Testing models of post-traumatic intrusions, trauma-related beliefs, hallucinations, and delusions in a first episode psychosis sample

Abstract

Objective: There is increasing evidence that childhood trauma may play a role in the aetiology of psychosis. Cognitive models implicate trauma-related symptoms, specifically post-traumatic intrusions and trauma-related beliefs as primary mechanisms, but these models have not been extensively tested. This study investigated relationships between childhood trauma, psychotic symptoms (hallucinations and delusions), post-traumatic intrusions, and trauma-related beliefs while accounting for comorbid symptoms. Methods: Sixty-six people with first episode psychosis aged between 15 and 24 years were assessed for hallucinations, delusions, childhood trauma, post-traumatic intrusions, post-traumatic avoidance, and trauma-related beliefs. Results: Fifty-three per cent of the sample had experienced childhood trauma, and 27% met diagnostic criteria for post-traumatic stress disorder. Both post-traumatic intrusions and trauma-related beliefs mediated the relationships between childhood trauma and hallucinations, and childhood trauma and delusions. Multiple regression analyses revealed that post-traumatic intrusions (but not childhood trauma, post-traumatic avoidance, or trauma-related beliefs) were independently associated with hallucination severity (β =.53, p =.01). Post-traumatic intrusions and trauma-related beliefs (but not childhood trauma or post-traumatic avoidance) were independently associated with delusion severity (β =.67, p