Childhood trauma, neurocognition, and clinical symptoms in patients with chronic schizophrenia: A network analysis

Background and objectives Cognitive impairment is a core feature of schizophrenia (SCZ), potentially influenced by childhood trauma (CT). This study employed a network analysis approach to investigate the relationship between CT, neurocognition, and clinical symptom dimensions in patients with chronic SCZ. Methods 522 patients with chronic SCZ were recruited. Clinical symptoms, CT, and neurocognition were assessed using the Positive and Negative Syndrome Scale (PANSS), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively. Network models were constructed for all participants and for subgroups stratified by the presence of CT. Expected influence (EI) and bridge EI (BEI) were calculated, and a network comparison test was performed. Results Both CT and neurocognition were widely associated with symptoms. In the network of all samples, emotional abuse exhibited the highest EI, and positive symptoms exhibited the highest BEI. Delayed memory and immediate memory showed relatively high EI among the RBANS subscales. Additionally, delayed memory showed higher EI within the network of the subgroup without CT, whereas immediate memory demonstrated higher EI within the network of the subgroup with CT. Conclusion Emotional abuse is the most pivotal CT subtype in the symptom network of chronic SCZ. CT may partially influence neurocognition through its impact on clinical symptoms, particularly positive symptoms. Delayed memory and immediate memory are the most critical subtypes of neurocognition in chronic SCZ patients. The presence of CT modulated the network centrality of delayed and immediate memory.