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Childhood trauma and psychotic experiences in a general population sample: A prospective study on the mediating role of emotion regulation

Published online by Cambridge University Press:  23 March 2020

T.M. Lincoln ,
N. Marin  and
E.S. Jaya
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Abstract

Background

The causal role of childhood trauma for psychosis is well established, but the mechanisms that link trauma to psychosis are largely unknown. Since childhood trauma is known to cause difficulties in emotion regulation (ER) and patients with psychosis show impaired ER, we hypothesize that impaired ER explains why people with a background of trauma are prone to psychotic experiences.

Methods

The study used a longitudinal cohort design based on a community sample (N = 562) from Germany, Indonesia, and the United States. Childhood trauma was assessed at baseline. ER and psychotic experiences (defined as positive symptom frequency and related distress) were measured repeatedly at a 4-, 8-, and 12-month follow-up. Cross-lagged panel and longitudinal mediation analyses with structural equation modeling were used to test the predictive value of ER on psychotic experiences and its mediating role in the association of childhood trauma and psychotic experiences.

Results

The cross-lagged paths from impaired ER to symptom distress (but not frequency) were significant. However, there was also evidence for the reverse causation from symptom frequency and distress to impaired ER. ER partially mediated the significant prospective paths from childhood trauma to symptom distress.

Conclusion

The findings demonstrate that ER plays a role in translating childhood trauma into distressing psychotic experiences in later life. Moreover, the findings point to a maintenance mechanism in which difficulties in ER and symptom distress exacerbate each other. Thus, ER could be a promising target for interventions aimed at prevention of psychosis.

Keywords

Schizophrenia and psychosisSymptom distressSocial adversityMediationStructural equation modelingProspective design
Type
Original article
Information
European Psychiatry , Volume 42 , May 2017 , pp. 111 - 119
Copyright
Copyright © European Psychiatric Association 2017

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