The relationship between childhood trauma and aberrant salience: a preliminary study in patients with Schizophrenia

Objectives Aberrant salience represents one of the main pathogenetic mechanisms of psychotic symptoms. Exposure to childhood trauma constitutes a relevant environmental risk factor for subsequent development of Schizophrenia, but the possible influence of trauma on aberrant salience is poorly studied in literature. The primary objective of this study was to verify the association between childhood trauma and aberrant salience and secondly to evaluate the impact of clinical variables on aberrant salience. Methods Overall 53 outpatients (39 diagnosed with Schizophrenia and 14 with Schizoaffective Disorder) were recruited. The Childhood Trauma Questionnaire Short-Form (CTQ-SF), the Aberrant Salience Inventory (ASI) and the Positive and Negative Schizophrenic Symptoms (PANSS) were administered. Psychopathological differences according to ASI scores were evaluated and independent predictors of aberrant salience were assessed through linear regression analysis. Results Consistent with ASI scores, aberrant salience was present among 57% of patients. Aberrant salience was associated with higher severity of delusions, hallucinatory behavior, mannerisms and unusual thought content (PANSS) and emotional abuse/neglect (CTQ). According to linear regression analysis, emotional abuse during childhood and previous psychiatric hospitalizations are associated with higher aberrant salience. Conclusions The most striking results of this preliminary study was that patients with psychosis who had experienced an emotional abuse during childhood can be associated with a higher level of aberrant salience. Further studies are needed to understand the mechanisms thanks which childhood trauma influences the creation of salience, including the possible presence of both adaptive and aberrant alterations in the mechanism of salience processing.