Barnes Georgina L, Emsley Richard, Garety Philippa, Hardy Amy
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK.
Schizophr Bull Open. 2023 Jun 15;4(1):sgad017. doi: 10.1093/schizbullopen/sgad017. eCollection 2023 Jan.
Childhood trauma is a risk factor for psychosis. It is proposed this is due to traumatic events giving rise to psychological mechanisms that are implicated in the development and maintenance of symptoms. Investigation of the psychological mechanisms accounting for relationships between trauma and psychosis will be assisted by focusing on specific trauma profiles, hallucination modalities, and delusion subtypes.
In 171 adults with schizophrenia-spectrum diagnoses and high-conviction delusions, associations between childhood trauma classes, and hallucination and delusion factors, were tested using structural equation models (SEMs). Anxiety, depression, and negative schema were examined as potential mediators of trauma class-psychosis symptom factor links.
Significant associations were found between the emotional abuse/neglect and poly-victimization classes with persecutory delusions and delusions of influence, that were all mediated through anxiety (β = 1.24-0.23, = < .05). There was an association between the physical abuse class and grandiose/religious delusions that was not explained by the mediators (β = 1.86, = < .05). Trauma class was not significantly associated with any hallucination modality (β = 0.004-1.46, = > .05).
In a sample of people with strongly held delusions, this study demonstrates that childhood victimization is associated with delusions of influence and grandiose beliefs, as well as with persecutory delusions in psychosis. Consistent with previous findings, the potent, mediating role of anxiety supports affective pathway theories and the utility of targeting threat-related processes when treating trauma effects in psychosis.
童年创伤是精神病的一个风险因素。有人提出，这是由于创伤性事件引发了与症状发展和维持相关的心理机制。通过关注特定的创伤特征、幻觉形式和妄想亚型，将有助于对解释创伤与精神病之间关系的心理机制进行调查。
在171名患有精神分裂症谱系诊断且有高度确信妄想的成年人中，使用结构方程模型（SEM）测试了童年创伤类别与幻觉和妄想因素之间的关联。将焦虑、抑郁和消极图式作为创伤类别与精神病症状因素联系的潜在中介因素进行了研究。
发现情感虐待/忽视和多重受害类别与被害妄想和被控制感妄想之间存在显著关联，这些关联均通过焦虑介导（β = 1.24 - 0.23，P <.05）。身体虐待类别与夸大/宗教妄想之间存在关联，而中介因素无法解释这种关联（β = 1.86，P <.05）。创伤类别与任何幻觉形式均无显著关联（β = 0.004 - 1.46，P >.05）。
在一个存在强烈妄想的人群样本中，本研究表明童年受害经历与被控制感妄想、夸大信念以及精神病中的被害妄想有关。与先前的研究结果一致，焦虑的强大中介作用支持了情感通路理论，以及在治疗精神病中的创伤影响时针对与威胁相关过程的效用。
