Associations between childhood trauma, cognitive function, and clinical symptoms in first-episode schizophrenia

Childhood trauma may influence clinical presentation in first-episode schizophrenia (FES), but its specific associations with cognitive function and clinical symptoms remain unclear.

Seventy-one FES participants and 62 healthy controls were assessed using the Childhood Trauma Questionnaire (CTQ-SF), MATRICS Consensus Cognitive Battery (MCCB), Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale (CDSS). Group comparisons, Spearman correlations, hierarchical regression, and mediation analyses (PROCESS macro) were performed.

FES participants reported significantly higher childhood trauma (except physical abuse) and performed worse on all MCCB domains (all *p* < 0.00625). Within the clinical group, those with childhood trauma (71.8%) showed nominally lower MCCB total scores (*p* = 0.042) and a trend toward higher negative symptoms (*p* = 0.083). Exploratory analyses indicated that physical neglect was associated with attention/vigilance (r = -0.54) and overall cognition (*r* = -0.69); physical abuse with social cognition (*r* = -0.54); sexual abuse with general psychopathology (*r* = 0.56). No independent associations of trauma subtypes were found in regression analyses. Attention/vigilance was significantly associated with negative symptoms (β = -0.43, *p* = 0.002) but did not mediate the trauma-symptom relationship.

FES participants report more childhood trauma and exhibit widespread cognitive impairment, with physical neglect most strongly linked to attentional deficits. Attention/vigilance was associated with negative symptoms, suggesting that trauma-informed cognitive rehabilitation may have potential value.