{
  "abstract": "Background\n\nAdverse childhood experiences (ACEs) exert transdiagnostic influences on disorders of the affective-to-psychotic spectrum which share genetic similarities. While ACEs are established risk factors for developing disorders across this spectrum, the impact of ACEs on functional outcomes in adulthood remains insufficiently understood. This study aims to investigate the impact of ACEs on functional outcomes such as relationship and employment stability.Methods\n\nWe used multistate Markov models to analyze data from the longitudinal PsyCourse Study (N = 810) to investigate whether ACEs and ACE subtypes influence relationship and employment stability in individuals with affective-to-psychotic spectrum disorders and neurotypical controls. We analyzed whether protective factors (e.g., experience of feeling loved in childhood and polygenic resilience score for schizophrenia) modify these associations.Results\n\nACEs significantly increased the hazard of job loss (hazard ratio [HR] = 2.02, p = 0.0005), even after controlling for disease status and illness severity. Feeling loved in childhood emerged as a protective factor against job loss (HR = 0.52, p = 0.0096). For personal relationships, illness severity overshadowed ACE effects, with higher clinical severity rating predicting a higher hazard ratio for partnership separation. Among ACE subtypes, emotional abuse significantly predicted a higher hazard for partnership separation and lower for re-employment. Polygenic resilience score of schizophrenia did not contribute significantly.Discussion\n\nIn participants of the PsyCourse Study, ACEs substantially impact employment stability, personal relationship stability appears to be predominantly influenced by illness severity. These findings suggest the need for ACE-guided approaches in vocational rehabilitation and tailored interventions for partnership support in this population.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Medizin, LMU Munich, Munich, Germany.",
    "Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Medizin, LMU Munich, Munich, Germany.",
    "Centres for Psychiatry Suedwuerttemberg, Ravensburg, Germany.",
    "Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany.",
    "Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany.",
    "Institute of Human Genetics, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany.",
    "German Center for Mental Health (DZPG), Munich/Augburg, Germany.",
    "Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.",
    "International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.",
    "Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Berlin, Germany.",
    "Institute for Translational Psychiatry, University of Münster, Münster, Germany.",
    "Department of Psychiatry, University of Münster, Münster, Germany.",
    "Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.",
    "The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.",
    "AMEOS Clinical Center Hildesheim, Hildesheim, Germany.",
    "Center for Systems Neuroscience (ZSN), Hannover, Germany.",
    "Department of Psychiatry, Medical School of Hannover, Hannover, Germany.",
    "Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany.",
    "German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany.",
    "Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany.",
    "Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany.",
    "Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany.",
    "Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany.",
    "Division of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria.",
    "Clinic for Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Bezirkskrankenhaus Augsburg, Augsburg, Germany.",
    "Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil.",
    "Max Planck Institute of Psychiatry, Munich, Germany.",
    "Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Konstanz, Germany.",
    "Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany.",
    "Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, United States.",
    "Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.",
    "University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 31,
  "authors": [
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        0,
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      "name": "Fanny Senner"
    },
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      ],
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        4,
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      "name": "Eva C Schulte"
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      "name": "Ion-George Anghelescu"
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      "name": "Volker Arolt"
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      "name": "Bernhard T Baune"
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      "name": "Detlef E Dietrich"
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      "name": "Andreas J Fallgatter"
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      "name": "Christian Figge"
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      "name": "Markus Jäger"
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    {
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      "name": "Georg Juckel"
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      "name": "Carsten Konrad"
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      "name": "Nathalie Kühnen"
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      "name": "Eva Z Reininghaus"
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      "name": "Max Schmauß"
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      "name": "Andrea Schmitt"
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      "name": "Simon Senner"
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      "name": "Carsten Spitzer"
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      "name": "Alkomiet Hasan"
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      "name": "Sergi Papiol"
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      "name": "Sophie-Kathrin Greiner"
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  "bibtex": "https://research.draconitic.com/paper/1x39kjr9zkgq2.bib",
  "cited_by": 0,
  "doi": "10.3389/fpsyt.2026.1930635",
  "fulltext_url": "https://europepmc.org/articles/PMC13680451",
  "id": "1x39kjr9zkgq2",
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    "1664-0640"
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  "landing_url": "https://europepmc.org/article/MED/42903255",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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  "pdf_url": "https://europepmc.org/articles/PMC13680451?pdf=render",
  "pmcid": "PMC13680451",
  "pmid": "42903255",
  "published": "2026-10-06",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/1x39kjr9zkgq2.ris",
  "sources": [
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      "first_seen": "2026-10-30T12:19:57Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Child Abuse and Trauma",
      "subfield": "psychiatry"
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  ],
  "title": "Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.",
  "title_text": "Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:18Z",
  "url": "https://research.draconitic.com/paper/1x39kjr9zkgq2",
  "venue": "Frontiers in psychiatry",
  "versions": []
}