Childhood trauma (CT) is associated with an increased risk of mental health disorders; however, it is unknown whether this represents a diagnosis-specific risk factor for specific psychopathology mediated by structural brain changes. Our aim was to explore whether (i) a predictive CT pattern for transdiagnostic psychopathology exists, and whether (ii) CT can differentiate between distinct diagnosis-dependent psychopathology. Furthermore, we aimed to identify the association between CT, psychopathology and brain structure.

We used multivariate pattern analysis in data from 643 participants of the Personalised Prognostic Tools for Early Psychosis Management study (PRONIA), including healthy controls (HC), recent onset psychosis (ROP), recent onset depression (ROD), and patients clinically at high-risk for psychosis (CHR). Participants completed structured interviews and self-report measures including the Childhood Trauma Questionnaire, SCID diagnostic interview, BDI-II, PANSS, Schizophrenia Proneness Instrument, Structured Interview for Prodromal Symptoms and structural MRI, analyzed by voxel-based morphometry.

(i) Patients and HC could be distinguished by their CT pattern with a reasonable precision [balanced accuracy of 71.2% (sensitivity = 72.1%, specificity = 70.4%, p ≤ 0.001]. (ii) Subdomains ‘emotional neglect’ and ‘emotional abuse’ were most predictive for CHR and ROP, while in ROD ‘physical abuse’ and ‘sexual abuse’ were most important. The CT pattern was significantly associated with the severity of depressive symptoms in ROD, ROP, and CHR, as well as with the PANSS total and negative domain scores in the CHR patients. No associations between group-separating CT patterns and brain structure were found.

These results indicate that CT poses a transdiagnostic risk factor for mental health disorders, possibly related to depressive symptoms. While differences in the quality of CT exposure exist, diagnostic differentiation was not possible suggesting a multi-factorial pathogenesis.

童年创伤 (CT) 与精神健康障碍的风险增加有关；然而，尚不清楚这是否代表由结构性大脑变化介导的特定精神病理学的特定诊断风险因素。我们的目的是探索 (i) 是否存在用于跨诊断精神病理学的预测 CT 模式，以及 (ii) CT 是否可以区分不同的诊断依赖性精神病理学。此外，我们旨在确定 CT、精神病理学和大脑结构之间的关联。

我们对来自早期精神病管理研究 (PRONIA) 的个性化预后工具的 643 名参与者的数据进行了多变量模式分析，包括健康对照 (HC)、近期发作的精神病 (ROP)、近期发作的抑郁症 (ROD) 和临床上处于高危状态的患者-精神病风险（CHR）。参与者完成了结构化访谈和自我报告措施，包括儿童创伤问卷、SCID 诊断访谈、BDI-II、PANSS、精神分裂症倾向性仪器、前驱症状结构化访谈和结构 MRI，通过基于体素的形态测量法进行分析。

(i) 患者和 HC 可以通过他们的 CT 模式以合理的精度区分 [平衡精度为 71.2%（灵敏度 = 72.1%，特异性 = 70.4%，p ≤ 0.001）]。（ii）子域“情感忽视”和“情感忽视”虐待”对 CHR 和 ROP 最有预测意义，而在 ROD 中，“身体虐待”和“性虐待”最重要。CT 模式与 ROD、ROP 和 CHR 中抑郁症状的严重程度以及与CHR 患者的 PANSS 总分和负分值。未发现分组 CT 模式与脑结构之间存在关联。

这些结果表明 CT 构成精神健康障碍的跨诊断风险因素，可能与抑郁症状有关。虽然 CT 曝光质量存在差异，但无法进行诊断区分，表明存在多因素发病机制。