Skip to content
DraconiticResearch
Search Sources API
203,948 studies31 sourcesUpdated 9 min ago
Peer-reviewedCC BYFrontiers in psychiatry

Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.

  • Fanny Senner1,2,3
  • Elena Merkle1
  • Michael Lauseker4
  • Eva C Schulte1,2,5,6,7
  • Urs Heilbronner1
  • Monika Budde1
  • Daniela Reich-Erkelenz1,2
  • Mojtaba Oraki Kohshour1,8
  • Alba Navarro-Flores1,9
  • Maria Heilbronner1
  • Ion-George Anghelescu10
  • Volker Arolt11
19 more authors
  • Bernhard T Baune12,13,14
  • Detlef E Dietrich15,16,17
  • Andreas J Fallgatter18,19
  • Christian Figge20
  • Markus Jäger21
  • Georg Juckel22
  • Carsten Konrad23
  • Nathalie Kühnen1
  • Eva Z Reininghaus24
  • Max Schmauß25
  • Andrea Schmitt2,7,26,27
  • Simon Senner28
  • Carsten Spitzer29
  • Alkomiet Hasan7,25
  • Peter Falkai2,7,27
  • Thomas G Schulze1,7,30,31
  • Kristina Adorjan1,32
  • Sergi Papiol1,27
  • Sophie-Kathrin Greiner2,25
32 affiliations
  1. 1Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Medizin, LMU Munich, Munich, Germany.
  2. 2Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Medizin, LMU Munich, Munich, Germany.
  3. 3Centres for Psychiatry Suedwuerttemberg, Ravensburg, Germany.
  4. 4Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany.
  5. 5Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany.
  6. 6Institute of Human Genetics, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany.
  7. 7German Center for Mental Health (DZPG), Munich/Augburg, Germany.
  8. 8Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  9. 9International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
  10. 10Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Berlin, Germany.
  11. 11Institute for Translational Psychiatry, University of Münster, Münster, Germany.
  12. 12Department of Psychiatry, University of Münster, Münster, Germany.
  13. 13Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
  14. 14The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
  15. 15AMEOS Clinical Center Hildesheim, Hildesheim, Germany.
  16. 16Center for Systems Neuroscience (ZSN), Hannover, Germany.
  17. 17Department of Psychiatry, Medical School of Hannover, Hannover, Germany.
  18. 18Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany.
  19. 19German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany.
  20. 20Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany.
  21. 21Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany.
  22. 22Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany.
  23. 23Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany.
  24. 24Division of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria.
  25. 25Clinic for Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Bezirkskrankenhaus Augsburg, Augsburg, Germany.
  26. 26Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil.
  27. 27Max Planck Institute of Psychiatry, Munich, Germany.
  28. 28Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Konstanz, Germany.
  29. 29Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
  30. 30Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, United States.
  31. 31Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
  32. 32University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Read full textPDFDOICite

Abstract

Background

Adverse 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

We 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

ACEs 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

In 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.

Related

  1. Lived Experiences of Adulthood with Foetal Alcohol Spectrum Disorder: A Qualitative Analysis of Diagnosis, Support, Employment, and Mental Health
    Hannah Quinn, Samuel Bennett
    PsyArXivPreprintCC BY 4.0Full textObstetrics, gynaecology & paediatricsOSF
  2. Case management-integrated supported employment for individuals with schizophrenia: a 3-year longitudinal study in China
    Jiangchan Li, Kan Yang, Longrun Guo +2
    Frontiers in PsychiatryPeer-reviewedCC BY 4.0Psychiatry & mental healthCrossref
  3. Precarious employment and its impact on chronic obstructive pulmonary disease in the Swedish working population – a longitudinal register-based study
    Filippa Lundh, Virginia Gunn, Bertina Kreshpaj +7
    Scandinavian Journal of Work, Environment & HealthPeer-reviewedCC BY 4.0Full textEpidemiology & public healthPMC
  4. The precarity trap: Modelling longitudinal trajectories of precarious youth employment and associations with mental health in the Australian HILDA Survey
    Amarina Donohoe-Bales, Ferdi Botha, Lauren Scott +9
    BMC Public HealthPeer-reviewedCC BY 4.0Epidemiology & public healthCrossref
  5. Adolescent health and not in education, employment or training (NEET) in young adulthood: Evidence from a UK prospective longitudinal study
    D. P. Kelly, J. Wels, P. Patalay
    medRxivPreprintCC BY-NDFull textEpidemiology & public healthmedRxiv

Cite

BibTeXRIS
BibTeX
@article{senner2026adverse,
  title = {{Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.}},
  author = {Fanny Senner and Elena Merkle and Michael Lauseker and Eva C Schulte and Urs Heilbronner and Monika Budde and Daniela Reich-Erkelenz and Mojtaba Oraki Kohshour and Alba Navarro-Flores and Maria Heilbronner and Ion-George Anghelescu and Volker Arolt and Bernhard T Baune and Detlef E Dietrich and Andreas J Fallgatter and Christian Figge and Markus Jäger and Georg Juckel and Carsten Konrad and Nathalie Kühnen and Eva Z Reininghaus and Max Schmauß and Andrea Schmitt and Simon Senner and Carsten Spitzer and Alkomiet Hasan and Peter Falkai and Thomas G Schulze and Kristina Adorjan and Sergi Papiol and Sophie-Kathrin Greiner},
  journal = {Frontiers in psychiatry},
  year = {2026},
  month = oct,
  doi = {10.3389/fpsyt.2026.1930635},
  url = {https://europepmc.org/article/MED/42903255},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.
AU  - Fanny Senner
AU  - Elena Merkle
AU  - Michael Lauseker
AU  - Eva C Schulte
AU  - Urs Heilbronner
AU  - Monika Budde
AU  - Daniela Reich-Erkelenz
AU  - Mojtaba Oraki Kohshour
AU  - Alba Navarro-Flores
AU  - Maria Heilbronner
AU  - Ion-George Anghelescu
AU  - Volker Arolt
AU  - Bernhard T Baune
AU  - Detlef E Dietrich
AU  - Andreas J Fallgatter
AU  - Christian Figge
AU  - Markus Jäger
AU  - Georg Juckel
AU  - Carsten Konrad
AU  - Nathalie Kühnen
AU  - Eva Z Reininghaus
AU  - Max Schmauß
AU  - Andrea Schmitt
AU  - Simon Senner
AU  - Carsten Spitzer
AU  - Alkomiet Hasan
AU  - Peter Falkai
AU  - Thomas G Schulze
AU  - Kristina Adorjan
AU  - Sergi Papiol
AU  - Sophie-Kathrin Greiner
PY  - 2026
DA  - 2026/10/06
JO  - Frontiers in psychiatry
DO  - 10.3389/fpsyt.2026.1930635
UR  - https://europepmc.org/article/MED/42903255
AB  - Background  Adverse 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  We 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  ACEs 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  In 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.
SN  - 1664-0640
ER  -