Researchers identify pathways between youth trauma, psychotic phenomena in adulthood

Distinct psychological pathways may exist between developmental trauma during childhood and/or adolescence and psychotic phenomena in adulthood, according to results of a systematic review and meta-analysis published in World Psychiatry.

“Most research to date has investigated the relationships between trauma and psychotic symptoms in general, rather than specific psychotic symptom domains,” Michael A.P. Bloomfield, PhD, MRCPsych, of the Division of Psychiatry at University College London, and colleagues wrote. “Understanding the psychological processes associated with specific psychotic symptoms in the context of [developmental trauma] has the potential to lead to improved treatments, including both psychotherapies and pharmacotherapies.”

The investigators aimed to conduct a systematic review of the literature, as well as to use meta-analytic techniques to elucidate the potential effects of psychological processes on the links between developmental trauma and specific psychotic experiences, such as hallucinations, delusions and paranoia. They searched three databases and included 22 studies.

Results showed dissociation, emotional dysregulation and PTSD symptoms played mediating roles between developmental trauma and hallucinations. Further, they observed evidence of a mediating role of negative schemata, such as mental constructs of meanings, between developmental trauma and delusions, as well as paranoia. Bloomfield and colleagues noted that a significant number of prior studies were of “poor quality” and that this research area has been limited by mostly cross-sectional research.

“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,” the researchers wrote. “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.”