Schizophrenia Research 261 (2023) 236–244

Contents lists available at ScienceDirect

Schizophrenia Research
journal homepage: www.elsevier.com/locate/schres

Tobacco smoking related to childhood trauma mediated by cognitive

control and impulsiveness in severe mental disorders
Synve Hoffart Lunding a, *, Torill Ueland a, b, Monica Aas a, Margrethe Collier Høegh a,
Maren Caroline Frogner Werner a, Linn Rødevand a, Ingrid Torp Johansen a, Gabriela Hjell a, c,
Monica Bettina Elkjær Greenwood Ormerod a, Petter Andreas Ringen d, e, Akiah Ottesen a, f,
Trine Vik Lagerberg a, Ingrid Melle a, Ole A. Andreassen a, Carmen Simonsen a, g, Nils Eiel Steen a
a
NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
b
Department of Psychology, University of Oslo, Oslo, Norway
c
Department of Psychiatry, Ostfold Hospital, Graalum, Norway
d
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
e
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
f
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
g
Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway

A R T I C L E I N F O A B S T R A C T

Keywords: Background: People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking
Adverse childhood experiences compared to the general population. Tobacco smoking and other adult adverse health behaviors have been
Schizophrenia associated with traumatic experiences in childhood. In the present study we investigated the relationship be­
Bipolar disorders
tween childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of
Cognition
Tobacco smoking
cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem.
Methods: Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N =
387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood
trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability,
and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted
mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group.
Results: Experience of one or more subtypes of childhood trauma was significantly associated with smoking
tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of
tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and
tobacco smoking.
Conclusions: These findings indicate the experience of childhood trauma as a predisposing factor for tobacco
smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the
importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in
individuals with SMDs and childhood trauma.

1. Introduction psychotic and affective symptoms, and cognitive deficits (Lieberman

and First, 2018). In addition, life expectancy is reduced by about 15
Schizophrenia and bipolar disorder are severe mental disorders years compared to the general population (Laursen et al., 2013; Wahl­
(SMDs) which constitute severe health challenges worldwide (Whiteford beck et al., 2011). Cardiovascular disease (CVD) and other somatic
et al., 2013). SMDs are generally characterized by reduced functioning, diseases including respiratory disease and cancer account for a

Abbreviations: SMD(s), severe mental disorder(s); SCZ, schizophrenia spectrum disorders; BD, bipolar spectrum disorders; CVD, cardiovascular disease; SES,
socioeconomic status.
* Corresponding author at: Oslo University Hospital HF, Psychosis Research Unit/TOP, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway.
E-mail address: [email protected] (S.H. Lunding).

https://doi.org/10.1016/j.schres.2023.09.041
Received 12 May 2022; Received in revised form 26 May 2023; Accepted 24 September 2023
Available online 6 October 2023
0920-9964/© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

significant part of the excess mortality (Brink et al., 2019; Momen et al., confounders such as age, sex, diagnostic group and symptom severity.
2020; Nordentoft et al., 2013; Olfson et al., 2015). We expect a positive relationship between childhood trauma and to­
While the increased CVD risk in SMDs may be related to genetic bacco smoking. Furthermore, we hypothesize that cognitive and per­
susceptibility (Andreassen et al., 2013; Bahrami et al., 2020; Enez Dar­ sonality characteristics (cognitive control, impulsiveness, affective
cin et al., 2015), the highest impact probably relates to modifiable fac­ lability and self-esteem) will mediate the relationship between child­
tors including diet, physical inactivity, metabolic side effects of hood trauma and tobacco smoking.
medication and smoking (Laursen et al., 2012; Ringen et al., 2014).
Smoking similarly is a major risk factor for respiratory disease and 2. Methods
cancer (Jha et al., 2013; Nordentoft et al., 2021; Olfson et al., 2015;
Zareifopoulos et al., 2018). Of note, smoking rates in people with SMDs 2.1. Study setting
have not declined the last decades as in the general population (Cook
et al., 2014; Rødevand et al., 2019), showing estimated prevalence rates The study sample comprised 871 participants, including 484 with
between 50–80 % and 54–68 % for schizophrenia and bipolar disorder, schizophrenia spectrum disorders (SCZ) (schizophrenia, schizophreni­
respectively (De Hert et al., 2011). People with SMDs also smoke more form disorder, schizoaffective disorder, delusional disorder and psy­
heavily compared to the general population (Kelly and McCreadie, chotic disorder not otherwise specified [NOS]) and 387 with bipolar
1999; Szatkowski and McNeill, 2015). The evidence of a relationship spectrum disorders (BD) (bipolar I disorder, bipolar II disorder, bipolar
extends to the point of indicating smoking as a risk factor for schizo­ disorder NOS or Major Depressive Disorder with Psychotic Features).
phrenia (Gurillo et al., 2015; McGrath et al., 2016). However, the pre­ Participants were recruited through the Thematically Organized Psy­
disposing and psychological factors of this smoking behavior in SMD are chosis (TOP) Study, an ongoing multi-center study at the Norwegian
unclear. Centre for Mental Disorders Research, consisting of inpatients and out­
Childhood trauma is a well-recognized risk factor for development of patients from psychiatric hospital units in the Oslo area. General in­
SMDs and has an impact on illness severity and course (Aas et al., 2016; clusion criteria for all participants were meeting the DSM-IV (APA,
Alameda et al., 2021; Etain and Aas, 2021; Misiak et al., 2017). In the 1994) criteria for SCZ or BD, ability to give informed consent, and age
general population, childhood trauma also shows adverse impact on 18–65 years. Participants were excluded if they had a history of severe
smoking habits and cardiopulmonary disease risk (Brown et al., 2010; head injury, severe somatic illness, neurological disorder or IQ < 70. In
Campbell et al., 2016; Clemens et al., 2018; Felitti et al., 1998; Ramiro this study only participants that completed the Childhood Trauma
et al., 2010). Adverse childhood experiences seem to substantially in­ Questionnaire were included.
crease risks of ever smoking, early smoking initiation, current smoking The study has been approved by the Regional Committee for Medical
and heavy smoking (Anda et al., 1999). Similarly, a study examining the Research Ethics and the Norwegian Data Inspectorate.
effects of childhood maltreatment on smoking and mental illness
revealed the highest number of cumulative adverse childhood experi­ 2.2. Clinical and cognitive assessment
ences in people with both smoking and severe mental illness (Sacco
et al., 2007). However, despite the involvement of childhood trauma in The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-
SMD and smoking and the poor cardiopulmonary health of these pa­ I) (First et al., 1995) was used to establish diagnoses as part of the
tients, there is a sparsity of studies of childhood trauma and smoking in clinical evaluation performed by trained physicians and psychologists.
SMD. Inter-rater reliability for diagnostic assessments is regularly assured by
Psychological and behavioral correlates of childhood trauma have scoring a series of videos (Ventura et al., 1998), indicating an overall
been investigated in the general population and in psychiatric patient kappa score between 0.92 and 0.99 (Høegh et al., 2020).
samples, including cognitive- and personality characteristics (Aas et al., For current core symptoms, we assessed psychotic symptoms with The
2014, 2017a; Bungert et al., 2015; Dauvermann and Donohoe, 2019; Positive and Negative Syndrome Scale (PANSS) (Kay et al., 1987), manic
Kilian et al., 2018; Reiland and Lauterbach, 2008; Richard-Lepouriel symptoms with the Young Mania Rating Scale (YMRS) (Young et al.,
et al., 2019; Roy, 2005). One review indicated associations between 1978), and depressive symptoms with Inventory of Depressive
childhood trauma and executive functions in SMD, although findings Symptomatology-Clinician Rated (IDS-C) (Rush et al., 1996) for partic­
were mixed (Dauvermann and Donohoe, 2019). In bipolar disorder, ipants in the BD group and with Calgary Depression Scale for Schizo­
impulsivity (Richard-Lepouriel et al., 2019), affective lability and af­ phrenia (CDSS) (Addington et al., 1996) for participants in the SCZ
fective intensity (Etain et al., 2008) are related to experience of child­ group. Moreover, intellectual functioning was assessed using the Wechsler
hood trauma. Moreover, a national survey by Reiland and Lauterbach Abbreviated Scale of Intelligence (WASI), two-subtest version (Wechs­
(2008) found lower self-esteem after physical abuse, sexual abuse, or ler, 2007). Cognitive control was measured by the inhibition condition
neglect in childhood. Cognitive- and personality characteristics also from the Color-Word Interference Test, D-KEFS (Delis et al., 2005), as
appear to be associated with an increased frequency and amount of part of a larger neurocognitive test battery. Regarding cognitive control,
smoking. A review of studies primarily from non-clinical populations total time to complete the test was registered (raw scores), with longer
indicated that smokers are more impulsive than non-smokers and that time manifesting poorer cognitive control. Impulsiveness was assessed
impulsivity is associated with degree of nicotine dependence (Kale et al., with the Barratt Impulsiveness Scale (BIS-11), a 30 item self-report
2018). Furthermore, a study of youths in the general population found questionnaire (Patton et al., 1995); responses across all items are sum­
affect dysregulation to be a risk factor for future escalation of smoking, marized to yield a total score between 30 and 120 with higher scores
and mood stabilizing effects of smoking was seen to reinforce and indicating more impulsiveness. Measurements of affective lability were
maintain daily cigarette use (Weinstein et al., 2008). Similarly, there is obtained from a Norwegian short form of the Affective Lability Scale
support for the importance of cognitive control in health behavior, (ALS-18) (Aas et al., 2015; Harvey et al., 1989; Oliver and Simons,
including smoking (Buckley et al., 2014; Evans et al., 2019). A meta- 2004); the sum of all item responses divided by 18 represents the total
analysis of 97 studies comparing groups with heavy substance use and score. The total score lays between 0 and 3, with 3 representing high
healthy controls, found deficits in cognitive control to be associated with affective lability. Self-esteem was assessed by the Rosenberg Self-Esteem
substance use disorders such as tobacco dependence and addiction-like Scale (RSES), a 10 item self-report questionnaire (Rosenberg, 2015); the
behavioral disorders (Smith et al., 2014). total score ranges from 0 to 30 with higher scores representing higher
The aim of the current study was to determine the relationship be­ self-esteem. Cognitive control and personality characteristics were
tween experience of childhood trauma and smoking in a large well- included in mediation effect analyses and recorded in the following
characterized sample of people with SMDs, controlling for potential subgroups of the sample: cognitive control, N = 746; impulsiveness, N =

237
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

369; affective lability, N = 257; and self-esteem, N = 681. groups separately. Additionally, associations between each subtype of
childhood trauma and tobacco smoking were tested in the total sample.
2.3. Childhood Trauma Questionnaire
2.6.2. Mediation effect analyses
History of childhood trauma was measured by a Norwegian 28-item Total effect of presence of childhood trauma on tobacco smoking was
version of the Childhood Trauma Questionnaire (CTQ) (Aas et al., 2012; tested for mediation through cognitive control, impulsiveness, affective
Bernstein and Fink, 1998; Bernstein et al., 2003). CTQ yields five cate­ lability and self-esteem, separately for each characteristic. Analyses
gories of trauma: physical, emotional and sexual abuse, and physical and were carried out with Hayes (2018) regression using PROCESS, version
emotional neglect. Each category is scored on a 5-point Likert-type scale 3.4 and 3.5 for SPSS. For three partitioned independent variables we
with scores ranging between 5 and 25 and higher scores denoting more applied indicator coding, i.e. membership in each category was coded as
severe mistreatment. Experience of childhood trauma was for each 0/1 (Hayes, 2018). Evaluation of the indirect effect was based on a
trauma category defined as meeting a moderate to severe cut-off score, i. bootstrap estimation approach with 5000 samplings.
e. for physical abuse ≥10, for emotional abuse ≥13, for sexual abuse ≥8, Lastly, we explored the relationship between experience (one or
for physical neglect ≥10, and for emotional neglect ≥15 (Bernstein more subtypes of childhood trauma vs. none) and level (none (refer­
et al., 1994; Bernstein et al., 2003).The moderate to severe cut-off has ence), one or two subtypes, and three or more subtypes of trauma) of
shown good specificity and sensitivity in classifying maltreated in­ childhood trauma and amount of tobacco smoking among smokers in
dividuals (Bernstein et al., 2003; Bernstein and Fink, 1998), and is linear regression analyses.
widely used in the literature (Aas et al., 2017b; Aas et al., 2019a; Church All analyses were as standard adjusted for age, sex, and diagnostic
et al., 2017; Guillen-Burgos et al., 2023; Hagborg et al., 2022; Heim group (SCZ, BD). To exclude false statistical associations between
et al., 2009). By combining the five trauma categories we generated the childhood trauma and tobacco smoking (yes/no) due to variations in
following variables: no subtypes of trauma (not meeting the moderate to symptom severity (psychosis/mania/depression) or household SES
severe cut-off score for any of the trauma categories), one or two sub­ during childhood, we made additional adjustments in the total effect
types of trauma (meeting the moderate to severe cut-off score for one or model (one or more subtypes of trauma) for PANSS and CDSS total score
two trauma categories), and three or more subtypes of trauma (meeting (tested separately) in the total SMD sample, for YMRS total score in BD,
the moderate to severe cut-off score for three or more trauma cate­ and for level of education of father (primary school or less, secondary
gories). For descriptive purposes we also included a total score by school, or college or university) in a subsample. Level of significance was
summing the scores for the five different categories of trauma (Lunding set at p ≤ 0.025 (0.05/2) according to the Bonferroni method, based on
et al., 2021). testing childhood trauma as both a dichotomous variable and at
different exposure levels. The indirect effects were significant if the 95 %
2.4. Tobacco smoking confidence intervals did not include zero (Hayes, 2018).

Tobacco smoking was assessed with the question “Do you smoke on a 3. Results
daily basis or do you use snuff?”, followed by a question of the average
number (‘amount’) of cigarettes, pipes, cigars or snuff units per day 3.1. Sample characteristics
(available in a subsample, N = 386). Data on snuff use was not included
in the study as the relevant literature pertains to smoking. There were more men (χ2 = 29.63, p < 0.001) and younger partic­
ipants (U = 80,627.0, z = − 3.53, p < 0.001) in the SCZ compared to the
2.5. Household socioeconomic status during childhood BD group. Also, a significantly higher percentage reached the cut-off for
moderate depression (χ2 = 8.62, p = 0.003) in the SCZ compared to the
Data on level of education of the patient’s father was available in a BD group. PANSS total score (U = 147,621.0, z = 15.44, p < 0.001) was
subsample (N = 425) and used as a proxy of socioeconomic status (SES) higher in the SCZ compared to BD group, whereas performance on
in the household during the patient’s childhood. Participants were asked cognitive control (U = 85,710.5, z = 5.60, p < 0.001) and IQ level (U =
if their father had any education followed by questions about the level of 50,205.0, z = − 7.25, p < 0.001) were lower in the SCZ group. The
education (primary school, secondary school, college/university). frequency of childhood trauma in the total sample was 48.9 % while
44.3 % smoked tobacco, with significantly more smokers in the SCZ than
2.6. Statistics in the BD group (χ2 = 10.86, p < 0.001). Sociodemographic, clinical,
and cognitive characteristics (N = 871) are shown in Table 1.
Statistical analyses were conducted using IBM SPSS Statistics for
Windows, Version 27.0 (IBM Corp., 2020). Normality of data was 3.2. Total effect of childhood trauma on tobacco smoking
evaluated by Kolmogorov-Smirnov tests and inspection of histograms
and Q-Q plots. Due to non-normal distribution, the dependent variable 3.2.1. Total SMD sample
“amount of tobacco smoking” was log transformed prior to entry into Experience of one or more subtypes of childhood trauma was signifi­
regression analyses. Sociodemographic and clinical variables were cantly associated (B = 0.433, Wald = 9.712, p = 0.002) with smoking
compared across SCZ and BD by Mann-Whitney U Tests. For comparison tobacco. Additional adjustments suggested a potential effect of level of
of proportions, we used Chi-Square test. depression (B = 0.029, Wald = 3.611, p = 0.057) and psychosis (B =
0.011, Wald = 4.355, p = 0.037) on smoking tobacco, but the associa­
2.6.1. Analyses of total effect of childhood trauma on tobacco smoking tion between childhood trauma and smoking remained significant (B =
We ran logistic regression analyses to investigate whether childhood 0.345, Wald = 5.638, p = 0.018, and B = 0.390, Wald = 7.565, p =
trauma was associated with increased risk of tobacco smoking. In the 0.006, respectively). There was no significant effect of level of education
first model, experience of childhood trauma (one or more subtypes of of father on smoking tobacco (p > 0.100). In tests of different exposure
childhood trauma vs. none) was set as independent variable and tobacco levels, both one or two subtypes (B = 0.409, Wald = 6.801, p = 0.009)
smoking (yes/no) as dependent variable. Secondly, we ran similar an­ and three or more subtypes of childhood trauma (B = 0.476, Wald =
alyses with tobacco smoking as a dependent variable and different 6.148, p = 0.013) were associated with smoking tobacco. There were no
exposure levels of childhood trauma as independent variables: one or significant associations between any of the tested trauma categories and
two subtypes, and three or more subtypes, vs. no childhood trauma. amount of tobacco smoking per day among smokers. Analysis of each
Analyses were performed in the total sample and for the diagnostic subtype of trauma indicated associations between abuse subtypes and

238
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

Table 1 tobacco smoking, see Supplementary Table 2.

Sample characteristics.
SCZ BD p- 3.2.2. Diagnostic groups
(N = 484) (N = 387) Valuef Experience of one or more subtypes of trauma was only trend level
N (%) N (%) associated with tobacco smoking in SCZ (B = 0.351, Wald = 3.661, p =
Sex, male 291 (60.1) 160 (41.3) <0.001 0.056) but significantly associated in BD (B = 0.538, Wald = 6.379, p =
Childhood traumaa 243 (50.2) 180 (46.5) 0.310 0.012). Additional adjustment for YMRS in the BD group showed no
1 or 2 subtypes of trauma 156 (32.2) 113 (29.2) 0.374 significant effect of mania symptom severity (p > 0.100) on smoking
≥3 subtypes of trauma 87 (18.0) 67 (17.3) 0.869
Above cut-off for moderate 194 (40.8) 116 (30.9) 0.003
tobacco. When separating into different levels of trauma exposure, one
depressionb or two subtypes of trauma was significantly associated with tobacco
Level of education of father smoking in BD (B = 0.592, Wald = 6.014, p = 0.014) and three or more
Primary school 43 (18.8) 30 (15.3) 0.414 subtypes of trauma was trend level associated with tobacco smoking in
Secondary school 64 (27.9) 43 (21.9) 0.190
SCZ (B = 0.500, Wald = 3.800, p = 0.051). There were no other sig­
College/university 122 (53.3) 123 (62.8) 0.061
Level of education of mother nificant associations.
No education 1 0 n.a.
Primary school 54 (23.4) 45 (22.3) 0.875
Secondary school 57 (24.7) 43 (21.3) 0.471 3.3. Mediation analysis
College/university 119 (52.0) 114 (56.4) 0.353
Tobacco smoking (yes/no) 239 (49.4) 147 (38.0) <0.001 See Table 2 for an overview of cognitive and personality character­
istics in mediation analyses of childhood trauma and tobacco smoking.
Median Median Supplementary Table 1 shows unadjusted correlations between child­
(IQR) (IQR) hood trauma, tobacco smoking, and cognitive- and personality
Age 27.0 (12.0) 30.0 (18.0) <0.001
characteristics.
PANSSc 61.0 (22.0) 43.0 (13.0) <0.001
YMRSc – 2.0 (4.0)
IDS-Cc – 15.0 (16.0) 3.3.1. Cognitive control and impulsiveness
CDSSc 4.0 (7.0) 4.0 (7.0) 0.577 Cognitive control and impulsiveness were significant mediators be­
Childhood traumac 40.0 (18.8) 39.0 (19.0) 0.374 tween presence (one or more subtypes) of trauma and tobacco smoking,
Males 39.0 (16.0)* 37.0 (15.8) n.a.
see Fig. 1 a) and b) for pathway-specific statistical parameters.
Females 41.0 (25.5) 39.0 (23.0) n.a.
Amount of tobacco smoking per dayd,e 12.0 (14.0) 12.0 (15.0) 0.322
IQ 103.0 (22.0) 110.0 (18.0) <0.001 3.3.2. Self-esteem
Cognitive controle 58.0 (21.0) 52.0 (17.0) <0.001 Self-esteem was a subsignificant mediator between presence (one or
Impulsivenessc,e 66.0 (15.0) 68.0 (18.0) 0.235
more subtypes) of trauma and tobacco smoking (confidence interval
Affective labilityc,e 1.08 (0.94) 1.22 (1.17) 0.088
Self-esteemc,e 25.0 (8.0) 25.5 (9.0) 0.505
highly skewed relative to zero, see Table 2 and Fig. 1 c).

Missingness: CDSS: 2.2%; IDS-C: 2.8%; PANSS: 1.1%; YMRS: 6.4%; IQ: 12.2%. 3.3.3. Affective lability
Abbreviations: Affective lability = Affective Lability Scale (ALS-18); BD = Bi­
Affective lability was not a significant mediator between presence
polar Spectrum Disorders (Bipolar I disorder, Bipolar II disorder, Bipolar Not
(one or more subtypes) of trauma and tobacco smoking.
Otherwise Specified, Major Depressive Disorder with Psychotic Features); CDSS
= Calgary Depression Scale for Schizophrenia; Childhood Trauma = Childhood
Trauma Questionnaire (CTQ); Cognitive control = The Inhibition condition in 3.3.4. Trauma subtypes and diagnostic groups
the Color-Word Interference Test, Delis Kaplan Executive Functioning System Cognitive control, impulsiveness and self-esteem were significant
(D-KEFS); IDS-C = Inventory of Depressive Symptomatology, Clinician-Rated; mediators between most abuse subtypes and tobacco smoking, see
Impulsiveness = Barratt Impulsiveness Scale (BIS-11); IQ = Intelligence Quo­ Supplementary Table 3. No significant mediation was found for the as­
tient, based on Wechsler Abbreviated Scale of Intelligence (WASI), two-subtest sociation between presence (one or more subtypes) of trauma and to­
version; IQR = interquartile range; PANSS = Positive and Negative Syndrome bacco smoking in the BD group, see Supplementary Table 4.
Scale; SCZ = Schizophrenia Spectrum Disorders (Schizophrenia, Schizophreni­
form disorder, Schizoaffective disorder, Delusional disorder, Psychosis Not
4. Discussion
Otherwise Specified); n.a. = not applicable; Self-esteem = Rosenberg Self
Esteem Scale (RSES); YMRS = Young Mania Rating Scale.
Values in bold: p < 0.05 In the current study, we found experience of childhood trauma to be
a
Meeting the moderate to severe cut-off score for ≥1 subtype(s) of childhood significantly associated with tobacco smoking in individuals with SMD,
trauma. both SCZ and BD. The association with presence of smoking was shown
b
CDSS cut-off for moderate depression ≥6; IDS-C cut-off for moderate
depression ≥22. Table 2
c
Total score (standardized scores for affective lability). Cognitive- and personality characteristics in mediation analyses of childhood
d
Including cigarettes, cigars or tobacco pipes. trauma and tobacco smoking.
e
Subsamples: cognitive control, N = 746 (SCZ:397, BD:349); impulsiveness,
Tobacco smoking (DV)
N = 369 (SCZ:190, BD:179); affective lability, N = 257 (SCZ:98, BD:159); self-
esteem, N = 681 (SCZ:387, BD:294); amount of tobacco smoking per day, N IV Mediator Indirect effecta SE 95% CI
= 386 (SCZ:239, BD:147); level of education of father, N = 425 (SCZ:229,
Lower Upper
BD:196); level of education mother, N = 433 (SCZ:231, BD:202).
f
Mann-Whitney U Test for variables represented by median (IQR) and chi- CTQ Cognitive control 0.0569* 0.0271 0.0135 0.1192
Impulsiveness 0.1822* 0.0778 0.0557 0.3616
square test for comparison of proportions.
* Affective lability − 0.0365 0.0598 − 0.1697 0.0713
p < 0.05, comparing childhood trauma scores between males and females.
Self-esteem 0.0942 0.0545 − 0.0122 0.2038

Abbreviations: CI = Confidence Interval; CTQ = Childhood Trauma Question­

naire; DV = Dependent Variable; IV = Independent Variable; SE = Standard
Error.
a
One or more subtypes of trauma relative to no trauma.
*
Significant indirect effect.

239
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

a) 2019). This, together with our findings, suggest childhood trauma as a

Cognitive control predictor of the pronounced smoking behavior in people with SMD.
Cognitive control and impulsiveness were both mediators between
childhood trauma and smoking. Deficits in cognitive control decreases
Beta= 4.52, p<0.001 Beta= 0.013, p<0.010 the possibility of cognitive regulation and there is substantial evidence
that cognitive control contributes to self-regulation (Evans et al., 2019).
Impulsiveness is characterized by a tendency to react quickly and in an
unplanned way to internal or external stimuli without taking negative
Smoking (yes/no)
effects into account (Stanford et al., 2009). A close relationship has been
Childhood trauma (yes/no)

Beta= 0.55, p<0.001

shown between impulsiveness and emotional dysregulation (Cackowski
et al., 2014; van Zutphen et al., 2015). Our results indicate that the
b)
relationship between childhood trauma and smoking may in part be
mediated by deficits in inhibition related self-regulatory aspects which
Impulsiveness

increase the susceptibility of unhealthy behavior as a regulatory strategy

in SMD. A recent study investigating motives for smoking in SCZ
revealed help in relaxing as the most frequent (60 %) motive as well as
Beta= 5.81, p<0.001 Beta=0.031, p<0.005

related aspects of coping with loneliness (16 %) and anxiety or depres­

sion (31 %) (Young et al., 2019). Notably, smoking is known to yield
Childhood trauma (yes/no) Smoking (yes/no) advantageous short term psychoactive effects (Gurpegui et al., 2007;
Beta=0.36, p=0.125 Pomerleau and Pomerleau, 1984). Thus, individuals with SMD exposed
to childhood trauma may be more likely to engage in smoking behavior,
c) especially to the extent that this strategy represents an immediate relief
Self-esteem from challenging emotional states. The indicated effect of self-
regulatory aspects is also in line with non-SMD studies reporting expe­
rience of childhood trauma to be associated with a range of unhealthy
Beta=-3.98, p <0.001 Beta=-0.024, p=0.068 behavior in addition to smoking (Garrido et al., 2018; Walker et al.,
1999). Importantly, maltreated children have shown increased negative
affect and general emotion dysregulation (e.g., emotional reactivity,
inability to temper emotional responses) (Lewis et al., 2007; Shields and
Cicchetti, 1998). Spinazzola et al. (2005) reported poor impulse control,
Childhood trauma (yes/no) Smoking (yes/no)

Beta= 0.22, p= 0.190 inattention, affect dysregulation, and poor self-image to be frequent in
over 50 % of their sample of traumatized children. Taken together, our
Fig. 1. Associations between childhood trauma and tobacco smoking in
results might suggest childhood trauma as a predisposing factor to def­
mediation analyses.
Betas are presented in unstandardized form.
icits in cognitive control and impulsiveness, making individuals more
Analyses performed in subsample with a) cognitive control, N = 746; b) prone to engage in smoking as a maladaptive coping strategy.
impulsiveness, N = 369; and c) self-esteem, N = 681. There was a subsignificant mediating effect of self-esteem while no
significant mediating effect of affective lability was found. Self-esteem
across different exposure levels of trauma, while no associations were refers to an individuals’ general sense of being found worthy or valu­
found between childhood trauma and amount of tobacco smoking per able (Rosenberg, 2015). Studies have detected a robust relationship
day. Furthermore, we found cognitive control and impulsiveness to be between childhood maltreatment and low self-esteem (Gross and Keller,
mediating factors between childhood trauma and tobacco smoking, 1992; Karakuş, 2012; Stein et al., 2002). Furthermore, lower self-esteem
suggesting smoking as a possible exaggerated regulatory behavior has been positively associated with ever- and current smoking and
related to impaired inhibitory abilities. excessive alcohol consumption (Szinay et al., 2019). Thus, one might
Individuals with experience of childhood trauma were 1.5 times speculate low self-esteem to be associated with proneness of engaging in
more likely to be among the 44.3 % current smokers in SMD. Individuals adverse health behavior and represent a mediating mechanism for the
with SMD have a several times increased standardized mortality ratio of association between childhood trauma and smoking. Even though the
CVD and pulmonary disease (Olfson et al., 2015; Osby et al., 2001). subsample with assessment of affective lability was limited compared to
However, despite the large impact of smoking on cardiopulmonary subsamples of the other cognitive and personality characteristics, the
health (Ambrose and Barua, 2004), only a few studies exist and pri­ results suggest affective lability to play a less important role in the
marily in SCZ. One recent study of childhood trauma and current to­ relationship between childhood trauma and cardiometabolic risk fac­
bacco smoking in SCZ found no significant relationship (Mallet et al., tors, including smoking.
2019), while a previous study of nicotine dependence in SCZ by the same In addition to the indicated cognitive- and personality features,
research group (Rey et al., 2017), reported a small, but significant as­ several factors might be involved in mechanisms underlying childhood
sociation (OR = 1.03, p = 0.044). Of note, the current study shows trauma and smoking in SMD. Other psychological and physiological
comparable results in SCZ and BD and the results are withheld for reactions to stress and level of support are factors associated with
different exposure levels of trauma, indicating stable effects across SMD childhood trauma and self-regulation as indicated in non-SMD samples.
from moderate to high exposure of childhood trauma. Moreover, Survivors of severe childhood adversities are not only more likely to
consistent with our findings, a relationship between history of childhood develop maladaptive coping strategies, but also seem to experience
trauma and smoking have been robustly reported in the general popu­ higher levels of stress, anger and depressed mood (Greenfield and
lation (Cammack et al., 2019; Taha et al., 2014). Data based on a lon­ Marks, 2009; Rohde et al., 2008). In addition to mental effects including
gitudinal national US survey found childhood trauma to be associated symptom levels, experiences of childhood trauma may affect physio­
with increased risk of ever smoking, smoking daily and persistent logical stress-related systems such as immune and neuroendocrine
smoking (Taha et al., 2014). A more recent study using online crowd­ functioning (McLaughlin et al., 2015), which is dysregulated in SMD
sourcing found exposure to four or more adverse childhood experiences (Aas et al., 2019b; Fernandes et al., 2016). However, despite an obvi­
to be associated with greater odds of cigarette use (Meadows et al., ously complex interplay between several factors, our results indicate
cognitive control and impulsiveness to be central components in

240
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

pathways between trauma exposure and smoking in SMD. CRediT authorship contribution statement
The present study has some notable limitations. Retrospective data
collection is susceptible to recall bias. Low consistency has been re­ Conception and design: SHL, CS, TU and NES. Acquisition, analysis,
ported between childhood trauma measured by prospective and retro­ or interpretation of data: All authors. Drafting the article: SHL and NES.
spective measures (Baldwin et al., 2019; Newbury et al., 2018). Critical revision of the article for important intellectual content: All
Nevertheless, both prospective and retrospective measures have been authors. All authors approved the final version of the article.
found to predict later adolescent outcomes (Reuben et al., 2016; Tajima
et al., 2004). Furthermore, while the applied models are easy to inter­ Declaration of competing interest
pret, we cannot rule out that alternative adjustment strategies may
reflect the underlying paths more accurately. Also, symptom severity Ole Andreas Andreassen has received speaker’s honorarium from
which may be associated with both childhood trauma (Varese et al., Lundbeck and is a consultant to HealthLytix. All other authors report no
2012) and the propensity to engage in smoking behavior (Meszaros conflicts of interest.
et al., 2011), and being a potential source of recall bias, did not seem to
affect the finding. Household SES during childhood has been associated Acknowledgements
with both experiencing childhood trauma (Walsh et al., 2019) and
future smoking behavior (Pedersen and Soest, 2017). While we were The authors are deeply grateful to the study participants for their
able to include childhood SES in a subsample analysis, a confounding time and effort devoted to participation in the Thematic Organized
effect cannot be fully excluded. Furthermore, studies suggest that anti­ Psychosis (TOP) study. We would also like to thank the research support
psychotics may increase cigarette smoking and the risk of developing personnel at Norwegian Centre for Mental Disorders Research
regular or dependent smoking in SMDs (Heffner et al., 2011; Matthews (NORMENT).
et al., 2011). Such effects were not explored in the current study.
Moreover, the outcome was current tobacco smoking, thus the partici­
References
pants full history of smoking behavior was not assessed. However,
assessment of cognitive- and personality characteristics and smoking Aas, M., Djurovic, S., Athanasiu, L., Steen, N.E., Agartz, I., Lorentzen, S., Sundet, K.,
status at the same time ensures the relevance of these scores relative to Andreassen, O.A., Melle, I., 2012. Serotonin transporter gene polymorphism,
childhood trauma, and cognition in patients with psychotic disorders. Schizophr.
smoking behavior. We applied a moderate significance threshold
Bull. 38 (1), 15–22. https://doi.org/10.1093/schbul/sbr113.
correction to reduce the risk of overlooking important associations with Aas, M., Aminoff, S.R., Vik Lagerberg, T., Etain, B., Agartz, I., Andreassen, O.A., Melle, I.,
tobacco smoking in this patient group, thus, significant findings should 2014. Affective lability in patients with bipolar disorders is associated with high
be interpreted cautiously. Also, some of the factors may be bidirec­ levels of childhood trauma. Psychiatry Res. 218 (1–2), 252–255. https://doi.org/
10.1016/j.psychres.2014.03.046.
tionally related; for example may long term smoking impact cognitive Aas, M., Pedersen, G., Henry, C., Bjella, T., Bellivier, F., Leboyer, M., Kahn, J.P.,
function resulting in reduced cognitive control (Evans et al., 2019). Cohen, R.F., Gard, S., Aminoff, S.R., Lagerberg, T.V., Andreassen, O.A., Melle, I.,
However, the cross-sectional design prevents conclusions about direc­ Etain, B., 2015. Psychometric properties of the Affective Lability Scale (54 and 18-
item version) in patients with bipolar disorder, first-degree relatives, and healthy
tionality between associated variables. Lastly, a healthy control group controls. J. Affect. Disord. 172, 375–380. https://doi.org/10.1016/j.
with data on both childhood trauma and smoking status for comparison, jad.2014.10.028.
would be beneficial; however, this information was not available. Aas, M., Andreassen, O.A., Aminoff, S.R., Færden, A., Romm, K.L., Nesvåg, R., Berg, A.O.,
Simonsen, C., Agartz, I., Melle, I., 2016. A history of childhood trauma is associated
To the best of our knowledge, the current study is one of few with slower improvement rates: findings from a one-year follow-up study of patients
investigating the relationship between experience of childhood trauma with a first-episode psychosis. BMC Psychiatry 16 (1), 126. https://doi.org/10.1186/
and tobacco smoking in SMD. One might speculate that experience of s12888-016-0827-4.
Aas, M., Henry, C., Bellivier, F., Lajnef, M., Gard, S., Kahn, J.P., Lagerberg, T.V.,
childhood trauma is a predisposing factor for the pronounced tobacco
Aminoff, S.R., Bjella, T., Leboyer, M., Andreassen, O.A., Melle, I., Etain, B., 2017a.
smoking behavior in SMD. Cognitive control and impulsiveness seemed Affective lability mediates the association between childhood trauma and suicide
to be involved in mediating mechanisms of the association, indicating attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders.
Psychol. Med. 47 (5), 902–912. https://doi.org/10.1017/S0033291716003081.
inhibition related self-regulatory aspects in smoking behavior. Thus,
Aas, M., Dieset, I., Hope, S., Hoseth, E., Mørch, R., Reponen, E., Steen, N.E.,
clinicians seeking to intervene with tobacco smoking in SMD, should Laskemoen, J.F., Ueland, T., Aukrust, P., Agartz, I., 2017b. Childhood maltreatment
screen for and if indicated assess for childhood maltreatment exposure, severity is associated with elevated C-reactive protein and body mass index in adults
and consider integrating trauma-informed approaches to reduce stress with schizophrenia and bipolar diagnoses. Brain Behav. Immun. 65, 342–349.
https://doi.org/10.1016/j.bbi.2017.06.005.
and prevent use of smoking as a highly unfortunate coping strategy Aas, M., Elvsåshagen, T., Westlye, L.T., Kaufmann, T., Athanasiu, L., Djurovic, S.,
contributing to excessive morbidity and mortality. Furthermore, Melle, I., van der Meer, D., Martin-Ruiz, C., Steen, N.E., Agartz, I., Andreassen, O.A.,
cognitive remediation has been shown to have a positive effect on 2019a. Telomere length is associated with childhood trauma in patients with severe
mental disorders. Transl. Psychiatry 9, 97. https://doi.org/10.1038/s41398-019-
cognitive function (Bowie et al., 2020). Whether remediation efforts 0432-7.
targeting inhibition related regulatory capacities may also improve Aas, M., Pizzagalli, D.A., Laskemoen, J.F., Reponen, E.J., Ueland, T., Melle, I., Agartz, I.,
health behaviors has to our knowledge not been explored. Efforts to Steen, N.E., Andreassen, O.A., 2019b. Elevated hair cortisol is associated with
childhood maltreatment and cognitive impairment in schizophrenia and in bipolar
improve smoking cessation for people with SMDs might potentially disorders. Schizophr. Res. 213, 65–71. https://doi.org/10.1016/j.
benefit from both strategies in the future. schres.2019.01.011.
Supplementary data to this article can be found online at https://doi. Addington, D., Addington, J., Atkinson, M., 1996. A psychometric comparison of the
Calgary depression scale for schizophrenia and the Hamilton depression rating scale.
org/10.1016/j.schres.2023.09.041.
Schizophr. Res. 19 (2–3), 205–212. https://doi.org/10.1016/0920-9964(95)00070-
4.
Role of the funding source Alameda, L., Christy, A., Rodriguez, V., Salazar de Pablo, G., Thrush, M., Shen, Y.,
Alameda, B., Spinazzola, E., Iacoponi, E., Trotta, G., Carr, E., Ruiz Veguilla, M.,
Aas, M., Morgan, C., Murray, R.M., 2021. Association between specific childhood
This study was funded by grants from the University of Oslo, South- adversities and symptom dimensions in people with psychosis: systematic review
Eastern Norway Health Authority (#2017-112, #2019-108), the and meta-analysis. Schizophr. Bull. 47 (4), 975–985. https://doi.org/10.1093/
Research Council of Norway (#223273, #273291) and the K.G. Jebsen schbul/sbaa199.
Ambrose, J.A., Barua, R.S., 2004. The pathophysiology of cigarette smoking and
Foundation. cardiovascular disease: an update. J. Am. Coll. Cardiol. 43 (10), 1731–1737. https://
The funding bodies had no role in the study design, or in the doi.org/10.1016/j.jacc.2003.12.047.
collection, analyses and interpretation of the data, or the decision to American Psychiatric Association (Ed.), 1994. Diagnostic and Statistical Manual of
Mental Disorders, fourth ed. American Psychiatric Association, Washington.
submit this work for publication. Anda, R.F., Croft, J.B., Felitti, V.J., Nordenberg, D., Giles, W.H., Williamson, D.F.,
Giovino, G.A., 1999. Adverse childhood experiences and smoking during

241
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

adolescence and adulthood. JAMA 282 (17), 1652–1658. https://doi.org/10.1001/ Etain, B., Aas, M., 2021. Childhood maltreatment in bipolar disorders. In: Young, A.H.,
jama.282.17.1652. Juruena, M.F. (Eds.), Bipolar Disorder: From Neuroscience to Treatment, Current
Andreassen, O.A., Djurovic, S., Thompson, W.K., Schork, A.J., Kendler, K.S., Topics in Behavioral Neurosciences, vol. 48. Springer International Publishing,
O’Donovan, M.C., Rujescu, D., Werge, T., van de Bunt, M., Morris, A.P., Cham, pp. 277–301. https://doi.org/10.1007/7854_2020_149.
McCarthy, M.I., International Consortium for Blood Pressure GWAS, Diabetes Etain, B., Henry, C., Bellivier, F., Mathieu, F., Leboyer, M., 2008. Beyond genetics:
Genetics Replication and Meta-analysis Consortium, Psychiatric Genomics childhood affective trauma in bipolar disorder. Bipolar Disord. 10 (8), 867–876.
Consortium Schizophrenia Working Group, Roddey, J.C., McEvoy, L.K., Desikan, R. https://doi.org/10.1111/j.1399-5618.2008.00635.x.
S., Dale, A.M., 2013. Improved detection of common variants associated with Evans, D.E., To, C.N., Ashare, R.L., 2019. The role of cognitive control in the self-
schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors. Am. regulation and reinforcement of smoking behavior. Nicotine Tob. Res. 21 (6),
J. Hum. Genet. 92 (2), 197–209. https://doi.org/10.1016/j.ajhg.2013.01.001. 747–754. https://doi.org/10.1093/ntr/nty029.
Bahrami, S., Steen, N.E., Shadrin, A., O’Connell, K., Frei, O., Bettella, F., Wirgenes, K.V., Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V.,
Krull, F., Fan, C.C., Dale, A.M., Smeland, O.B., Djurovic, S., Andreassen, O.A., 2020. Koss, M.P., Marks, J.S., 1998. Relationship of childhood abuse and household
Shared genetic loci between body mass index and major psychiatric disorders: a dysfunction to many of the leading causes of death in adults. The Adverse Childhood
genome-wide association study. JAMA Psychiatry 77 (5), 503–512. https://doi.org/ Experiences (ACE) Study. Am. J. Prev. Med. 14 (4), 245–258. https://doi.org/
10.1001/jamapsychiatry.2019.4188. 10.1016/s0749-3797(98)00017-8.
Baldwin, J.R., Reuben, A., Newbury, J.B., Danese, A., 2019. Agreement between Fernandes, B.S., Steiner, J., Bernstein, H.G., Dodd, S., Pasco, J.A., Dean, O.M., Nardin, P.,
prospective and retrospective measures of childhood maltreatment: a systematic Gonçalves, C.A., Berk, M., 2016. C-reactive protein is increased in schizophrenia but
review and meta-analysis. JAMA Psychiatry 76 (6), 584–593. https://doi.org/ is not altered by antipsychotics: meta-analysis and implications. Mol. Psychiatry 21
10.1001/jamapsychiatry.2019.0097. (4), 554–564. https://doi.org/10.1038/mp.2015.87.
Bernstein, D., Fink, L., 1998. Childhood Trauma Questionnaire: A Retrospective Self- First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B., 1995. Structured Clinical Interview
report Questionnaire and Manual. The Psychological Corporation, San Antonio, TX. for DSM-IV Axis I Disorders: Patient Edition (SCID-P), Version 2. Biometrics
Bernstein, D.P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., Research, New York State Psychiatric Institute, New York.
Ruggiero, J., 1994. Initial reliability and validity of a new retrospective measure of Garrido, E.F., Weiler, L.M., Taussig, H.N., 2018. Adverse childhood experiences and
child abuse and neglect. Am. J. Psychiatry 151 (8), 1132–1136. https://doi.org/ health-risk behaviors in vulnerable early adolescents. J. Early Adolesc. 38 (5),
10.1176/ajp.151.8.1132. 661–680. https://doi.org/10.1177/0272431616687671.
Bernstein, D.P., Stein, J.A., Newcomb, M.D., Walker, E., Pogge, D., Ahluvalia, T., Greenfield, E.A., Marks, N.F., 2009. Violence from parents in childhood and obesity in
Stokes, J., Handelsman, L., Medrano, M., Desmond, D., Zule, W., 2003. Development adulthood: using food in response to stress as a mediator of risk. Soc. Sci. Med. 68
and validation of a brief screening version of the Childhood Trauma Questionnaire. (5), 791–798. https://doi.org/10.1016/j.socscimed.2008.12.004.
Child Abuse Negl. 27 (2), 169–190. https://doi.org/10.1016/s0145-2134(02)00541- Gross, A.B., Keller, H.R., 1992. Long-term consequences of childhood physical and
0. psychological maltreatment. Aggress. Behav. 18, 171–185. https://doi.org/10.1002/
Bowie, C.R., Bell, M.D., Fiszdon, J.M., Johannesen, J.K., Lindenmayer, J.P., McGurk, S. 1098-2337199218:3<171::aid-ab2480180302<3.0.co;2-i.
R., Medalia, A.A., Penadés, R., Saperstein, A.M., Twamley, E.W., Ueland, T., Guillen-Burgos, H., Moreno-Lopez, S., Acevedo-Vergara, K., Pérez-Florez, M., Pachón-
Wykes, T., 2020. Cognitive remediation for schizophrenia: an expert working group Garcia, C., Gálvez-Flórez, J.F., 2023. Risk of childhood trauma exposure and severity
white paper on core techniques. Schizophr. Res. 215, 49–53. https://doi.org/ of bipolar disorder in Colombia. Int. J. Bipolar Disord. 11 (1), 7. https://doi.org/
10.1016/j.schres.2019.10.047. 10.1186/s40345-023-00289-5.
Brink, M., Green, A., Bojesen, A.B., Lamberti, J.S., Conwell, Y., Andersen, K., 2019. Gurillo, P., Jauhar, S., Murray, R.M., MacCabe, J.H., 2015. Does tobacco use cause
Excess medical comorbidity and mortality across the lifespan in schizophrenia: a psychosis? Systematic review and meta-analysis. Lancet Psychiatry 2 (8), 718–725.
nationwide Danish register study. Schizophr. Res. 206, 347–354. https://doi.org/ https://doi.org/10.1016/S2215-0366(15)00152-2.
10.1016/j.schres.2018.10.020. Gurpegui, M., Martínez-Ortega, J.M., Jurado, D., Aguilar, M.C., Diaz, F.J., de Leon, J.,
Brown, D.W., Anda, R.F., Felitti, V.J., Edwards, V.J., Malarcher, A.M., Croft, J.B., 2007. Subjective effects and the main reason for smoking in outpatients with
Giles, W.H., 2010. Adverse childhood experiences are associated with the risk of schizophrenia: a case-control study. Compr. Psychiatry 48 (2), 186–191. https://doi.
lung cancer: a prospective cohort study. BMC Public Health 10, 20. https://doi.org/ org/10.1016/j.comppsych.2006.10.002.
10.1186/1471-2458-10-20. Hagborg, J.M., Kalin, T., Gerdner, A., 2022. The Childhood Trauma Questionnaire-Short
Buckley, J., Cohen, J.D., Kramer, A.F., McAuley, E., Mullen, S.P., 2014. Cognitive control Form (CTQ-SF) used with adolescents - methodological report from clinical and
in the self-regulation of physical activity and sedentary behavior. Front. Hum. community samples. J. Child Adolesc. Trauma 15 (4), 1199–1213. https://doi.org/
Neurosci. 8, 747. https://doi.org/10.3389/fnhum.2014.00747. 10.1007/s40653-022-00443-8.
Bungert, M., Liebke, L., Thome, J., Haeussler, K., Bohus, M., Lis, S., 2015. Rejection Harvey, P.D., Greenberg, B.R., Serper, M.R., 1989. The affective lability scales:
sensitivity and symptom severity in patients with borderline personality disorder: development, reliability, and validity. J. Clin. Psychol. 45 (5), 786–793. https://doi.
effects of childhood maltreatment and self-esteem. Borderline Personal. Disord. org/10.1002/1097-4679(198909)45:5<786::aid-jclp2270450515>3.0.co;2-p.
Emot. Dysregulation 2, 4. https://doi.org/10.1186/s40479-015-0025-x. Hayes, A.F., 2018. Introduction to Mediation, Moderation, and Conditional Process
Cackowski, S., Reitz, A.C., Ende, G., Kleindienst, N., Bohus, M., Schmahl, C., Krause- Analysis: A Regression-based Approach, second ed. Guilford Publications, New York.
Utz, A., 2014. Impact of stress on different components of impulsivity in borderline Heffner, J.L., Strawn, J.R., DelBello, M.P., Strakowski, S.M., Anthenelli, R.M., 2011. The
personality disorder. Psychol. Med. 44 (15), 3329–3340. https://doi.org/10.1017/ co-occurrence of cigarette smoking and bipolar disorder: phenomenology and
S0033291714000427. treatment considerations. Bipolar Disord. 13 (5–6), 439–453. https://doi.org/
Cammack, A.L., Haardörfer, R., Suglia, S.F., 2019. Associations between child 10.1111/j.1399-5618.2011.00943.x.
maltreatment, cigarette smoking, and nicotine dependence in young adults with a Heim, C., Nater, U.M., Maloney, E., Boneva, R., Jones, J.F., Reeves, W.C., 2009.
history of regular smoking. Ann. Epidemiol. 40, 13–20. https://doi.org/10.1016/j. Childhood trauma and risk for chronic fatigue syndrome: association with
annepidem.2019.10.003 e4. neuroendocrine dysfunction. Arch. Gen. Psychiatry 66 (1), 72–80. https://doi.org/
Campbell, J.A., Walker, R.J., Egede, L.E., 2016. Associations between adverse childhood 10.1001/archgenpsychiatry.2008.508.
experiences, high-risk behaviors, and morbidity in adulthood. Am. J. Prev. Med. 50 Høegh, M.C., Melle, I., Aminoff, S.R., Laskemoen, J.F., Büchmann, C.B., Ueland, T.,
(3), 344–352. https://doi.org/10.1016/j.amepre.2015.07.022. Lagerberg, T.V., 2020. Affective lability across psychosis spectrum disorders. Eur.
Church, C., Andreassen, O.A., Lorentzen, S., Melle, I., Aas, M., 2017. Childhood trauma Psychiatry 63 (1), e53. https://doi.org/10.1192/j.eurpsy.2020.44.
and minimization/denial in people with and without a severe mental disorder. Front. IBM Corp, 2020. IBM SPSS Statistics for Windows (Version 27.0). IBM Corp., Armonk,
Psychol. 8, 1276. https://doi.org/10.3389/fpsyg.2017.01276. NY.
Clemens, V., Huber-Lang, M., Plener, P.L., Brähler, E., Brown, R.C., Fegert, J.M., 2018. Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R.N.,
Association of child maltreatment subtypes and long-term physical health in a McAfee, T., Peto, R., 2013. 21st-century hazards of smoking and benefits of cessation
German representative sample. Eur. J. Psychotraumatol. 9 (1), 1510278. https://doi. in the United States. N. Engl. J. Med. 368 (4), 341–350. https://doi.org/10.1056/
org/10.1080/20008198.2018.1510278. NEJMsa1211128.
Cook, B.L., Wayne, G.F., Kafali, E.N., Liu, Z., Shu, C., Flores, M., 2014. Trends in smoking Kale, D., Stautz, K., Cooper, A., 2018. Impulsivity related personality traits and cigarette
among adults with mental illness and association between mental health treatment smoking in adults: a meta-analysis using the UPPS-P model of impulsivity and
and smoking cessation. JAMA 311 (2), 172–182. https://doi.org/10.1001/ reward sensitivity. Drug Alcohol Depend. 185, 149–167. https://doi.org/10.1016/j.
jama.2013.284985. drugalcdep.2018.01.003.
Dauvermann, M.R., Donohoe, G., 2019. The role of childhood trauma in cognitive Karakuş, Ö., 2012. Relation between childhood abuse and self esteem in adolescence.
performance in schizophrenia and bipolar disorder–a systematic review. Schizophr. J. Hum. Sci. 9 (2), 753–763. Retrieved from. https://www.j-humansciences.com/
Res. Cogn. 16, 1–11. https://doi.org/10.1016/j.scog.2018.11.001. ojs/index.php/IJHS/article/view/2348.
De Hert, M., Correll, C.U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., Kay, S.R., Fiszbein, A., Opler, L.A., 1987. The positive and negative syndrome scale
Detraux, J., Gautam, S., Möller, H.J., Ndetei, D.M., Newcomer, J.W., Uwakwe, R., (PANSS) for schizophrenia. Schizophr. Bull. 13 (2), 261–276. https://doi.org/
Leucht, S., 2011. Physical illness in patients with severe mental disorders. I. 10.1093/schbul/13.2.261.
Prevalence, impact of medications and disparities in health care. World Psychiatry Kelly, C., McCreadie, R.G., 1999. Smoking habits, current symptoms, and premorbid
10 (1), 52–77. https://doi.org/10.1002/j.2051-5545.2011.tb00014.x. characteristics of schizophrenic patients in Nithsdale, Scotland. Am. J. Psychiatry
Delis, D., Kaplan, E., Kramer, J.K., 2005. Delis-Kaplan Executive Function System (D- 156 (11), 1751–1757. https://doi.org/10.1176/ajp.156.11.1751.
KEFS). Norwegian Manual Supplement. Kilian, S., Asmal, L., Chiliza, B., Olivier, M.R., Phahladira, L., Scheffler, F., Seedat, S.,
Enez Darcin, A., Yalcin Cavus, S., Dilbaz, N., Kaya, H., Dogan, E., 2015. Metabolic Marder, S.R., Green, M.F., Emsley, R., 2018. Childhood adversity and cognitive
syndrome in drug-naïve and drug-free patients with schizophrenia and in their function in schizophrenia spectrum disorders and healthy controls: evidence for an
siblings. Schizophr. Res. 166 (1–3), 201–206. https://doi.org/10.1016/j. association between neglect and social cognition. Psychol. Med. 48 (13), 2186–2193.
schres.2015.05.004. https://doi.org/10.1017/S0033291717003671.

242
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

Laursen, T.M., Munk-Olsen, T., Vestergaard, M., 2012. Life expectancy and Pomerleau, O.F., Pomerleau, C.S., 1984. Neuroregulators and the reinforcement of
cardiovascular mortality in persons with schizophrenia. Curr. Opin. Psychiatry 25 smoking: towards a biobehavioral explanation. Neurosci. Biobehav. Rev. 8 (4),
(2), 83–88. https://doi.org/10.1097/YCO.0b013e32835035ca. 503–513. https://doi.org/10.1016/0149-7634(84)90007-1.
Laursen, T.M., Wahlbeck, K., Hällgren, J., Westman, J., Ösby, U., Alinaghizadeh, H., Ramiro, L.S., Madrid, B.J., Brown, D.W., 2010. Adverse childhood experiences (ACE) and
Gissler, M., Nordentoft, M., 2013. Life expectancy and death by diseases of the health-risk behaviors among adults in a developing country setting. Child Abuse
circulatory system in patients with bipolar disorder or schizophrenia in the Nordic Negl. 34 (11), 842–855. https://doi.org/10.1016/j.chiabu.2010.02.012.
countries. PLoS One 8 (6), e67133. https://doi.org/10.1371/journal.pone.0067133. Reiland, S., Lauterbach, D., 2008. Effects of trauma and religiosity on self-esteem.
Lewis, M.D., Todd, R.M., Honsberger, M.J.M., 2007. Event-related potential measures of Psychol. Rep. 102 (3), 779–790. https://doi.org/10.2466/pr0.102.3.779-790.
emotion regulation in early childhood. Neuroreport 18 (1), 61–65. https://doi.org/ Reuben, A., Moffitt, T.E., Caspi, A., Belsky, D.W., Harrington, H., Schroeder, F.,
10.1097/WNR.0b013e328010a216. Hogan, S., Ramrakha, S., Poulton, R., Danese, A., 2016. Lest we forget: comparing
Lieberman, J.A., First, M.B., 2018. Psychotic disorders. N. Engl. J. Med. 379 (3), retrospective and prospective assessments of adverse childhood experiences in the
270–280. https://doi.org/10.1056/NEJMra1801490. prediction of adult health. J. Child Psychol. Psychiatry 57 (10), 1103–1112. https://
Lunding, S.H., Simonsen, C., Aas, M., Rødevand, L., Werner, M.C.F., Laskemoen, J.F., doi.org/10.1111/jcpp.12621.
Hjell, G., Ringen, P.A., Lagerberg, T.V., Melle, I., Andreassen, O.A., Ueland, T., Rey, R., D’Amato, T., Boyer, L., Brunel, L., Aouizerate, B., Berna, F., Capdevielle, D.,
Steen, N.E., 2021. Childhood trauma and cardiometabolic risk in severe mental Chereau, I., Chesnoy-Servanin, G., Denizot, H., Dorey, J.M., Dubertret, C.,
disorders: the mediating role of cognitive control. Eur. Psychiatry 64 (1), e24. Dubreucq, J., Faget, C., Gabayet, F., Lancon, C., Mallet, J., Misdrahi, D.,
https://doi.org/10.1192/j.eurpsy.2021.14. Passerieux, C., Schandrin, A., Schürhoff, F., Urbach, M., Vidailhet, P., Llorca, P.M.,
Mallet, J., Le Strat, Y., Schürhoff, F., Mazer, N., Portalier, C., Andrianarisoa, M., Fond, G., FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia)
Aouizerate, B., Berna, F., Brunel, L., Capdevielle, D., Chereau, I., D’Amato, T., group, 2017. Nicotine dependence is associated with depression and childhood
Dubreucq, J., Faget, C., Gabayet, F., Honciuc, R.M., Lançon, C., Llorca, P.M., trauma in smokers with schizophrenia: results from the FACE-SZ dataset. Eur. Arch.
Misdrahi, D., Rey, R., Roux, P., Schandrin, A., Urbach, M., Vidailhet, P., Fond, G., Psychiatry Clin. Neurosci. 267 (6), 567–577. https://doi.org/10.1007/s00406-017-
Dubertret, C., FACE-SZ (FondaMental Academic Centers of Expertise for 0779-9.
Schizophrenia) group, 2019. Tobacco smoking is associated with antipsychotic Richard-Lepouriel, H., Kung, A.L., Hasler, R., Bellivier, F., Prada, P., Gard, S., Ardu, S.,
medication, physical aggressiveness, and alcohol use disorder in schizophrenia: Kahn, J.P., Dayer, A., Henry, C., Aubry, J.M., Leboyer, M., Perroud, N., Etain, B.,
results from the FACE-SZ national cohort. Eur. Arch. Psychiatry Clin. Neurosci. 269 2019. Impulsivity and its association with childhood trauma experiences across
(4), 449–457. https://doi.org/10.1007/s00406-018-0873-7. bipolar disorder, attention deficit hyperactivity disorder and borderline personality
Matthews, A.M., Wilson, V.B., Mitchell, S.H., 2011. The role of antipsychotics in smoking disorder. J. Affect. Disord. 244, 33–41. https://doi.org/10.1016/j.jad.2018.07.060.
and smoking cessation. CNS Drugs 25 (4), 299–315. https://doi.org/10.2165/ Ringen, P.A., Engh, J.A., Birkenaes, A.B., Dieset, I., Andreassen, O.A., 2014. Increased
11588170-000000000-00000. mortality in schizophrenia due to cardiovascular disease - a non-systematic review of
McGrath, J.J., Alati, R., Clavarino, A., Williams, G.M., Bor, W., Najman, J.M., epidemiology, possible causes, and interventions. Front. Psychiatry 5, 137. https://
Connell, M., Scott, J.G., 2016. Age at first tobacco use and risk of subsequent doi.org/10.3389/fpsyt.2014.00137.
psychosis-related outcomes: a birth cohort study. Aust. N. Z. J. Psychiatry 50 (6), Rødevand, L., Steen, N.E., Elvsåshagen, T., Quintana, D.S., Reponen, E.J., Mørch, R.H.,
577–583. https://doi.org/10.1177/0004867415587341. Lunding, S.H., Vedal, T.S.J., Dieset, I., Melle, I., Lagerberg, T.V., Andreassen, O.A.,
McLaughlin, K.A., Sheridan, M.A., Tibu, F., Fox, N.A., Zeanah, C.H., Nelson III, C.A., 2019. Cardiovascular risk remains high in schizophrenia with modest improvements
2015. Causal effects of the early caregiving environment on development of in bipolar disorder during past decade. Acta Psychiatr. Scand. 139 (4), 348–360.
stressresponse systems in children. Proc. Natl. Acad. Sci. U. S. A. 112 (18), https://doi.org/10.1111/acps.13008.
5637–5642. https://doi.org/10.1073/pnas.1423363112. Rohde, P., Ichikawa, L., Simon, G.E., Ludman, E.J., Linde, J.A., Jeffery, R.W.,
Meadows, A.L., Strickland, J.C., Kerr, M.S., Rayapati, A.O., Rush, C.R., 2019. Adverse Operskalski, B.H., 2008. Associations of child sexual and physical abuse with obesity
childhood experiences, tobacco use, and obesity: a crowdsourcing study. Subst. Use and depression in middle-aged women. Child Abuse Negl. 32 (9), 878–887. https://
Misuse 54 (10), 1743–1749. https://doi.org/10.1080/10826084.2019.1608254. doi.org/10.1016/j.chiabu.2007.11.004.
Meszaros, Z.S., Dimmock, J.A., Ploutz-Snyder, R.J., Abdul-Malak, Y., Leontieva, L., Rosenberg, M., 2015. Society and the Adolescent Self-image. Princeton University Press.
Canfield, K., Batki, S.L., 2011. Predictors of smoking severity in patients with Roy, A., 2005. Childhood trauma and impulsivity. Possible relevance to suicidal
schizophrenia and alcohol use disorders. Am. J. Addict. 20 (5), 462–467. https://doi. behavior. Arch. Suicide Res. 9 (2), 147–151. https://doi.org/10.1080/
org/10.1111/j.1521-0391.2011.00150.x. 13811110590903990.
Misiak, B., Krefft, M., Bielawski, T., Moustafa, A.A., Sąsiadek, M.M., Frydecka, D., 2017. Rush, A.J., Gullion, C.M., Basco, M.R., Jarrett, R.B., Trivedi, M.H., 1996. The Inventory
Toward a unified theory of childhood trauma and psychosis: a comprehensive review of Depressive Symptomatology (IDS): psychometric properties. Psychol. Med. 26 (3),
of epidemiological, clinical, neuropsychological and biological findings. Neurosci. 477–486. https://doi.org/10.1017/s0033291700035558.
Biobehav. Rev. 75, 393–406. https://doi.org/10.1016/j.neubiorev.2017.02.015. Sacco, K.A., Head, C.A., Vessicchio, J.C., Easton, C.J., Prigerson, H.G., George, T.P.,
Momen, N.C., Plana-Ripoll, O., Agerbo, E., Benros, M.E., Børglum, A.D., Christensen, M. 2007. Adverse childhood experiences, smoking and mental illness in adulthood: a
K., Dalsgaard, S., Degenhardt, L., de Jonge, P., Debost, J.P.G., Fenger-Grøn, M., preliminary study. Ann. Clin. Psychiatry 19 (2), 89–97. https://doi.org/10.1080/
Gunn, J.M., Iburg, K.M., Kessing, L.V., Kessler, R.C., Laursen, T.M., Lim, C.C.W., 10401230701334762.
Mors, O., Mortensen, P.B., Musliner, K.L., Nordentoft, M., Pedersen, C.B., Shields, A., Cicchetti, D., 1998. Reactive aggression among maltreated children: the
Petersen, L.V., Ribe, A.R., Roest, A.M., Saha, S., Schork, A.J., Scott, K.M., Sievert, C., contributions of attention and emotion dysregulation. J. Clin. Child Psychol. 27 (4),
Sørensen, H.J., Stedman, T.J., Vestergaard, M., Vilhjalmsson, B., Werge, T., 381–395. https://doi.org/10.1207/s15374424jccp2704_2.
Weye, N., Whiteford, H.A., Prior, A., McGrath, J.J., 2020. Association between Smith, J.L., Mattick, R.P., Jamadar, S.D., Iredale, J.M., 2014. Deficits in behavioural
mental disorders and subsequent medical conditions. N. Engl. J. Med. 382 (18), inhibition in substance abuse and addiction: a meta-analysis. Drug Alcohol Depend.
1721–1731. https://doi.org/10.1056/NEJMoa1915784. 145, 1–33. https://doi.org/10.1016/j.drugalcdep.2014.08.009.
Newbury, J.B., Arseneault, L., Moffitt, T.E., Caspi, A., Danese, A., Baldwin, J.R., Spinazzola, J., Ford, J.D., Zucker, M., van der Kolk, B.A., Silva, S., Smith, S.F.,
Fisher, H.L., 2018. Measuring childhood maltreatment to predict early-adult Blaustein, M., 2005. Survey evaluates complex trauma exposure, outcome, and
psychopathology: comparison of prospective informant-reports and retrospective intervention among children and adolescents. Psychiatr. Ann. 35, 433–439. https://
self-reports. J. Psychiatr. Res. 96, 57–64. https://doi.org/10.1016/j. doi.org/10.3928/00485713-20050501-09.
jpsychires.2017.09.020. Stanford, M.S., Mathias, C.W., Dougherty, D.M., Lake, S.L., Anderson, N.E., Patton, J.H.,
Nordentoft, M., Wahlbeck, K., Hällgren, J., Westman, J., Osby, U., Alinaghizadeh, H., 2009. Fifty years of the Barratt Impulsiveness Scale: an update and review. Pers.
Gissler, M., Laursen, T.M., 2013. Excess mortality, causes of death and life Individ. Differ. 47, 385–395. https://doi.org/10.1016/j.paid.2009.04.008.
expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Stein, J.A., Leslie, M.B., Nyamathi, A., 2002. Relative contributions of parent substance
Finland and Sweden. PLoS One 8 (1), e55176. https://doi.org/10.1371/journal. use and childhood maltreatment to chronic homelessness, depression, and substance
pone.0055176. abuse problems among homeless women: mediating roles of self-esteem and abuse in
Nordentoft, M., Plana-Ripoll, O., Laursen, T.M., 2021. Cancer and schizophrenia. Curr. adulthood. Child Abuse Negl. 26 (10), 1011–1027. https://doi.org/10.1016/s0145-
Opin. Psychiatry 34 (3), 260–265. https://doi.org/10.1097/ 2134(02)00382-4.
YCO.0000000000000697. Szatkowski, L., McNeill, A., 2015. Diverging trends in smoking behaviors according to
Olfson, M., Gerhard, T., Huang, C., Crystal, S., Stroup, T.S., 2015. Premature mortality mental health status. Nicotine Tob. Res. 17 (3), 356–360. https://doi.org/10.1093/
among adults with schizophrenia in the United States. JAMA Psychiatry 72 (12), ntr/ntu173.
1172–1181. https://doi.org/10.1001/jamapsychiatry.2015.1737. Szinay, D., Tombor, I., Garnett, C., Boyt, N., West, R., 2019. Associations between self-
Oliver, M.N., Simons, J.S., 2004. The affective lability scales: development of a short- esteem and smoking and excessive alcohol consumption in the UK: a cross-sectional
form measure. Pers. Individ. Differ. 37 (6), 1279–1288. https://doi.org/10.1016/j. study using the BBC UK Lab database. Addict. Behav. Rep. 10, 100229 https://doi.
paid.2003.12.013. org/10.1016/j.abrep.2019.100229.
Osby, U., Brandt, L., Correia, N., Ekbom, A., Sparén, P., 2001. Excess mortality in bipolar Taha, F., Galea, S., Hien, D., Goodwin, R.D., 2014. Childhood maltreatment and the
and unipolar disorder in Sweden. Arch. Gen. Psychiatry 58 (9), 844–850. https:// persistence of smoking: a longitudinal study among adults in the US. Child Abuse
doi.org/10.1001/archpsyc.58.9.844. Negl. 38 (12), 1995–2006. https://doi.org/10.1016/j.chiabu.2014.10.022.
Patton, J.H., Stanford, M.S., Barratt, E.S., 1995. Factor structure of the Barratt Tajima, E.A., Herrenkohl, T.I., Huang, B., Whitney, S.D., 2004. Measuring child
impulsiveness scale. J. Clin. Psychol. 51 (6), 768–774. https://doi.org/10.1002/ maltreatment: a comparison of prospective parent reports and retrospective
1097-4679(199511)51:63.0.CO;2-1. adolescent reports. Am. J. Orthop. 74 (4), 424–435. https://doi.org/10.1037/0002-
Pedersen, W., Soest, T.V., 2017. How is low parental socioeconomic status associated 9432.74.4.424.
with future smoking and nicotine dependence in offspring? A population-based van Zutphen, L., Siep, N., Jacob, G.A., Goebel, R., Arntz, A., 2015. Emotional sensitivity,
longitudinal 13-year follow-up. Scand. J. Public Health 45 (1), 16–24. https://doi. emotion regulation and impulsivity in borderline personality disorder: a critical
org/10.1177/1403494816680800.

243
S.H. Lunding et al. Schizophrenia Research 261 (2023) 236–244

review of fMRI studies. Neurosci. Biobehav. Rev. 51, 64–76. https://doi.org/ Wechsler, D., 2007. Wechsler Abbreviated Scale of Intelligence. Norwegian Manual
10.1016/j.neubiorev.2015.01.001. Supplement. Pearson Assessment, Stockholm.
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., Read, J., Weinstein, S.M., Mermelstein, R., Shiffman, S., Flay, B., 2008. Mood variability and
van Os, J., Bentall, R.P., 2012. Childhood adversities increase the risk of psychosis: a cigarette smoking escalation among adolescents. Psychol. Addict. Behav. 22 (4),
meta-analysis of patient-control, prospective- and cross-sectional cohort studies. 504–513. https://doi.org/10.1037/0893-164X.22.4.504.
Schizophr. Bull. 38 (4), 661–671. https://doi.org/10.1093/schbul/sbs050. Whiteford, H.A., Degenhardt, L., Rehm, J., Baxter, A.J., Ferrari, A.J., Erskine, H.E.,
Ventura, J., Liberman, R.P., Green, M.F., Shaner, A., Mintz, J., 1998. Training and Charlson, F.J., Norman, R.E., Flaxman, A.D., Johns, N., Burstein, R., Murray, C.J.,
quality assurance with the Structured Clinical Interview for DSM-IV (SCID-I/P). Vos, T., 2013. Global burden of disease attributable to mental and substance use
Psychiatry Res. 79 (2), 163–173. https://doi.org/10.1016/s0165-1781(98)00038-9. disorders: findings from the global burden of disease study 2010. Lancet 382,
Wahlbeck, K., Westman, J., Nordentoft, M., Gissler, M., Laursen, T.M., 2011. Outcomes 1575–1586. https://doi.org/10.1016/SO140-6736(13)61611-6.
of Nordic mental health systems: life expectancy of patients with mental disorders. Young, R.C., Biggs, J.T., Ziegler, V.E., Meyer, D.A., 1978. A rating scale for mania:
Br. J. Psychiatry 199 (6), 453–458. https://doi.org/10.1192/bjp.bp.110.085100. reliability, validity and sensitivity. Br. J. Psychiatry 133, 429–435. https://doi.org/
Walker, E.A., Gelfand, A., Katon, W.J., Koss, M.P., Von Korff, M., Bernstein, D., Russo, J., 10.1192/bjp.133.5.429.
1999. Adult health status of women with histories of childhood abuse and neglect. Young, K.S., Sandman, C.F., Craske, M.G., 2019. Positive and negative emotion
Am. J. Med. 107 (4), 332–339. https://doi.org/10.1016/s0002-9343(99)00235-1. regulation in adolescence: links to anxiety and depression. Brain Sci. 9 (4), 76.
Walsh, D., McCartney, G., Smith, M., Armour, G., 2019. Relationship between childhood https://doi.org/10.3390/brainsci9040076.
socioeconomic position and adverse childhood experiences (ACEs): a systematic Zareifopoulos, N., Bellou, A., Spiropoulou, A., Spiropoulos, K., 2018. Prevalence of
review. J. Epidemiol. Community Health 73 (12), 1087–1093. https://doi.org/ comorbid chronic obstructive pulmonary disease in individuals suffering from
10.1136/jech-2019-212738. schizophrenia and bipolar disorder: a systematic review. COPD 15 (6), 612–620.
https://doi.org/10.1080/15412555.2019.1572730.

244