Green Kathleen, Webster Anthony
Nottinghamshire Healthcare NHS foundation Trust, Nottingham, England.
Centre for Forensic and Family Psychology, University of Nottingham, Nottingham, England.
J Child Adolesc Trauma. 2021 Nov 18;15(3):605-614. doi: 10.1007/s40653-021-00422-5. eCollection 2022 Sep.
There is now substantial evidence that childhood adverse events are a significant risk factor for symptoms of psychosis in both clinical and community samples. Both childhood trauma and positive symptoms of psychosis are associated with an increased risk of self-harming behaviours. Therefore the current study aimed to consider the relationship between retrospective reports of childhood adversity, sub-clinical positive symptoms of psychosis and self-harm in a non-clinical community sample. The study employed a cross-sectional survey design, distributed online. Participants were asked to complete psychometric assessments relating to: demographic characteristics including past-year substance misuse; childhood adversity; sub-clinical symptoms of psychosis (delusions and hallucinations) and self-harming behaviours. The results found that, after controlling for substance misuse, childhood adversity predicted significant variance in sub-clinical delusions and hallucinations in the general population. Both symptoms of psychosis and childhood adversity increased the risk of self-harming behaviours. Positive symptoms partially mediated the relationship between early adversity and self-harming behaviours. For some people, the sequelae of early adversity including sub-clinical delusions and hallucinations may increase the risk of self-harming behaviours. Future research would benefit from considering the role of dissociation in these relationships and the affective impact of pseudo-psychotic experiences. Practitioners should consider the impact of childhood adversity, unusual perceptual experiences and distorted beliefs when working with people who self-harm. The current research was limited by the cross-sectional survey design and non-random sampling methodology.
现在有大量证据表明，在临床样本和社区样本中，童年不良事件都是精神病症状的一个重要风险因素。童年创伤和精神病的阳性症状都与自伤行为风险增加有关。因此，本研究旨在探讨在非临床社区样本中，童年逆境的回顾性报告、精神病的亚临床阳性症状和自伤之间的关系。该研究采用在线发放的横断面调查设计。参与者被要求完成与以下方面相关的心理测量评估：人口统计学特征，包括过去一年的物质滥用情况；童年逆境；精神病的亚临床症状（妄想和幻觉）以及自伤行为。结果发现，在控制物质滥用因素后，童年逆境可预测一般人群中亚临床妄想和幻觉的显著差异。精神病症状和童年逆境都会增加自伤行为的风险。阳性症状部分介导了早期逆境与自伤行为之间的关系。对一些人来说，早期逆境的后遗症，包括亚临床妄想和幻觉，可能会增加自伤行为的风险。未来的研究若能考虑分离在这些关系中的作用以及假性精神病体验的情感影响，将会有所助益。从业者在与有自伤行为的人打交道时，应考虑童年逆境、异常感知体验和扭曲信念的影响。本研究受到横断面调查设计和非随机抽样方法的限制。
