Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; II Department of Psychiatry, Medical University of Warsaw, Poland.
Institute of Psychology, Jagiellonian University, Krakow, Poland.
Schizophr Res. 2018 Mar;193:218-224. doi: 10.1016/j.schres.2017.07.023. Epub 2017 Jul 13.
Traumatic life events have been established as an environmental risk factor for psychosis. However, the exact mechanisms by which traumatic life events increase risk for psychosis are unknown. In the present study we tested an integrative model of traumatic life events being related to psychosis proneness via self-disturbances and cognitive biases.
The sample consisted of 653 healthy people. Traumatic life events, self-disturbances, cognitive biases and psychosis proneness were assessed with self-report questionnaires. The direct and an indirect model of the relationship between traumatic life events and psychosis proneness were compared using path analyses with structural equation modelling in a cross-sectional study.
There was a significant direct effect of traumatic life events on psychosis proneness. However, path analysis suggested better fit of the indirect model including paths from trauma to psychosis proneness via cognitive biases and self-disturbances. There were significant paths from traumatic life events to cognitive biases and self-disorders. Self-disorders significantly predicted cognitive biases. Finally, cognitive biases and self-disorders significantly predicted psychosis proneness. Exclusion of any paths, apart from direct path in the model, significantly reduced model fitness.
The results revealed that a direct relationship between trauma and psychosis proneness became insignificant when taking into account the influence of self-disorders and cognitive biases. This suggests that the interactions between disrupted self-experience, impaired information processing and traumatic life events are of importance in psychosis proneness. This model should be further tested in a longitudinal study on a clinical sample.
创伤性生活事件已被确定为精神分裂症的环境风险因素。然而，创伤性生活事件增加精神分裂症风险的确切机制尚不清楚。在本研究中，我们通过自我干扰和认知偏差测试了创伤性生活事件与精神分裂症易感性相关的综合模型。
样本由 653 名健康人组成。创伤性生活事件、自我干扰、认知偏差和精神分裂症易感性通过自我报告问卷进行评估。使用路径分析和结构方程模型在横断面研究中比较了创伤性生活事件与精神分裂症易感性之间的直接和间接模型。
创伤性生活事件对精神分裂症易感性有显著的直接影响。然而，路径分析表明，包括从创伤到认知偏差和自我干扰的途径的间接模型拟合更好。创伤性生活事件与认知偏差和自我障碍之间存在显著路径。自我障碍显著预测认知偏差。最后，认知偏差和自我障碍显著预测精神分裂症易感性。除了模型中的直接路径外，排除任何路径都会显著降低模型拟合度。
结果表明，当考虑到自我障碍和认知偏差的影响时，创伤与精神分裂症易感性之间的直接关系变得不显著。这表明，自我体验中断、信息处理受损和创伤性生活事件之间的相互作用在精神分裂症易感性中很重要。该模型应在对临床样本的纵向研究中进一步测试。
