Negativ verzerrte kognitive Denkschemata sind typisch für Depressionen und auch bei der Emotionsverarbeitung nachweisbar. Depressionen können durch Kindheitstraumata und dysfunktionale Einstellungen begünstigt werden; auch bei dem Vorliegen von Kindheitstraumata wurden Veränderungen in der Emotionswahrnehmung ermittelt. Diese Studie untersucht Zusammenhänge zwischen Kindheitstraumata beziehungsweise dysfunktionalen Einstellungen und der automatischen Emotionsbewertung mittels eines affektiven Priming Experimentes und der kontrollierten Emotionsbewertung mittels Bouhuys Faces Experiment in einer Stichprobe von 45 depressiven Patienten. Es konnten Beziehungen zwischen Emotionsbewertung und Kindheitstraumata beziehungsweise dysfunktionalen Einstellungen belegt werden: Kindheitstraumata könnten auf kontrollierter Verarbeitungsebene die positive Bewertung emotionaler Gesichter absenken. Dysfunktionale Einstellungen könnten die negative Bewertung von Gesichtern im Allgemeinen sowie von ambigen Gesichtern verstärken und die positive Bewertung ambiger Gesichter vermindern. Auf der automatischen Verarbeitungsebene konnten keine signifikanten Zusammenhänge zwischen der Emotionsevaluation und Kindheitstraumata oder dysfunktionalen Einstellungen gefunden werden. Die Ergebnisse der Studie legen nahe, dass bei der Therapie von Depressiven die Erkennung und Aufarbeitung traumatischer Kindheitserfahrungen, die Schulung der Fähigkeiten zur Emotionsinterpretation und die Änderung negativer kognitiver Denkschemata wichtige Herausforderungen darstellen.

Background. Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. Method. In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive–compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. Results. The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose–response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56–68%, all p < 0.001). Within individuals with MD/OCD, the association between PEs and help-seeking behaviour, as an index of severity, was moderated by trauma (ICR = 1.87, p = 0.009) and urbanicity (ICR = 1.48, p = 0.005), but not by cannabis use. Conclusions. In non-psychotic disorder, environmental factors increase the likelihood of psychosis admixture and helpseeking behaviour through an increase in general psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network.

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Background: Childhood maltreatment is associated with the development and maintenance of mental disorders. The purpose of this naturalistic study was (a) to identify different patterns of childhood maltreatment, (b) to examine how these patterns are linked to the severity of mental disorders and (c) whether they are predictive of treatment outcome. Methods: 742 adult patients of a university hospital for psychotherapy and psychosomatics were assessed at intake and discharge by standardized questionnaires assessing depression (Beck Depression Inventory, BDI) and general mental distress (Symptom Check List-90-R, SCL-90-R). Traumatic childhood experience (using the Childhood Trauma Questionnaire, CTQ) and ICD-10 diagnoses were assessed at intake. Results: The patients could be allocated to three different patterns of early childhood trauma experience: mild traumatization, multiple traumatization without sexual abuse and multiple traumatization with sexual abuse. The three patterns showed highly significant differences in BDI, General Severity Index (GSI) and in the number of comorbidity at intake. For both BDI and GSI a general decrease in depression and general mental distress from intake to discharge could be shown. The three patterns differed in BDI and GSI at intake and discharge, indicating lowest values for mild traumatization and highest values for multiple traumatization with sexual abuse. Patients with multiple traumatization with sexual abuse showed the least favourable outcome. Conclusion: The results provide evidence that the severity of childhood traumatization is linked to the severity of mental disorders and also to the treatment outcome in inpatient psychotherapy. In the study, three different patterns of childhood traumatization (mild traumatization, multiple traumatization without sexual abuse, multiple traumatization with sexual abuse) showed differences in the severity of mental disorder and in the course of treatment within the same therapy setting.