PART I: Is there an association between caregiver antipathy and psychosis? A systematic review. PART II: Empirical research project:Investigating specific relationships between childhood trauma and psychosis symptoms and the mediating roles of emotions and schema.

Student thesis: Doctoral ThesisDoctor of Clinical Psychology


Background: Existing reviews of trauma and psychosis have identified a relationship between childhood emotional abuse (CEA) and psychosis, but have not distinguished between different types of CEA. Thus, further investigation is needed. This systematic review aimed to explore the relationship between caregiver antipathy in childhood (i.e. criticism, hostility, coldness or rejection shown by parent figures towards the child) and psychosis diagnosis/symptoms.

Method: Five databases were searched and studies were evaluated against inclusion/exclusion criteria. The relevant data was extracted and a narrative synthesis of key findings was completed. Estimates of effect size for antipathy-psychosis associations were calculated using standardised conventions. Assessment of study quality was undertaken using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies.

Results: Fourteen papers met all inclusion criteria. Twelve studies found significant associations between caregiver antipathy and psychosis and two did not. There was evidence that adults with schizophrenia-spectrum diagnosis reported more severe caregiver antipathy in childhood than non-clinical controls. In addition, caregiver antipathy was associated with more severe psychosis symptoms. Most studies received weak or moderate overall quality ratings.

Conclusions: This is the first review to focus on investigating the relationship between caregiver antipathy and psychosis. The variability in study methods and quality makes it difficult to draw firm conclusions about the nature and strength of these associations. Further studies using more robust methodological and statistical procedures are required to consolidate the emerging evidence.
Date of Award2020
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorAmy Hardy (Supervisor) & Richard Emsley (Supervisor)

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