Lofthouse Katie, Beeson Ella, Dalgleish Tim, Danese Andrea, Hodgekins Joanne, Mahoney-Davies Gerwyn, Smith Patrick, Stallard Paul, Wilson Jon, Meiser-Stedman Richard
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.
Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK.
Eur J Psychotraumatol. 2024;15(1):2435790. doi: 10.1080/20008066.2024.2435790. Epub 2024 Dec 18.
PTSD is comorbid with a number of other mental health difficulties and the link between voice hearing and PTSD has been explored in adult samples. To compare the trauma history, symptomatology, and cognitive phenotypes of children and adolescents with a PTSD diagnosis following exposure to multiple traumatic events presenting with voice hearing with those who do not report hearing voices. Participants ( = 120) were aged 8-17 years and had PTSD following exposure to multiple traumas. Three primary analyses were conducted, comparing PTSD symptom severity, prevalence of sexual trauma, and level of negative post-traumatic cognitions between the voice hearing and non-voice hearing groups. Participants were allocated to the voice hearing group if they reported hearing voices in the past two weeks. A range of mental health and cognitive-behavioural factors were considered in exploratory secondary analyses. All analyses were pre-registered. The voice hearing group ( = 50, 41.7%) scored higher than the non-voice hearing group ( = 70, 58.3%) for negative post-traumatic cognitions, but not PTSD symptom severity or prevalence of sexual trauma. In secondary analyses, the voice hearing group had more sensory-based and fragmented memories and higher scores for panic symptoms than the non-voice hearing group. When participants whose voices were not distinguishable from intrusions or flashbacks were removed from the voice hearing group in a sensitivity analysis, the voice hearing group ( = 29, 24.2%) scored higher on negative post-traumatic cognitions and trauma memory quality, with similar effect sizes to the original analysis. Voice hearing is common among youth exposed to multiple traumas with PTSD and is related to cognitive mechanisms proposed to underpin PTSD (appraisals, memory quality) and more panic symptoms. Further research should seek to investigate the underlying mechanisms and directionality for these relationships.
创伤后应激障碍（PTSD）与许多其他心理健康问题并存，并且在成人样本中已经探讨了幻听与PTSD之间的联系。为了比较在经历多次创伤事件后出现幻听的儿童和青少年与未报告幻听的儿童和青少年的创伤史、症状学和认知表型。参与者（n = 120）年龄在8至17岁之间，在经历多次创伤后患有PTSD。进行了三项主要分析，比较了幻听组和非幻听组之间的PTSD症状严重程度、性创伤患病率以及创伤后消极认知水平。如果参与者报告在过去两周内有幻听，则被分配到幻听组。在探索性的二次分析中考虑了一系列心理健康和认知行为因素。所有分析均预先登记。幻听组（n = 50，41.7%）在创伤后消极认知方面的得分高于非幻听组（n = 70，58.3%），但在PTSD症状严重程度或性创伤患病率方面并非如此。在二次分析中，幻听组比非幻听组有更多基于感觉的和碎片化的记忆，以及更高的惊恐症状得分。在敏感性分析中，当将那些声音与侵入性思维或闪回难以区分的参与者从幻听组中剔除后，幻听组（n = 29，24.2%）在创伤后消极认知和创伤记忆质量方面得分更高，效应大小与原始分析相似。幻听在患有PTSD的经历多次创伤的青少年中很常见，并且与被认为是PTSD基础的认知机制（评估、记忆质量）以及更多的惊恐症状有关。进一步的研究应该寻求调查这些关系的潜在机制和方向性。
