Poor Nutrition at Age 3 and Schizotypal Personality at Age 23: The Mediating Role of Age 11 Cognitive Functioning

William Penn University, Filadelfia, Pennsylvania, United States
American Journal of Psychiatry (Impact Factor: 12.3). 07/2012; 169(8):822-30. DOI: 10.1176/appi.ajp.2012.11081173
Source: PubMed


Poor prenatal nutrition has been associated with schizophrenia spectrum disorders in the Netherlands and China, and it has been suggested that perinatal and postnatal nutritional factors lead to the development of schizophrenia and the exhibition of schizotypal traits later in life. There appears to be no prior research on the existence of possible factors that may mediate the relationship between malnutrition and schizophrenia spectrum disorders or whether this association is a direct one. The authors tested the hypothesis that low IQ mediates the relationship between early childhood malnutrition and adult schizotypal personality.
Participants were drawn from a birth cohort of 1,795 boys and girls who were followed prospectively. Objective indicators of malnutrition (anemia and stunting) were assessed at age 3. Verbal and performance intelligence were assessed at age 11, and schizotypal personality was assessed at age 23.
Both stunting and anemia at age 3 were associated with low IQ at age 11. Low performance IQ at age 11 was associated with increased interpersonal and disorganized features of schizotypal personality at age 23. Poor performance IQ was found to mediate the relationship between poor nutrition at age 3 and interpersonal and disorganized features of schizotypy at age 23. Findings in female participants were replicated in male participants.
Given that poor nutrition is an alterable risk factor, these findings suggest that nutritional enhancements may improve brain functioning and possibly reduce some features of schizotypal personality disorder.

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Available from: Peter H Venables, Sep 10, 2015
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    • "As best as we could ascertain, our study is the first and only study to use the NEO-PI-R measure of fivefactor model (FFM) of personality to characterize the differences between previously malnourished and matched control participants. Our study, which is based on a dimensional measure, cannot identify individuals who would meet DSM-IV criteria for personality disorders, which have been reported as being increased in earlier studies of the Dutch Famine cohort (Hoek et al., 1996; Neugebauer et al., 1999), childhood malnutrition in Mauritius (Raine et al., 2003, 2010; Venables & Raine, 2012) and in Finnish adults with slow growth in the first year of life (Lahti et al., 2011). The current findings, however , point to a higher prevalence of neuroticism, especially anxiety and vulnerability, and lower extraversion (less assertiveness, gregariousness, and excitement seeking) and openness, as well as less orderliness, trust and openness to new ideas, in previously malnourished Barbadian participants relative to healthy controls. "
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    ABSTRACT: Background: Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods: Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age (M 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate-to-severe protein-energy malnutrition (PEM) in the first year of life (n = 77) with healthy controls, who were former classmates of the index cases and were matched for age, gender, and handedness in childhood (n = 57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented up to 12 years of age, and study participants were followed longitudinally from childhood to 40 years. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. Results: At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness, and Conscientiousness than did the healthy controls. At the subdomain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Conclusions: Malnutrition limited to the first year of life with good health and nutrition documented up to 12 years of age is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes.
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    • "For example, early gestational famine may increase risk of schizophrenia, and later gestational famine may give rise to affective disorder in particular (Brown et al., 2000). The long-term effects of early-life nutrition on physical health are well recognized, and this study is an important addition to the accumulating body of evidence that early-life nutrition also has a profound, life-long effect on neurological development and psychological health (Galler & Barrett, 2001; Galler et al., 2005; Levitsky & Strupp, 1995; Lumey et al., 2011; Roth et al., 2011; Venables & Raine, 2012), but our findings are limited to women. "
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