***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Adverse childhood experiences ( ACEs ; e.g. abuse , neglect , and parental loss ) have been associated with increased risk for later-life disease and dysfunction using adults ' retrospective self-reports of ACEs . Research should test whether associations between ACEs and health outcomes are the same for prospect i ve and retrospective ACE measures . METHODS We estimated agreement between ACEs prospect ively recorded throughout childhood ( by Study staff at Study member ages 3 , 5 , 7 , 9 , 11 , 13 , and 15 ) and retrospectively recalled in adulthood ( by Study members when they reached age 38 ) , in the population -representative Dunedin cohort ( N = 1,037 ) . We related both retrospective and prospect i ve ACE measures to physical , mental , cognitive , and social health at midlife measured through both objective ( e.g. biomarkers and neuropsychological tests ) and subjective ( e.g. self-reported ) means . RESULTS Dunedin and U.S. Centers for Disease Control ACE distributions were similar . Retrospective and prospect i ve measures of adversity showed moderate agreement ( r = .47 , p < .001 ; weighted Kappa = .31 , 95 % CI : .27-.35 ) . Both associated with all midlife outcomes . As compared to prospect i ve ACEs , retrospective ACEs showed stronger associations with life outcomes that were subjectively assessed , and weaker associations with life outcomes that were objective ly assessed . Recalled ACEs and poor subjective outcomes were correlated regardless of whether prospect ively recorded ACEs were evident . Individuals who recalled more ACEs than had been prospect ively recorded were more neurotic than average , and individuals who recalled fewer ACEs than recorded were more agreeable . CONCLUSIONS Prospect i ve ACE records confirm associations between childhood adversity and negative life outcomes found previously using retrospective ACE reports . However , more agreeable and neurotic dispositions may , respectively , bias retrospective ACE measures toward underestimating the impact of adversity on objective ly measured life outcomes and overestimating the impact of adversity on self-reported outcomes . Associations between personality factors and the propensity to recall adversity were extremely modest and warrant further investigation . Risk predictions based on retrospective ACE reports should utilize objective outcome measures . Where objective outcome measurements are difficult to obtain , correction factors may be warranted BACKGROUND Strong evidence exists for an association between childhood trauma , particularly childhood sexual abuse , and hallucinations in schizophrenia . Hallucinations are also well-documented symptoms in people with bipolar affective disorder . AIMS To investigate the relationship between childhood sexual abuse and other childhood traumas and hallucinations in people with bipolar affective disorder . METHOD A sample of 96 participants was drawn from the Medical Research Council multi-centre trial of cognitive-behavioural therapy for bipolar affective disorder . The trial therapists recorded spontaneous reports of childhood sexual abuse made during the course of therapy . Symptom data were collected by trained research assistants masked to the hypothesis . RESULTS A significant association was found between those reporting general trauma ( n=38 ) and auditory hallucinations . A highly significant association was found between those reporting childhood sexual abuse ( n=15 ) and auditory hallucinations . CONCLUSIONS The relationship between childhood sexual abuse and hallucinations in bipolar disorder warrants further investigation OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity Cross-section research suggests reported childhood abuse in schizophrenia spectrum disorders is linked with graver symptom levels and social dysfunction . To examine this prospect ively , we compared biweekly ratings of positive and emotional discomfort symptoms and weekly accounts of hours worked over 4 months of rehabilitation of 12 participants with schizophrenia or schizoaffective disorder and childhood sexual abuse history and 31 with schizophrenia or schizoaffective disorder and no childhood sexual abuse history . Repeated- measures ANOVA revealed the abuse group had consistently higher levels of both symptom components and poorer participation in vocational rehabilitation . A time by group effect was observed for hours of work , with the abuse group working increasingly fewer hours over time . Participants reporting abuse also were more likely to perform poorly on a test of executive function and to have particularly higher levels of hallucinations and anxiety over time . Clinical and theoretical implication s are discussed OBJECTIVE Using longitudinal and prospect i ve measures , the authors assessed the relationship between childhood trauma and psychotic experiences , addressing the following questions : 1 ) Does exposure to trauma predict incident psychotic experiences ? 2 ) Does cessation of trauma predict cessation of psychotic experiences ? 3 ) What is the direction of the relationship between childhood trauma and psychotic experiences ? METHOD This was a nationally representative prospect i ve cohort study of 1,112 school-based adolescents 13 - 16 years of age , assessed at baseline and at 3-month and 12-month follow-ups for childhood trauma ( physical assault and bullying ) and psychotic experiences . RESULTS A bidirectional relationship was observed between childhood trauma and psychosis , with trauma predicting psychotic experiences over time and vice versa . However , even after accounting for this bidirectional relationship with a number of strict adjustments ( only newly incident psychotic experiences occurring over the course of the study following exposure to traumatic experiences were examined ) , trauma was strongly predictive of psychotic experiences . A dose-response relationship was observed between severity of bullying and risk for psychotic experiences . Moreover , cessation of trauma predicted cessation of psychotic experiences , with the incidence of psychotic experiences decreasing significantly in individuals whose exposure to trauma ceased over the course of the study . CONCLUSIONS After a series of conservative adjustments , the authors found that exposure to childhood trauma predicted newly incident psychotic experiences . The study also provides the first direct evidence that cessation of traumatic experiences leads to a reduced incidence of psychotic experiences BACKGROUND Of young people with first episode psychosis ( FEP ) , over half report exposure to childhood trauma and consequent co-morbid post-traumatic stress disorder ( PTSD ) or symptoms . Currently no evidence -based interventions exist for PTSD in FEP . Clinicians report concerns that trauma-focused interventions with young people with FEP could result in distress and symptom exacerbation . Scant research suggests that talking about trauma in therapy can be distressing for some people . AIMS To explore young people 's reactions to a trauma-focused treatment for PTSD in FEP . METHOD Semi-structured interviews were conducted with eight participants ( age 18 - 27 years ) with co-morbid PTSD and FEP , after completing a trauma-focused intervention .  Transcripts were analysed using an interpretative phenomenological approach . Participants ' baseline and end-of-treatment PTSD and psychotic symptoms were assessed . RESULTS Three themes related to participants ' reactions were identified from the analysis : ( 1 ) distress in session ; ( 2 ) feeling relieved in and out of session ; and ( 3 ) symptom exacerbation out of session . All but one participant reported experiencing increased distress in session . Four participants described PTSD , psychotic symptoms and /or suicidal ideation worsening in immediate reaction to talking about trauma in therapy sessions . 86 % of participants showed improvement in their PTSD and psychotic symptoms at end of treatment . All participants described the intervention as beneficial and worthwhile . CONCLUSIONS Results suggest that feelings of distress are to be expected from individuals with PTSD and FEP during trauma-focused treatment .  Psychotic and PTSD symptom exacerbation can occur in PTSD treatment in FEP . Clinicians should be aware of , plan for , and clearly inform their clients of treatment risks 
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Conclusion The results lend support for cognitive and biological theories that traumas in childhood may lead to hallucinations and delusions within psychotic disorders and have important implication s for clinical practice