Institute for Psychology, Health and Society, University of Liverpool, Waterhouse Building Block B, Liverpool L69 3GL, UK.
Schizophr Bull. 2012 Jun;38(4):734-40. doi: 10.1093/schbul/sbs049. Epub 2012 Apr 10.
Previous studies have reported associations between childhood adversities, eg, loss of a parent, being raised in institutional care, sexual and other kinds of abuse by adults and bullying by peers, and psychosis in adulthood. However, the mechanisms by which these adversities lead to psychotic experiences are poorly understood. From models of the psychological processes involved in positive symptoms, it was predicted that childhood sexual abuse would be specifically associated with auditory hallucinations in adulthood, and that disruption of early attachment relations and more chronic forms of victimization such as bullying would be specifically associated with paranoid ideation. We therefore examined the associations between sexual trauma, physical abuse, bullying, and being brought up in institutional or local authority care and reports of auditory hallucinations and paranoid beliefs in the 2007 Adult Psychiatric Morbidity Survey. All simple associations between childhood adversities and the two symptom types were significant. Childhood rape was associated only with hallucinations (OR 8.9, CI = 1.86-42.44) once co-occurring paranoia was controlled for. Being brought up in institutional care (OR = 11.08, CI = 3.26-37.62) was specifically associated with paranoia once comorbid hallucinations had been controlled for. For each symptom, dose-response relationships were observed between the number of childhood traumas and the risk of the symptom. The specific associations observed are consistent with current psychological theories about the origins of hallucinations and paranoia. Further research is required to study the psychological and biological mediators of these associations.
先前的研究报告了儿童期逆境（例如失去父母、在机构中长大、遭受成年人的性虐待和其他形式的虐待以及受到同龄人的欺凌）与成年期精神病之间的关联。然而，这些逆境导致精神病体验的机制仍知之甚少。从涉及阳性症状的心理过程模型预测，童年期性虐待将与成年期的听觉幻觉特别相关，而早期依恋关系的破坏以及更慢性的受害形式（如欺凌）将与偏执观念特别相关。因此，我们在 2007 年成人精神发病率调查中检查了性创伤、身体虐待、欺凌以及在机构或地方当局照料下长大与听觉幻觉和偏执信念报告之间的关联。所有儿童逆境与两种症状类型之间的简单关联均具有统计学意义。在控制同时发生的偏执后，童年期强奸仅与幻觉相关（OR 8.9，CI = 1.86-42.44）。在控制共病幻觉后，在机构中长大（OR = 11.08，CI = 3.26-37.62）与偏执有关。对于每种症状，在儿童期创伤次数与症状风险之间观察到剂量反应关系。观察到的特定关联与当前关于幻觉和偏执起源的心理理论一致。需要进一步研究以研究这些关联的心理和生物学中介。
