Prodromal Symptoms of Schizophrenia, Childhood Maltreatment, Attachment Insecurity, and Alexithymia: A Correlation Network Approach.

Introduction: Prodromal psychotic symptoms have been increasingly linked to childhood maltreatment, attachment insecurity, and alexithymia, particularly difficulties in identifying and expressing emotions.

Method and results: This study employed correlation network analysis to examine the interplay among early adversities, alexithymia, and prodromal psychosis symptoms in 93 adolescents (64% female) attending their first visit to a youth mental health center. Of these, 39% met the criteria for prodromal symptoms of psychosis. The network identified difficulty identifying feelings, emotional abuse, and physical neglect as the most central nodes. Difficulty identifying feelings and general psychopathology emerged as key bridge nodes connecting symptom domains.

Conclusions: Findings suggest that difficulties in emotion regulation and general psychological distress may mediate the pathway from child maltreatment to prodromal psychotic symptoms. These dimensions represent important targets for early intervention in at-risk adolescents.