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Researchers Find Resilience Counteracts Effects of Childhood Abuse and Neglect on Health

They also note acquired resiliency provides coping benefit and a new avenue for treatment

Researchers at University of California San Diego School of Medicine have determined that psychological resilience has a positive effect on health outcomes for people living with schizophrenia. This is the first study to quantitatively assess the effects of both childhood trauma and psychological resilience on health and metabolic function in people living with schizophrenia.

Globally 1% of people suffer from schizophrenia, a chronic and severe mental disorder that can affect all types of people and greatly impacts how a person thinks, feels, and behaves. The psychiatric symptoms are typically treated with antipsychotic drugs; however, persons with schizophrenia are also more vulnerable to physical disorders, such as diabetes and cardiovascular disease and premature death. Although the cause of schizophrenia is not entirely known, the disorder is linked to genetic and environmental risk factors, including childhood adversity.

The findings are published in the Journal of Clinical Psychiatry.

"In this study, we found that people living with schizophrenia who had a history of severe childhood adversity and high levels of psychological resilience had health and biomarkers of insulin resistance similar to those in nonpsychiatric comparison participants (NCs) with severe adversity and low levels of resilience," says senior author Dilip V. Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences and director of the UC San Diego Center for Healthy Aging.

"What is further striking is the observation that in both groups (those with schizophrenia and NCs), persons with high levels of resilience had overall better physical and mental health and metabolic biomarkers."

Ellen Lee, MD, first author and a research fellow at UC San Diego described resilience as "a psychological trait that helps people cope with and recover from adversities or hardships of different kinds. It is essentially a personality trait that is partially genetic but is also determined by a variety of life and social experiences."

As such, Jeste says it should be possible to ameliorate some of the negative effects of adversities associated with schizophrenia. "There are a variety of resilience-enhancing interventions that exist in a variety of settings. The military has been using resilience training for years to enhance this trait in soldiers before they head to war. Other resilience-enhancing interventions include mindfulness, meditation, and positive psychology," he says.

The research team evaluated data from 114 participants with schizophrenia and 101 nonpsychiatric comparison subjects between the ages of 26 and 65 years. The participants were recruited from the larger San Diego area.

Childhood abuse was assessed with the Childhood Trauma Questionnaire, a 25-item scale that evaluates emotional, physical, and sexual abuse or neglect that occurred in childhood. Jeste and colleagues used the 10-item Connor-Davidson Resilience scale to measure resilience, using factors such as hardiness ("the ability to cope with change and adversity"), and persistence ("putting forth one's best effort despite adverse circumstance").

Metabolic biomarkers of the most interest to the research team were Homeostatic Model Assessment of Insulin Resistance and hemoglobin A1C. These were selected for their ability to indicate health problems, such as diabetes, obesity, and cardiovascular diseases that are common in persons suffering from schizophrenia.

Additionally, the measures of childhood abuse and resilience were based on self-reporting by participants; however, these have been previously validated in other studies and are commonly used. Jeste also cautions that the results of this cross-sectional study will need to be replicated in a longitudinal investigation.

"The finding that resilience can play a protective or coping role in persons with schizophrenia provides clinicians an opportunity to use non-drug interventions in treatment," Jeste says. "High resilience could potentially play a large role in improving health outcomes for people living with schizophrenia. Interventions, like resilience training, could be combined with other therapies, allowing for more comprehensive treatment plans."

Source: University of California San Diego Health