the participants were considered as victims, and 53.8 percent of the children as not mistreated at either ages of eight or ten. After monitoring the follow-up results, they indicated the following:

• 13.7 percent had broad psychosis-like symptoms, meaning one or more symptoms suspected or positively present.

• 11.5 percent had intermediate symptoms, meaning one or more of the symptoms was suspected or present from time to time, other than when going to sleep, waking from sleep, having fever or after using substance.

• 5.6 percent had narrow symptoms, meaning one or more symptoms definitely present.

Independent of other psychiatric illness, family hardship, or the child’s IQ, the risk of psychotic symptoms was multiplied by two for children who suffered bullying at age eight or ten. The correlation was more notable in cases where victimization was persistent or more traumatic.

The authors remark: “A range of mechanisms has been proposed to explain the link between traumatic events, such as victimization, and psychotic symptoms.” For example, bullying can cause chronic stress that may have an effect on a genetic predisposition to schizophrenia and set off 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 write in conclusion. “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.”

“Prospective Study of Peer Victimization in Childhood and Psychotic Symptoms in a Nonclinical Population at Age 12 Years”
Andrea Schreier; Dieter Wolke; Kate Thomas; Jeremy Horwood; Chris Hollis; David Gunnell; Glyn Lewis; Andrew Thompson; Stanley Zammit; Larisa Duffy; Giovanni Salvi; Glynn Harrison
Arch Gen Psychiatry. 2009; 66[5]:527-536.

Written by Stephanie Brunner (B.A.)