Psychological processes mediating the association between developmental trauma and specific psychotic symptoms in adults: a systematic review and meta-analysis
Citation
Michael A.P. Bloomfield, Tinya Chang, Maximillian J. Woodl , Laura M. Lyons , Zhen Cheng , Clarissa Bauer-Staeb, Catherine Hobbs, Sophie Bracke, Helen Kennerley, Louise Isham, Chris Brewin, Jo Billings, Talya Greene, Glyn Lewis. Psychological processes mediating the association between developmental trauma and specific psychotic symptoms in adults: a systematic review and meta-analysis. World Psychiatry 20:1 - February 2021
Abstract
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.