TY - JOUR
T1 - Investigating Specific Associations Between Childhood Victimization Profiles and Positive Psychosis Symptoms
T2 - The Mediating Roles of Anxiety, Depression, and Schema
AU - Barnes, Georgina L
AU - Emsley, Richard
AU - Garety, Philippa
AU - Hardy, Amy
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.
Funding Information:
This work was supported by the Wellcome Trust, UK (085396). P.G., R.E., and A.H. are part funded by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. R.E. is supported by an NIHR Research Professorship, (NIHR300051). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Childhood trauma is a risk factor for psychosis. It is proposed this is due to traumatic events giving rise to psychological mechanisms that are implicated in the development and maintenance of symptoms. Investigation of the psychological mechanisms accounting for relationships between trauma and psychosis will be assisted by focusing on specific trauma profiles, hallucination modalities, and delusion subtypes.STUDY DESIGN: In 171 adults with schizophrenia-spectrum diagnoses and high-conviction delusions, associations between childhood trauma classes, and hallucination and delusion factors, were tested using structural equation models (SEMs). Anxiety, depression, and negative schema were examined as potential mediators of trauma class-psychosis symptom factor links.STUDY RESULTS: Significant associations were found between the emotional abuse/neglect and poly-victimization classes with persecutory delusions and delusions of influence, that were all mediated through anxiety (β = 1.24-0.23,
P = < .05). There was an association between the physical abuse class and grandiose/religious delusions that was not explained by the mediators (β = 1.86,
P = < .05). Trauma class was not significantly associated with any hallucination modality (β = 0.004-1.46,
P = > .05).
CONCLUSIONS: In a sample of people with strongly held delusions, this study demonstrates that childhood victimization is associated with delusions of influence and grandiose beliefs, as well as with persecutory delusions in psychosis. Consistent with previous findings, the potent, mediating role of anxiety supports affective pathway theories and the utility of targeting threat-related processes when treating trauma effects in psychosis.
AB - BACKGROUND: Childhood trauma is a risk factor for psychosis. It is proposed this is due to traumatic events giving rise to psychological mechanisms that are implicated in the development and maintenance of symptoms. Investigation of the psychological mechanisms accounting for relationships between trauma and psychosis will be assisted by focusing on specific trauma profiles, hallucination modalities, and delusion subtypes.STUDY DESIGN: In 171 adults with schizophrenia-spectrum diagnoses and high-conviction delusions, associations between childhood trauma classes, and hallucination and delusion factors, were tested using structural equation models (SEMs). Anxiety, depression, and negative schema were examined as potential mediators of trauma class-psychosis symptom factor links.STUDY RESULTS: Significant associations were found between the emotional abuse/neglect and poly-victimization classes with persecutory delusions and delusions of influence, that were all mediated through anxiety (β = 1.24-0.23,
P = < .05). There was an association between the physical abuse class and grandiose/religious delusions that was not explained by the mediators (β = 1.86,
P = < .05). Trauma class was not significantly associated with any hallucination modality (β = 0.004-1.46,
P = > .05).
CONCLUSIONS: In a sample of people with strongly held delusions, this study demonstrates that childhood victimization is associated with delusions of influence and grandiose beliefs, as well as with persecutory delusions in psychosis. Consistent with previous findings, the potent, mediating role of anxiety supports affective pathway theories and the utility of targeting threat-related processes when treating trauma effects in psychosis.
UR - http://www.scopus.com/inward/record.url?scp=85164451128&partnerID=8YFLogxK
U2 - 10.1093/schizbullopen/sgad017
DO - 10.1093/schizbullopen/sgad017
M3 - Article
C2 - 37398699
SN - 2632-7899
VL - 4
JO - Schizophrenia Bulletin Open
JF - Schizophrenia Bulletin Open
IS - 1
M1 - sgad017
ER -