Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; II Department of Psychiatry, Medical University of Warsaw, Poland.
Eur Psychiatry. 2019 Feb;56:84-90. doi: 10.1016/j.eurpsy.2018.11.009. Epub 2018 Dec 31.
Psychotic-like experiences (PLEs) often occur across different non-psychotic disorders in adolescent and young adult population and are related to early trauma. However, the mechanisms of how exposure to early trauma shapes the risk of PLEs are unclear. In our study, we investigated whether borderline personality features and further non-psychotic symptoms, i.e. factors related to both PLEs and childhood trauma, may mediate the relationship between childhood trauma and PLEs.
Two hundred inpatients aged 16-21 years who were treated due to non-psychotic disorders were included. PLEs were assessed with the Prodromal Questionnaire (PQ-16). Childhood Trauma was assessed with the Adverse Childhood Experience Questionnaire (ACE). Borderline personality features were assessed by using the Borderline-Symptom Checklist (BSL-23). Presence and frequency of depressive symptoms and anxiety were assessed by Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7).
A significant relationship between childhood trauma (ACE total score) and PLEs was found (ß = 0.30, 95% CI 0.247--0.659). In particular, emotional neglect (r = 0.298, p < 0.001) and sexual abuse (r = 0.264, p < 0.001) were significantly associated with PLEs. Borderline personality features fully mediated the relationship of childhood trauma and PLEs (ß = 0.12, 95% CI: -0.019--0.370). Anxiety and Depression showed a significant, but partial mediation of the relationship.
Borderline personality features seem to be an important mediator of the relationship between childhood trauma and PLEs in adolescent patients with different non-psychotic psychiatric disorders. Theoretical and clinical implications are discussed.
在青少年和年轻成人中，精神病样体验（PLEs）经常出现在各种非精神病障碍中，且与早期创伤有关。然而，暴露于早期创伤如何影响 PLEs 风险的机制尚不清楚。在我们的研究中，我们调查了边缘性人格特征以及进一步的非精神病症状，即与 PLEs 和童年创伤相关的因素，是否可以作为童年创伤与 PLEs 之间关系的中介。
纳入了 200 名因非精神病障碍而住院的 16-21 岁患者。使用前驱症状问卷（PQ-16）评估 PLEs。使用不良童年经历问卷（ACE）评估童年创伤。使用边缘症状清单（BSL-23）评估边缘性人格特征。使用患者健康问卷（PHQ-9）和广泛性焦虑症问卷（GAD-7）评估抑郁症状和焦虑症状的存在和频率。
发现童年创伤（ACE 总分）与 PLEs 之间存在显著关系（β=0.30，95%CI 0.247-0.659）。特别是情感忽视（r=0.298，p<0.001）和性虐待（r=0.264，p<0.001）与 PLEs 显著相关。边缘性人格特征完全介导了童年创伤与 PLEs 之间的关系（β=0.12，95%CI：-0.019-0.370）。焦虑和抑郁对两者的关系有显著的部分中介作用。
在患有不同非精神病性精神障碍的青少年患者中，边缘性人格特征似乎是童年创伤与 PLEs 之间关系的重要中介。讨论了理论和临床意义。
