Does cortical brain morphology act as a mediator between childhood trauma and transition to psychosis in young individuals at ultra-high risk?

Research output: Contribution to journalArticlepeer-review


  • Marta Rapado-castro
  • Sarah Whittle
  • Christos Pantelis
  • Andrew Thompson
  • Barnaby Nelson
  • Eleni P Ganella
  • Ashleigh Lin
  • Patrick D McGorry
  • Alison Yung
  • Cali F Bartholomeusz

External organisations

  • Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health
  • Telethon Kids Institute, The University of Western Australia
  • Centre for Youth Mental Health
  • Orygen
  • Warwick Medical School
  • The National Centre of Excellence in Youth Mental Health
  • Orygen, The National Centre of Excellence in Youth Mental Health
  • University of Manchester


Background: Childhood trauma, particularly sexual abuse, has been associated with transition to psychosis in individuals at “ultra high-risk” (UHR). This study investigated whether the effects of various forms of childhood trauma on transition to psychosis are mediated by cortical thickness and surface area abnormalities. Methods: This prospective study used data from 62 UHR individuals from a previous (PACE 400) cohort study. At follow-up, 24 individuals had transitioned to psychosis (UHR-T) and 38 individuals had not transitioned (UHR-NT). Student-t/Mann-Whitney-U tests were performed to assess morphological differences in childhood trauma (low/high) and transition. Mediation analyses were conducted using regression and bootstrapping techniques. Results: UHR individuals with high sexual trauma histories presented with decreased cortical thickness in bilateral middle temporal gyri and the left superior frontal gyrus compared to those with low sexual trauma. Participants with high physical abuse had increased cortical thickness in the right middle frontal gyrus compared to those with low physical abuse. No differences were found for emotional abuse or physical/emotional neglect. Reduced cortical thickness in the right middle temporal gyrus and increased surface area in the right cingulate were found in UHR-T compared to UHR-NT individuals. Sexual abuse had an indirect effect on transition to psychosis, where decreased cortical thickness in the right middle temporal gyrus was a mediator. Conclusions: Results suggest that childhood sexual abuse negatively impacted on cortical development of the right temporal gyrus, and this heightened the risk of transition to psychosis in our sample. Further longitudinal studies are needed to precisely understand this link.


Original languageEnglish
JournalSchizophrenia Research
Publication statusPublished - 15 Oct 2020


  • cortical surface area, cortical thickness, sexual abuse, childhood trauma, psychosis, Ultra-high risk, UHR