Early family trauma: a comparison between adults with schizophrenia and depression

Abstract

[Abstract]: This study explores similarities and differences in the early family history of an adult group with schizophrenia, and a matched group with major depression. Attachment theory, trauma theory and their relation to serious mental illnesses are used to understand the clinical participants’ reported early traumatic experiences of emotional deprivation and neglect. A retrospective design includes self-report questionnaires from clinical participants, and semi-structured interviews with participants’ mothers/primary caregivers. Data analysis includes: 1. Assessment of matched participants’ reported prevalence of emotional deprivation and neglect in four different age groups; 2. Assessment of themes of early family trauma and sequelae from the mother interviews; 3. Qualitative analysis of sample mother/primary caregiver interviews from each diagnostic group of the manner in which the interviewees construct their stories around trauma; 4. Quantitative analysis of a conceptualised model representing the arguments developed in the body of this dissertation. The second and third forms of analysis above include a panel of three experts, blind to diagnosis, validating this researcher’s findings. Standard multiple regression analysis indicates participants’ reported neglect across all age groups significantly predicts emotional deprivation, with neglect contributing 27.4% of the variability, but with no individual age band contributing significantly to the equation. Themes from the mother interviews are clustered into three constructs, guided by the research questions and this researcher’s clinical experience, the mothers’ emphases and the expert panel into Early Family Trauma, Maternal Fatigue, and Clinical Participants’ Early Attachment Difficulties. The mothers’ manner of discussing early family trauma is defined via speech markers as dissociative (disorganised, incoherent, and unresolved) or coherent (grounded, sequential and resolved) according to Attachment Theory and the literature on dissociation. Speakers are assigned as using dissociation or not as a categorical variable. A model is conceptualised to represent the interrelatedness of data from the participants and their mothers, including the manner in which the mothers relate early family trauma. Canonical Discriminant Function Analysis indicates that early family trauma and maternal fatigue discriminate little between diagnostic groups and that maternal non-resolution of early traumatic events and (possibly related) participant offspring attachment difficulties contribute most to distinguishing between the two diagnostic groups. Finally, a greater number of participants from the schizophrenia sample than from the depression sample continue to live with mother, possibly indicating that the early attachment difficulties remain unresolved. Discussion offers a reconceptualisation of several major and/or established theories concerning risk factors in schizophrenia, and examines shortcomings in the literature, concluding with suggestions for future research.