Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK.
Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK.
Psychiatry Res. 2014 Jul 30;217(3):202-9. doi: 10.1016/j.psychres.2014.03.019. Epub 2014 Mar 24.
Accumulated evidence over the past decade consistently demonstrates a relationship between childhood adversity and psychosis in adulthood. There is some evidence of specific associations between childhood sexual abuse and hallucinations, and between insecure attachment and paranoia. Data from the National Comorbidity Survey were used in assessing whether current attachment styles influenced the association between adverse childhood experiences and psychotic symptoms in adulthood. Hallucinations and paranoid beliefs were differentially associated with sexual abuse (rape and sexual molestation) and neglect, respectively. Sexual abuse and neglect were also associated with depression. The relationship between neglect and paranoid beliefs was fully mediated via anxious and avoidant attachment. The relationship between sexual molestation and hallucinations was independent of attachment style. The relationship between rape and hallucinations was partially mediated via anxious attachment; however this effect was no longer present when depression was included as a mediating variable. The findings highlight the importance of addressing and understanding childhood experiences within the context of current attachment styles in clinical interventions for patients with psychosis.
过去十年的积累证据一致表明，儿童时期的逆境与成年期的精神病之间存在关联。有一些证据表明，儿童期性虐待与幻觉之间，以及不安全依恋与偏执之间存在特定关联。本研究使用全国共病调查的数据来评估当前的依恋风格是否会影响儿童期不良经历与成年期精神病症状之间的关联。幻觉和偏执信念分别与性虐待（强奸和性虐待）和忽视有关。性虐待和忽视也与抑郁有关。忽视与偏执信念之间的关系完全通过焦虑和回避依恋来介导。性虐待与幻觉之间的关系与依恋风格无关。强奸与幻觉之间的关系部分通过焦虑依恋来介导；但是，当将抑郁作为中介变量包含在内时，这种影响就不再存在。这些发现强调了在精神病患者的临床干预中，在当前依恋风格的背景下解决和理解儿童期经历的重要性。
