Impact of social adversity on the developmental trajectory to mental illness: A study of a whole-population cohort of children at familial high-risk for psychotic disorders

There is a growing literature on the role of stress, adversity and other socially mediated risk factors in the aetiology of schizophrenia and other psychotic disorders. These risk factors include: childhood abuse; discontinuity in parenting, person-level socio-demographic risk (e.g. born to a single mother; being second generation migrant) and area-level socio-structural risk (e.g. socio-economic disadvantage; residential mobility; urbanicity). However, much remains to be understood about the nature of the adverse social conditions that are associated with the development of severe mental disorder. This includes not only the type of social adversity, its timing and the effect of accumulation of multiple exposures, but also its interaction with other predisposing factors. To fill this gap, this study is using the rich multi-generational data collection that we have assembled on the life course of a whole-population birth cohort and their parents to address specific research questions on the contribution of social adversity to the pathogenesis of psychotic illness, taking into account the interplay of social adversity with genetic risk and other contributing factors on the developmental trajectory to mental illness such as obstetric trauma, behavioural abnormalities and cognitive dysfunction.

Its broad aims are to:

  • Identify the extent of the contribution of social adversity to risk for psychotic illness;
  • Examine the interplay between social adversity, genetic risk and other predictors of psychotic illness;
  • Distinguish developmental trajectories to psychotic illness using available data on predisposing factors so as to identify modifiable targets amenable to intervention/prevention; and
  • Investigate the nature of individual resilience that distinguishes those who do not develop psychotic illness following exposure to social adversity from those who do.

For each aim, we will examine specificity for psychotic illness, compared to mental illness more generally.

The design to disentangle genetic liability, obstetric trauma and exposure to social adversity and other environmental risks for schizophrenia in ‘high risk’ children of mothers with schizophrenia can be found here: Pathways_Vera Morgan

Winthrop Professor Vera Morgan

Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, The University of Western Australia