TY - JOUR
T1 - Psychological processes mediating the association between developmental trauma and specific psychotic symptoms in adults
T2 - a systematic review and meta-analysis
AU - Bloomfield, Michael A.P.
AU - Chang, Tinya
AU - Woodl, Maximillian J.
AU - Lyons, Laura M.
AU - Cheng, Zhen
AU - Bauer-Staeb, Clarissa
AU - Hobbs, Catherine
AU - Bracke, Sophie
AU - Kennerley, Helen
AU - Isham, Louise
AU - Brewin, Chris
AU - Billings, Jo
AU - Greene, Talya
AU - Lewis, Glyn
N1 - Funding Information:
M.A.P. Bloomfield is funded by an Excellence Fellowship from University College London and supported by the UK National Institute for Health Research (NIHR) University College Hospitals Biomedical Research Centre. The authors are grateful to J. McDonnell for commenting on an early draft of the manuscript.
Publisher Copyright:
© 2021 World Psychiatric Association
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/28
Y1 - 2021/2/28
N2 - Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psychological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
AB - Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psychological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
KW - adolescence
KW - childhood
KW - delusions
KW - Developmental trauma
KW - dissociation
KW - hallucinations
KW - paranoia
KW - post-traumatic stress disorder
KW - psychological processes
KW - psychotic symptoms
UR - http://www.scopus.com/inward/record.url?scp=85099225251&partnerID=8YFLogxK
U2 - 10.1002/wps.20841
DO - 10.1002/wps.20841
M3 - Article
AN - SCOPUS:85099225251
VL - 20
SP - 107
EP - 123
JO - World Psychiatry : official journal of the World Psychiatric Association (WPA)
JF - World Psychiatry : official journal of the World Psychiatric Association (WPA)
SN - 1723-8617
IS - 1
ER -