TY - JOUR
T1 - Psychopathological Mechanisms Linking Childhood Traumatic Experiences to Risk of Psychotic Symptoms: Analysis of a Large, Representative Population-Based Sample
AU - van Nierop, Martine
AU - Lataster, Tineke
AU - Smeets, Feikje
AU - Gunther, Nicole
AU - van Zelst, Catherine
AU - de Graaf, Ron
AU - ten Have, Margreet
AU - van Dorsselaer, Saskia
AU - Bak, Maarten
AU - Myin-Germeys, Inez
AU - Viechtbauer, Wolfgang
AU - van Os, Jim
AU - van Winkel, Ruud
PY - 2014/3
Y1 - 2014/3
N2 - Background: Different psychological models of trauma-induced psychosis have been postulated, often based on the observation of specific associations between particular types of childhood trauma (CT) and particular psychotic symptoms or the co-occurrence of delusions and hallucinations. However, the actual specificity of these associations remains to be tested. Methods: In 2 population-based studies with comparable methodology (Netherlands Mental Health Survey and Incidence Study-1 [NEMESIS-1] and NEMESIS-2, N 13 722), trained interviewers assessed CT, psychotic symptoms, and other psychopathology. Specificity of associations was assessed with mixed-effects regression models with multiple outcomes, a statistical method suitable to examine specificity of associations in case of multiple correlated outcomes. Results: Associations with CT were strong and significant across the entire range of psychotic symptoms, without evidence for specificity in the relationship between particular trauma variables and particular psychotic experiences (PEs). Abuse and neglect were both associated with PEs (ORabuse: 2.12, P <.001; ORneglect: 1.96, P <.001), with no large or significant difference in effect size. Intention-to-harm experiences showed stronger associations with psychosis than CT without intent ((2) 58.62, P <.001). Most trauma variables increased the likelihood of co-occurrence of delusions and hallucinations rather than either symptom in isolation. Discussion: Intention to harm is the key component linking childhood traumatic experiences to psychosis, most likely characterized by co-occurrence of hallucinations and delusions, indicating buildup of psychotic intensification, rather than specific psychotic symptoms in isolation. No evidence was found to support psychological theories regarding specific associations between particular types of CT and particular psychotic symptoms.
AB - Background: Different psychological models of trauma-induced psychosis have been postulated, often based on the observation of specific associations between particular types of childhood trauma (CT) and particular psychotic symptoms or the co-occurrence of delusions and hallucinations. However, the actual specificity of these associations remains to be tested. Methods: In 2 population-based studies with comparable methodology (Netherlands Mental Health Survey and Incidence Study-1 [NEMESIS-1] and NEMESIS-2, N 13 722), trained interviewers assessed CT, psychotic symptoms, and other psychopathology. Specificity of associations was assessed with mixed-effects regression models with multiple outcomes, a statistical method suitable to examine specificity of associations in case of multiple correlated outcomes. Results: Associations with CT were strong and significant across the entire range of psychotic symptoms, without evidence for specificity in the relationship between particular trauma variables and particular psychotic experiences (PEs). Abuse and neglect were both associated with PEs (ORabuse: 2.12, P <.001; ORneglect: 1.96, P <.001), with no large or significant difference in effect size. Intention-to-harm experiences showed stronger associations with psychosis than CT without intent ((2) 58.62, P <.001). Most trauma variables increased the likelihood of co-occurrence of delusions and hallucinations rather than either symptom in isolation. Discussion: Intention to harm is the key component linking childhood traumatic experiences to psychosis, most likely characterized by co-occurrence of hallucinations and delusions, indicating buildup of psychotic intensification, rather than specific psychotic symptoms in isolation. No evidence was found to support psychological theories regarding specific associations between particular types of CT and particular psychotic symptoms.
KW - epidemiology
KW - childhood adversity
KW - psychosis
U2 - 10.1093/schbul/sbt150
DO - 10.1093/schbul/sbt150
M3 - Article
C2 - 24562491
VL - 40
SP - S123-S130
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
SN - 0586-7614
ER -