Sex differences in the effect of childhood adversity and coping strategies on psychosis expression: A TwinssCan study
Issued Date
2026-01-01
Resource Type
ISSN
09249338
eISSN
17783585
Scopus ID
2-s2.0-105030868610
Pubmed ID
41714187
Journal Title
European Psychiatry
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Psychiatry (2026)
Suggested Citation
Karaçam Doğan M., Prachason T., Fusar-Poli L., Menne-Lothmann C., Decoster J., van Winkel R., Collip D., Delespaul P., De Hert M., Derom C., Thiery E., Jacobs N., Wichers M., Rutten B.P.F., van Os J., Pries L.K., Guloksuz S. Sex differences in the effect of childhood adversity and coping strategies on psychosis expression: A TwinssCan study. European Psychiatry (2026). doi:10.1192/j.eurpsy.2026.10173 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115483
Title
Sex differences in the effect of childhood adversity and coping strategies on psychosis expression: A TwinssCan study
Author's Affiliation
The University of British Columbia
Yale School of Medicine
University Medical Center Utrecht
Università degli Studi di Pavia
Universitair Medisch Centrum Groningen
KU Leuven– University Hospital Leuven
Maastricht Universitair Medisch Centrum+
Uniklinik Köln
Universitair Ziekenhuis Gent
University of British Columbia, Faculty of Medicine
Ramathibodi Hospital
Open Universiteit
University of Northern British Columbia
King's Health Partners
Ankara Bilkent City Hospital
Yale School of Medicine
University Medical Center Utrecht
Università degli Studi di Pavia
Universitair Medisch Centrum Groningen
KU Leuven– University Hospital Leuven
Maastricht Universitair Medisch Centrum+
Uniklinik Köln
Universitair Ziekenhuis Gent
University of British Columbia, Faculty of Medicine
Ramathibodi Hospital
Open Universiteit
University of Northern British Columbia
King's Health Partners
Ankara Bilkent City Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Sex differences in psychosis pathoetiology are insufficiently understood. This study explores how childhood adversity (CA) and coping mechanisms relate to psychosis expression (PE) across males and females in the general population. Method: Data from the TwinssCan project (males: n=312; females: n=478) were used. The Childhood Trauma Questionnaire assessed CA domains. The Utrecht Coping List assessed coping strategies. Psychosis expression was assessed using the Community Assessment of Psychic Experiences (CAPE). Mixed linear regression analyses examined sex-stratified associations of CAPE scores with CA, coping strategies, and their interactions. Results: Emotional abuse (EA) was associated with increased total CAPE scores (T-CAPE), explaining the greatest variance among CA across sexes. Sex-specific effects showed that sexual abuse (SA) and physical abuse (PA) were linked to higher T-CAPE in females, whereas physical neglect (PN) was linked to higher T-CAPE in males. Passive-reacting was associated with increased T-CAPE, explaining the greatest variance among coping styles across both sexes. Sex-specific effects showed that, in females, seeking social support was linked to decreased T-CAPE, while emotional expression increased it. The only sex-shared interaction effect was between reassuring thoughts and emotional neglect (EN), associated with decreased T-CAPE. In females, social support (× PA/PN/EA), reassuring thoughts (× PA/PN), and palliative-reacting (× PN/PA) were associated with decreased T-CAPE, while passive-reacting (× EN) increased it. In males, avoidance (× SA/PA) and passive-reacting (× PN) were associated with increased T-CAPE. Conclusion: Sex differences in the associations of PE with CA and coping underscore the necessity for sex-specific interventions that promote adaptive coping strategies.