{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:11:56Z","timestamp":1786374716240,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Shandong Provincial Medical and Health Science and Technology Development Program Project","award":["202003090933"],"award-info":[{"award-number":["202003090933"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Schizophrenia (SCZ) is a highly heterogeneous disorder. Childhood trauma (CT) is a well\u2011established risk factor, although the contribution of specific CT dimensions remains incompletely understood. This study systematically investigated which CT dimensions were most strongly associated with symptom severity in drug\u2011na\u00efve first\u2011episode SCZ patients. In a cross\u2011sectional design, 284 patients were classified into a SCZ\u2011ct group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009234) and a SCZ\u2011nct group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950) based on Childhood Trauma Questionnaire. Symptom severity was assessed using the Positive and Negative Syndrome Scale. Hierarchical regression analyses adjusted for demographic and clinical covariates were performed, with rater effects examined via a linear mixed\u2011effects model. The SCZ\u2011ct group exhibited significantly higher total and positive symptom scores, whereas negative symptom scores did not differ. Higher total CTQ scores were associated with greater overall symptom severity. Emotional abuse was independently associated with total PANSS scores after adjustment for other CT dimensions and covariates, and this association remained robust after additionally accounting for rater effects. These findings support the potential value of addressing childhood trauma, particularly emotional abuse, in both clinical practice and public health strategies.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-63324-2","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:13:30Z","timestamp":1784801610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Childhood trauma, specifically emotional abuse, is associated with psychiatric symptom severity in drug\u2011na\u00efve first\u2011episode patients with schizophrenia"],"prefix":"10.1038","volume":"16","author":[{"given":"Shilong","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailuo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renyun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sufang","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"63324_CR1","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1093\/schbul\/sby058","volume":"44","author":"FJ Charlson","year":"2018","unstructured":"Charlson, F. J. et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull. 44, 1195\u20131203. https:\/\/doi.org\/10.1093\/schbul\/sby058 (2018).","journal-title":"Schizophr Bull."},{"key":"63324_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.schres.2013.05.028","volume":"150","author":"R Tandon","year":"2013","unstructured":"Tandon, R. et al. Definition and description of schizophrenia in the DSM-5. Schizophr Res. 150, 3\u201310. https:\/\/doi.org\/10.1016\/j.schres.2013.05.028 (2013).","journal-title":"Schizophr Res."},{"key":"63324_CR3","doi-asserted-by":"publisher","first-page":"5319","DOI":"10.1038\/s41380-023-02138-4","volume":"28","author":"M Solmi","year":"2023","unstructured":"Solmi, M. et al. Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the global burden of disease (GBD) 2019. Mol. Psychiatry. 28, 5319\u20135327. https:\/\/doi.org\/10.1038\/s41380-023-02138-4 (2023).","journal-title":"Mol. Psychiatry"},{"key":"63324_CR4","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.schres.2015.09.001","volume":"169","author":"JM Haro","year":"2015","unstructured":"Haro, J. M. et al. Understanding the impact of persistent symptoms in schizophrenia: cross-sectional findings from the Pattern study. Schizophr Res. 169, 234\u2013240. https:\/\/doi.org\/10.1016\/j.schres.2015.09.001 (2015).","journal-title":"Schizophr Res."},{"key":"63324_CR5","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/s0140-6736(21)01730-x","volume":"399","author":"S Jauhar","year":"2022","unstructured":"Jauhar, S., Johnstone, M., McKenna, P. J. & Schizophrenia Lancet 399, 473\u2013486 https:\/\/doi.org\/10.1016\/s0140-6736(21)01730-x (2022).","journal-title":"Lancet"},{"key":"63324_CR6","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1176\/appi.ajp.20230189","volume":"181","author":"S Tramazzo","year":"2024","unstructured":"Tramazzo, S. et al. Long-term course of remission and recovery in psychotic disorders. Am. J. Psychiatry. 181, 532\u2013540. https:\/\/doi.org\/10.1176\/appi.ajp.20230189 (2024).","journal-title":"Am. J. Psychiatry"},{"key":"63324_CR7","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1176\/appi.ajp.20240456","volume":"182","author":"L Zhou","year":"2025","unstructured":"Zhou, L. et al. What do four decades of research tell us about the association between childhood adversity and psychosis: an updated and extended multi-level meta-analysis. Am. J. Psychiatry. 182, 360\u2013372. https:\/\/doi.org\/10.1176\/appi.ajp.20240456 (2025).","journal-title":"Am. J. Psychiatry"},{"key":"63324_CR8","doi-asserted-by":"publisher","first-page":"sbae209","DOI":"10.1093\/schbul\/sbae209","volume":"52","author":"CC Chan","year":"2026","unstructured":"Chan, C. C. et al. Childhood trauma across the schizophrenia spectrum: a comparison of schizotypal personality disorder and schizophrenia. Schizophr Bull. 52, sbae209. https:\/\/doi.org\/10.1093\/schbul\/sbae209 (2026).","journal-title":"Schizophr Bull."},{"key":"63324_CR9","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1093\/schbul\/sbs050","volume":"38","author":"F Varese","year":"2012","unstructured":"Varese, F. et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 38, 661\u2013671. https:\/\/doi.org\/10.1093\/schbul\/sbs050 (2012).","journal-title":"Schizophr Bull."},{"key":"63324_CR10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1111\/acps.13268","volume":"143","author":"MT McKay","year":"2021","unstructured":"McKay, M. T. et al. Childhood trauma and adult mental disorder: a systematic review and meta-analysis of longitudinal cohort studies. Acta Psychiatr Scand. 143, 189\u2013205. https:\/\/doi.org\/10.1111\/acps.13268 (2021).","journal-title":"Acta Psychiatr Scand."},{"key":"63324_CR11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.schres.2020.11.047","volume":"228","author":"R Vila-Badia","year":"2021","unstructured":"Vila-Badia, R. et al. Types, prevalence and gender differences of childhood trauma in first-episode psychosis. What is the evidence that childhood trauma is related to symptoms and functional outcomes in first episode psychosis? A systematic review. Schizophr Res. 228, 159\u2013179. https:\/\/doi.org\/10.1016\/j.schres.2020.11.047 (2021).","journal-title":"Schizophr Res."},{"key":"63324_CR12","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1093\/schbul\/sbm069","volume":"34","author":"M Shevlin","year":"2008","unstructured":"Shevlin, M., Houston, J. E., Dorahy, M. J. & Adamson, G. Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British psychiatric morbidity survey. Schizophr Bull. 34, 193\u2013199. https:\/\/doi.org\/10.1093\/schbul\/sbm069 (2008).","journal-title":"Schizophr Bull."},{"key":"63324_CR13","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1097\/NMD.0000000000001788","volume":"212","author":"K Ware","year":"2024","unstructured":"Ware, K., Misiak, B., Hamza, E. A., Nalla, S. & Moustafa, A. A. The impact of childhood trauma on the negative symptoms of schizophrenia. J. Nerv. Ment Dis. 212, 460\u2013470. https:\/\/doi.org\/10.1097\/NMD.0000000000001788 (2024).","journal-title":"J. Nerv. Ment Dis."},{"key":"63324_CR14","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1093\/schbul\/sbaa199","volume":"47","author":"L Alameda","year":"2021","unstructured":"Alameda, L. et al. Association between specific childhood adversities and symptom dimensions in people with psychosis: systematic review and meta-analysis. Schizophr Bull. 47, 975\u2013985. https:\/\/doi.org\/10.1093\/schbul\/sbaa199 (2021).","journal-title":"Schizophr Bull."},{"key":"63324_CR15","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/schbul\/13.2.261","volume":"13","author":"SR Kay","year":"1987","unstructured":"Kay, S. R., Fiszbein, A. & Opler, L. A. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 13, 261\u2013276. https:\/\/doi.org\/10.1093\/schbul\/13.2.261 (1987).","journal-title":"Schizophr Bull."},{"key":"63324_CR16","first-page":"105","volume":"9","author":"X Zhao","year":"2005","unstructured":"Zhao, X. et al. Reliability and validity of the Chinese version of childhood trauma questionnaire. Chin. J. Clin. Rehabilitation. 9, 105\u2013107 (2005). (in Chinese).","journal-title":"Chin. J. Clin. Rehabilitation"},{"key":"63324_CR17","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1093\/schbul\/sbx161","volume":"44","author":"T Bailey","year":"2018","unstructured":"Bailey, T. et al. Childhood trauma is associated with severity of hallucinations and delusions in psychotic disorders: a systematic review and meta-analysis. Schizophr Bull. 44, 1111\u20131122. https:\/\/doi.org\/10.1093\/schbul\/sbx161 (2018).","journal-title":"Schizophr Bull."},{"key":"63324_CR18","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.neubiorev.2019.05.024","volume":"107","author":"A Cancel","year":"2019","unstructured":"Cancel, A., Dallel, S., Zine, A., El-Hage, W. & Fakra, E. Understanding the link between childhood trauma and schizophrenia: a systematic review of neuroimaging studies. Neurosci. Biobehav Rev. 107, 492\u2013504 (2019).","journal-title":"Neurosci. Biobehav Rev."},{"key":"63324_CR19","first-page":"489","volume":"45","author":"CA Ross","year":"1994","unstructured":"Ross, C. A., Anderson, G. & Clark, P. Childhood abuse and the positive symptoms of schizophrenia. Hosp. Community Psychiatry. 45, 489\u2013491 (1994).","journal-title":"Hosp. Community Psychiatry"},{"key":"63324_CR20","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.schres.2016.06.005","volume":"176","author":"A Egerton","year":"2016","unstructured":"Egerton, A. et al. Adversity in childhood linked to elevated striatal dopamine function in adulthood. Schizophr Res. 176, 171\u2013176. https:\/\/doi.org\/10.1016\/j.schres.2016.06.005 (2016).","journal-title":"Schizophr Res."},{"key":"63324_CR21","doi-asserted-by":"publisher","first-page":"e0270494","DOI":"10.1371\/journal.pone.0270494","volume":"17","author":"D Toutountzidis","year":"2022","unstructured":"Toutountzidis, D., Gale, T. M., Irvine, K., Sharma, S. & Laws, K. R. Childhood trauma and schizotypy in non-clinical samples: a systematic review and meta-analysis. PLoS One. 17, e0270494. https:\/\/doi.org\/10.1371\/journal.pone.0270494 (2022).","journal-title":"PLoS One"},{"key":"63324_CR22","doi-asserted-by":"publisher","first-page":"4","DOI":"10.13109\/prkk.2024.73.1.4","volume":"73","author":"F Hoffmann","year":"2024","unstructured":"Hoffmann, F. & Heim, C. Emotional abuse in childhood and adolescence: biological embedding and clinical implications. Prax Kinderpsychol Kinderpsychiatr. 73, 4\u201327. https:\/\/doi.org\/10.13109\/prkk.2024.73.1.4 (2024).","journal-title":"Prax Kinderpsychol Kinderpsychiatr"},{"key":"63324_CR23","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1016\/j.chiabu.2004.01.008","volume":"28","author":"M Dong","year":"2004","unstructured":"Dong, M. et al. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child. Abuse Negl. 28, 771\u2013784. https:\/\/doi.org\/10.1016\/j.chiabu.2004.01.008 (2004).","journal-title":"Child. Abuse Negl."},{"key":"63324_CR24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.chiabu.2006.06.008","volume":"31","author":"D Finkelhor","year":"2007","unstructured":"Finkelhor, D., Ormrod, R. K. & Turner, H. A. Poly-victimization: a neglected component in child victimization. Child. Abuse Negl. 31, 7\u201326. https:\/\/doi.org\/10.1016\/j.chiabu.2006.06.008 (2007).","journal-title":"Child. Abuse Negl."},{"key":"63324_CR25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1038\/s41572-025-00667-6","volume":"11","author":"S Leucht","year":"2025","unstructured":"Leucht, S. et al. Schizophrenia. Nat. Rev. Dis. Primers. 11, 83. https:\/\/doi.org\/10.1038\/s41572-025-00667-6 (2025).","journal-title":"Nat. Rev. Dis. Primers"},{"key":"63324_CR26","unstructured":"The Psychiatric Branch of the Chinese Medical Association. Chinese Guideline for the Diagnosis and Treatment of Schizophrenia, 2025 version (People\u2019s Medical Publishing House, 2025). (in Chinese)."},{"key":"63324_CR27","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1176\/appi.ajp.2020.177901","volume":"177","author":"GA Keepers","year":"2020","unstructured":"Keepers, G. A. et al. The American psychiatric association practice guideline for the treatment of patients with schizophrenia. Am. J. Psychiatry. 177, 868\u2013872. https:\/\/doi.org\/10.1176\/appi.ajp.2020.177901 (2020).","journal-title":"Am. J. Psychiatry"},{"key":"63324_CR28","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.schres.2018.05.003","volume":"205","author":"RL Loewy","year":"2019","unstructured":"Loewy, R. L. et al. Childhood trauma and clinical high risk for psychosis. Schizophr Res. 205, 10\u201314. https:\/\/doi.org\/10.1016\/j.schres.2018.05.003 (2019).","journal-title":"Schizophr Res."},{"key":"63324_CR29","doi-asserted-by":"publisher","first-page":"55","DOI":"10.3389\/fpsyt.2017.00055","volume":"8","author":"D Mayo","year":"2017","unstructured":"Mayo, D. et al. The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Front. Psychiatry. 8, 55. https:\/\/doi.org\/10.3389\/fpsyt.2017.00055 (2017).","journal-title":"Front. Psychiatry"},{"key":"63324_CR30","doi-asserted-by":"publisher","first-page":"105899","DOI":"10.1016\/j.chiabu.2022.105899","volume":"134","author":"JFB Thielemann","year":"2022","unstructured":"Thielemann, J. F. B., Kasparik, B., K\u00f6nig, J., Unterhitzenberger, J. & Rosner, R. A systematic review and meta-analysis of trauma-focused cognitive behavioral therapy for children and adolescents. Child. Abuse Negl. 134, 105899. https:\/\/doi.org\/10.1016\/j.chiabu.2022.105899 (2022).","journal-title":"Child. Abuse Negl."},{"key":"63324_CR31","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.chc.2015.02.005","volume":"24","author":"JA Cohen","year":"2015","unstructured":"Cohen, J. A. & Mannarino, A. P. Trauma-focused cognitive behavior therapy for traumatized children and families. Child. Adolesc. Psychiatr Clin. N Am. 24, 557\u2013570. https:\/\/doi.org\/10.1016\/j.chc.2015.02.005 (2015).","journal-title":"Child. Adolesc. Psychiatr Clin. N Am."},{"key":"63324_CR32","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1176\/appi.ps.20220624","volume":"74","author":"HJ Wood","year":"2023","unstructured":"Wood, H. J., Babusci, C., Bendall, S., Sarpal, D. K. & Jones, N. Trauma and trauma-informed care in early intervention in psychosis: state of implementation and provider views on challenges. Psychiatr Serv. 74, 1240\u20131246. https:\/\/doi.org\/10.1176\/appi.ps.20220624 (2023).","journal-title":"Psychiatr Serv."},{"key":"63324_CR33","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/s2215-0366(20)30041-9","volume":"7","author":"MAP Bloomfield","year":"2020","unstructured":"Bloomfield, M. A. P. et al. Trauma-informed care for adult survivors of developmental trauma with psychotic and dissociative symptoms: a systematic review of intervention studies. Lancet Psychiatry. 7, 449\u2013462. https:\/\/doi.org\/10.1016\/s2215-0366(20)30041-9 (2020).","journal-title":"Lancet Psychiatry"},{"key":"63324_CR34","doi-asserted-by":"publisher","first-page":"S298","DOI":"10.2105\/ajph.2022.306737","volume":"112","author":"J Ballard","year":"2022","unstructured":"Ballard, J., Turner, L., Cuca, Y. P., Lobo, B. & Dawson-Rose, C. S. Trauma-informed home visiting models in public health nursing: an evidence-based approach. Am. J. Public. Health. 112, S298\u2013s305. https:\/\/doi.org\/10.2105\/ajph.2022.306737 (2022).","journal-title":"Am. J. Public. Health"},{"key":"63324_CR35","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1001\/jamapediatrics.2015.2206","volume":"170","author":"ML Marsac","year":"2016","unstructured":"Marsac, M. L. et al. Implementing a trauma-informed approach in pediatric health care networks. JAMA Pediatr. 170, 70\u201377. https:\/\/doi.org\/10.1001\/jamapediatrics.2015.2206 (2016).","journal-title":"JAMA Pediatr."},{"key":"63324_CR36","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1177\/10775595241259994","volume":"30","author":"MR Sanders","year":"2025","unstructured":"Sanders, M. R. et al. Parenting, child maltreatment, and social disadvantage: a population-based implementation and evaluation of the triple P system of evidence-based parenting support. Child. Maltreat. 30, 177\u2013191. https:\/\/doi.org\/10.1177\/10775595241259994 (2025).","journal-title":"Child. Maltreat"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63324-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63324-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63324-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:08:49Z","timestamp":1786370929000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63324-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["63324"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-63324-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"assertion":[{"value":"17 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The procedure was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Shandong Mental Health Center (Batch No: [2021] (Research) Ethics Approval No. [1]). Informed consent was obtained from all the individual participants included in the study.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"24736"}}