University of Manchester, Division of Psychology and Mental Health, Manchester Academic Health Science, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom.
University of Manchester, Division of Psychology and Mental Health, Manchester Academic Health Science, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester, Greater Manchester M25 3BL, United Kingdom.
Schizophr Res. 2022 Mar;241:142-148. doi: 10.1016/j.schres.2022.01.043. Epub 2022 Feb 2.
Paranoia is associated with significant distress and is associated with childhood trauma. Understanding the mechanisms responsible for this association is important for informing psychological interventions. Theoretical proposals suggest that negative schema and insecure attachment may be important mechanisms in the development of paranoia. Disorganised attachment may be particularly relevant. The current study is the first to examine whether the relationship between childhood interpersonal trauma and paranoia is mediated by disorganised attachment, and the impact of disorganised attachment on negative self and negative other schema. A large online sample of 242 people with self-reported psychosis completed measures of childhood trauma, attachment, self and other schema, paranoia and psychosis symptomatology. Path analysis indicated that childhood interpersonal trauma was associated with disorganised attachment, which in turn was associated with negative self-schema, negative other schema, and paranoia. Negative schema about others, but not self, was associated with paranoia. Disorganised attachment and negative other schema fully mediated the relationship between trauma and paranoia. Negative other schema partially mediated the association between disorganised attachment and paranoia. Results were found when controlling for depression, hallucinations and age. Results suggest that interventions that aim to modify disorganised attachment patterns and negative schema about others can potentially alleviate the impact of trauma on paranoia. Findings provide justification for longitudinal studies to confirm the direction of effects, and intervention studies that aim to manipulate disorganised attachment and negative schema about others and observe the impact of this on paranoia.
偏执与明显的痛苦有关，并与儿童创伤有关。了解导致这种关联的机制对于告知心理干预措施非常重要。理论建议表明，消极模式和不安全依恋可能是偏执发展的重要机制。混乱的依恋可能尤为重要。目前的研究首次检验了儿童期人际创伤与偏执之间的关系是否通过混乱的依恋来介导，以及依恋紊乱对消极自我和消极他人模式的影响。一个由 242 名自我报告有精神病的人组成的大型在线样本完成了儿童期创伤、依恋、自我和他人模式、偏执和精神病症状的测量。路径分析表明，儿童期人际创伤与依恋紊乱有关，而依恋紊乱又与消极的自我模式、消极的他人模式和偏执有关。关于他人的消极模式，而不是自我，与偏执有关。混乱的依恋和消极的他人模式完全介导了创伤与偏执之间的关系。消极的他人模式部分介导了依恋紊乱与偏执之间的关系。当控制抑郁、幻觉和年龄时，结果仍然存在。研究结果表明，旨在改变依恋紊乱模式和消极他人模式的干预措施可能有助于减轻创伤对偏执的影响。研究结果为证实因果关系的纵向研究以及旨在操纵依恋紊乱和他人消极模式并观察其对偏执影响的干预研究提供了依据。
