The influence of childhood trauma on aggression and violent behavior in first episode psychosis: A critical review

The association between childhood trauma and aggressive and violent behavior in chronic psychotic conditions (e.g., schizophrenia) is well-established. However, the impact of childhood trauma on aggression and violent behavior in first episode psychosis is unclear and comparatively understudied. To date, studies examining these relations in first episode psychosis have found that individuals experiencing early psychosis have high rates of both childhood trauma and aggressive and violent behavior compared to healthy controls prior to initial contact with mental health services. Childhood trauma is related to an increase in the prevalence and severity of aggression. These findings stress the importance and necessity of early detection and intervention in first episode psychosis, as both have been effective in reducing aggression in non-FEP samples with trauma histories. Incorporating trauma-focused interventions into treatment plans for individuals in the beginning phases of psychosis might reduce rates of aggression for individuals with a history of trauma and improve outcomes. Here, we review the literature on childhood trauma and aggression in first episode psychosis and discuss implications for future research.