Exploring the Interplay Between Adversity, Neurocognition, Social Cognition, and Functional Outcome in People With Psychosis: A Narrative Review

History of adversity is associated with subsequent psychosis, and with a spectrum of cognitive alterations in individuals with psychosis. These cognitive features go from neurocognitive aspects as working memory and attention, to complex social cognitive processes as theory of mind and emotional perception. Difficulties in these domains impact patients' social and occupational functioning, which has been shown to be more impaired in those previously exposed to childhood trauma. However, the interplay between adversity, neurocognition, and functioning is yet poorly understood. This narrative review aims to explore the evidence on whether deficits in neurocognitive and social cognitive domains may act as possible putative mechanism linking adversity with functioning in people with psychosis. We show available evidence supporting the link between adversity and poorer functioning in psychosis, especially in chronic stages; and replicated evidence suggesting associations of social cognition and, to a lesser extent, neurocognition with impairment in functioning in patients; although there is still an important gap in the literature testing particularly deficits in social cognition as mediator of the link between adversity and functional decline in psychosis. Targeting interventions focusing on neurocognition and social cognition in individuals with adversity and psychosis seems important, given the severe deterioration of these patients in these domains, although more research is needed to test whether such treatments can specifically improve functioning in individuals with psychosis and adversity. Literature aiming to understand the determinants of functional outcome should consider the pervasive impact of childhood adversity, and its related effects on cognition.

• Publication year

  2021

• Venue

  Frontiers in Psychiatry

• Publication date

  2021-03-08

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.3389/fpsyt.2021.596949PMID 33762975PMCID 7982734
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Effects of childhood trauma on facial recognition of fear in psychosis.

  2022cited by this paper
• Randomized controlled trial of social cognition and interaction training compared to befriending group

  2020cited by this paper
• A systematic review on mediators between adversity and psychosis: potential targets for treatment

  2020cited by this paper
• Social Cognition Training for People With a Psychotic Disorder: A Network Meta-analysis

  2020cited by this paper
• Childhood trauma is associated with poorer social functioning in severe mental disorders both during an active illness phase and in remission.

  2020cited by this paper
• Brain-derived neurotrophic factor and mental disorders

  2020cited by this paper
• Does childhood trauma influence cognitive functioning in schizophrenia? The association of childhood trauma and cognition in schizophrenia spectrum disorders.

  2020cited by this paper
• Childhood trauma, parental bonding, and social cognition in patients with schizophrenia and healthy adults.

  2020cited by this paper
• Multimodal prevention of first psychotic episode through N‐acetyl‐l‐cysteine and integrated preventive psychological intervention in individuals clinically at high risk for psychosis: Protocol of a randomized, placebo‐controlled, parallel‐group trial

  2019cited by this paper
• Elevated hair cortisol is associated with childhood maltreatment and cognitive impairment in schizophrenia and in bipolar disorders.

  2019cited by this paper
• Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

  2019influential reference
• Childhood adversities and psychotic symptoms: The potential mediating or moderating role of neurocognition and social cognition.

  2019cited by this paper
• Reduced brain-derived neurotrophic factor is associated with childhood trauma experiences and number of depressive episodes in severe mental disorders.

  2019cited by this paper
• Childhood adversity and clinical and psychosocial outcomes in psychosis

  2019cited by this paper
• Pathways to Functional Outcomes in Schizophrenia Spectrum Disorders: Meta-Analysis of Social Cognitive and Neurocognitive Predictors.

  2019influential reference
• Effects of childhood trauma on facial recognition of fear in psychosis.

  2019cited by this paper
• Interplay Among Psychopathologic Variables, Personal Resources, Context-Related Factors, and Real-life Functioning in Individuals With Schizophrenia: A Network Analysis

  2018cited by this paper
• Early-life and pubertal stress differentially modulate grey matter development in human adolescents

  2018cited by this paper
• Redox dysregulation as a link between childhood trauma and psychopathological and neurocognitive profile in patients with early psychosis

  2018influential reference
• Childhood Trauma and Neurocognition in Adults With Psychotic Disorders: A Systematic Review and Meta-analysis.

  2018cited by this paper
• Different types of childhood adversity and 5-year outcomes in a longitudinal cohort of first-episode psychosis patients.

  2018cited by this paper
• Traumatic life event exposure and psychotic-like experiences: A multiple mediation model of cognitive-based mechanisms.

  2018cited by this paper
• Mentalizing impairment as a mediator between reported childhood abuse and outcome in nonaffective psychotic disorder.

  2018cited by this paper
• Early life experiences and social cognition in major psychiatric disorders: A systematic review

  2018cited by this paper
• Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective

  2018cited by this paper
• Social Cognition Psychometric Evaluation: Results of the Final Validation Study

  2018cited by this paper
• Defining the impact of childhood adversities on cognitive deficits in psychosis: An exploratory analysis.

  2017cited by this paper
• N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis

  2017influential reference
• Evidence That the Impact of Childhood Trauma on IQ Is Substantial in Controls, Moderate in Siblings, and Absent in Patients With Psychotic Disorder

  2017cited by this paper
• Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients

  2017cited by this paper
• Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

  2017cited by this paper
• The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

  2017cited by this paper
• Exploring the impact of adverse childhood experiences on symptomatic and functional outcomes in adulthood: advances, limitations and considerations

  2017cited by this paper
• Childhood Adversity, Cortisol Levels, and Psychosis: A Retrospective Investigation

  2017cited by this paper
• Influence of early trauma on features of schizophrenia

  2017cited by this paper
• Treatment of social cognition in schizophrenia: Current status and future directions.

  2017cited by this paper
• Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition

  2017cited by this paper
• Sex differences in the effect of childhood trauma on the clinical expression of early psychosis.

  2016cited by this paper
• Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies.

  2016cited by this paper
• The developmental origins of metacognitive deficits in schizophrenia.

  2016cited by this paper
• Interplay of hippocampal volume and hypothalamus-pituitary-adrenal axis function as markers of stress vulnerability in men at ultra-high risk for psychosis

  2016cited by this paper
• Childhood adversity and social functioning in psychosis: Exploring clinical and cognitive mediators.

  2016cited by this paper
• Revisiting the validity of measures of social cognitive bias in schizophrenia: Additional results from the Social Cognition Psychometric Evaluation (SCOPE) study.

  2016cited by this paper
• The effects of childhood maltreatment on brain structure, function and connectivity

  2016cited by this paper
• Childhood trauma is associated with increased brain responses to emotionally negative as compared with positive faces in patients with psychotic disorders

  2016cited by this paper
• Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study

  2015cited by this paper
• Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients

  2015influential reference
• Metacognition, symptoms and premorbid functioning in a first episode psychosis sample.

  2014cited by this paper
• Pathways Associating Childhood Trauma to the Neurobiology of Schizophrenia.

  2014cited by this paper
• Schizophrenia: an integrated sociodevelopmental-cognitive model

  2014cited by this paper
• Interplay between childhood trauma and BDNF val66met variants on blood BDNF mRNA levels and on hippocampus subfields volumes in schizophrenia spectrum and bipolar disorders.

  2014cited by this paper
• A randomized, controlled trial of Social Cognition and Interaction Training (SCIT) for outpatients with schizophrenia spectrum disorders.

  2014cited by this paper
• Personality compensates for impaired quality of life and social functioning in patients with psychotic disorders who experienced traumatic events.

  2014cited by this paper
• Impact of interpersonal trauma on the social functioning of adults with first-episode psychosis.

  2014cited by this paper
• Neurocognition, social cognition and functional outcome in schizophrenia

  2014cited by this paper
• A systematic review and meta-analysis of recovery in schizophrenia.

  2013cited by this paper
• Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study.

  2013cited by this paper
• Adjunctive pharmacotherapy for cognitive deficits in schizophrenia: meta-analytical investigation of efficacy.

  2013cited by this paper
• BDNF val66met modulates the association between childhood trauma, cognitive and brain abnormalities in psychoses.

  2013cited by this paper
• Pathways between childhood victimization and psychosis-like symptoms in the ALSPAC birth cohort.

  2013cited by this paper
• Risk factors for psychosis: impaired social and role functioning.

  2012cited by this paper
• Is cognitive impairment following early life stress in severe mental disorders based on specific or general cognitive functioning?

  2012cited by this paper
• Social Cognition Moderates the Influence of Child Physical Abuse on Inpatient Psychiatric Rehabilitation

  2011cited by this paper
• Deficits in the ability to recognize one's own affects and those of others: associations with neurocognition, symptoms and sexual trauma among persons with schizophrenia spectrum disorders.

  2011cited by this paper
• The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis.

  2011cited by this paper
• Efficacy and specificity of social cognitive skills training for outpatients with psychotic disorders.

  2011cited by this paper
• Stress and inflammation reduce brain-derived neurotrophic factor expression in first-episode psychosis: a pathway to smaller hippocampal volume.

  2011cited by this paper
• THE RELATIONSHIP BETWEEN NEUROCOGNITION AND SOCIAL COGNITION WITH FUNCTIONAL OUTCOMES IN

  2011cited by this paper
• Social Cognition in Schizophrenia

  2010cited by this paper
• Social cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia-spectrum disorders.

  2010cited by this paper
• Pretreatment and outcome correlates of sexual and physical trauma in an epidemiological cohort of first-episode psychosis patients.

  2010cited by this paper
• Child maltreatment and adult socioeconomic well-being.

  2009cited by this paper
• A Longitudinal Study of the Effects of Childhood Trauma on Symptoms and Functioning of People with Severe Mental Health Problems

  2009cited by this paper
• The association of child abuse and neglect with adult disability in schizophrenia and the prominent role of physical neglect.

  2009cited by this paper
• Preliminary evidence for sensitive periods in the effect of childhood sexual abuse on regional brain development.

  2008cited by this paper
• Social cognition in schizophrenia: an NIMH workshop on definitions, assessment, and research opportunities.

  2008cited by this paper
• N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial.

  2008cited by this paper
• Emotion perception and learning potential: Mediators between neurocognition and social problem-solving in schizophrenia?

  2008cited by this paper
• Stress, sensitive periods and maturational events in adolescent depression.

  2008cited by this paper
• Social cognition in schizophrenia.

  2007cited by this paper
• A meta-analysis of cognitive remediation in schizophrenia.

  2007cited by this paper
• Social Cognition in Schizophrenia: An Overview

  2007cited by this paper
• The functional significance of social cognition in schizophrenia: a review.

  2006cited by this paper
• Cognitive impairment and functional outcome in schizophrenia and bipolar disorder.

  2006cited by this paper
• Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning.

  2006cited by this paper
• A systematic review of longitudinal outcome studies of first-episode psychosis

  2006cited by this paper
• Reported History of Child Sexual Abuse in Schizophrenia: Associations With Heightened Symptom Levels and Poorer Participation Over Four Months in Vocational Rehabilitation

  2005cited by this paper
• Size of burden of schizophrenia and psychotic disorders.

  2005cited by this paper
• Social cognition in schizophrenia: recommendations from the measurement and treatment research to improve cognition in schizophrenia new approaches conference.

  2005cited by this paper
• Histories of childhood maltreatment in schizophrenia: relationships with premorbid functioning, symptomatology, and cognitive deficits.

  2005cited by this paper
• Vocational Function Among Persons with Schizophrenia with and Without History of Childhood Sexual Trauma

  2004cited by this paper
• Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS.

  2004cited by this paper
• Sex, stress and the hippocampus: allostasis, allostatic load and the aging process.

  2002cited by this paper
• Nonverbal social perception and symptomatology in schizophrenia.

  2002cited by this paper
• Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress.

  1997cited by this paper
• Child abuse, child development, and social policy

  1993cited by this paper

• The shadow of trauma: impaired mentalization in clinical populations – a systematic review

  2025cites this paper
• The impact of childhood sexual and physical abuse on needs for care among people with first episode psychosis.

  2025cites this paper
• Social inclusion profiles in first episode psychosis and their links to social cognition and symptoms: A cluster analysis approach

  2025cites this paper
• Trajectory classes of suicidal ideation and anhedonia among Chinese vocational school students: Links with childhood trauma, school bullying victimization, and emotion regulation.

  2025cites this paper
• The power of youth: Long-term differential effects of developmental functioning trajectory on social functioning, quality of life and personal recovery across the schizophrenia spectrum.

  2025cites this paper
• Active treatment of affective disturbances may improve functional outcomes in patients in the early state of psychosis: Results of the PRONIA study

  2025cites this paper
• Interplay Between Childhood Maltreatment, Subclinical Post‐Traumatic Stress Symptoms, and IQ: Findings From the EU‐GEI Multicentre Case–Control Study

  2025cites this paper
• The relationship between childhood interpersonal and non-interpersonal trauma and autobiographical memory: a systematic review

  2024cites this paper
• Independent effects of early life adversity on social cognitive function in patients with schizophrenia

  2024cites this paper
• Social exclusion as a major outcome domain of psychotic disorders: early predictors, and associations with non-recovery and clinical staging 21 years after a first episode of psychosis

  2024cites this paper
• The association of adverse childhood experiences with long-term outcomes of psychosis: a 21-year prospective cohort study after a first episode of psychosis.

  2024cites this paper
• The effect of childhood trauma on moral cognition in patients with schizophrenia

  2024cites this paper
• Epistemic trust and associations with psychopathology: Validation of the German version of the Epistemic Trust, Mistrust and Credulity-Questionnaire (ETMCQ)

  2024cites this paper
• A better understanding of the impact of childhood trauma on depression in early psychosis: A differential item functioning approach.

  2023cites this paper
• Childhood trauma and real-world social experiences in psychosis.

  2023cites this paper
• Exploring the mediation of DNA methylation across the epigenome between childhood adversity and First Episode of Psychosis—findings from the EU-GEI study

  2023cites this paper
• Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review

  2023cites this paper
• Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis

  2023influential citation
• Association Between Childhood Adversity and Functional Outcomes in People With Psychosis: A Meta-analysis.

  2022cites this paper
• Childhood Maltreatment, Educational Attainment, and IQ: Findings From a Multicentric Case-control Study of First-episode Psychosis (EU-GEI).

  2022cites this paper
• Childhood Trauma As a Mediator of the Association Between Autistic Traits and Psychotic Experiences: Evidence From the Avon Longitudinal Study of Parents and Children Cohort

  2022cites this paper
• Childhood Trauma As a Mediator of the Association Between Autistic Traits and Psychotic Experiences: Evidence From the Avon Longitudinal Study of Parents and Children

  2022cites this paper
• Time of exposure to social defeat stress during childhood and adolescence and redox dysregulation on long-lasting behavioral changes, a translational study

  2022cites this paper
• Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol

  2021cites this paper
• Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations.

  2021cites this paper
• Mitochondrial, exosomal miR137-COX6A2 and gamma synchrony as biomarkers of parvalbumin interneurons, psychopathology, and neurocognition in schizophrenia

  2021cites this paper