title: Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey.
abstract: Accumulated evidence over the past decade consistently demonstrates a relationship between childhood adversity and psychosis in adulthood. There is some evidence of specific associations between childhood sexual abuse and hallucinations, and between insecure attachment and paranoia. Data from the National Comorbidity Survey were used in assessing whether current attachment styles influenced the association between adverse childhood experiences and psychotic symptoms in adulthood. Hallucinations and paranoid beliefs were differentially associated with sexual abuse (rape and sexual molestation) and neglect, respectively. Sexual abuse and neglect were also associated with depression. The relationship between neglect and paranoid beliefs was fully mediated via anxious and avoidant attachment. The relationship between sexual molestation and hallucinations was independent of attachment style. The relationship between rape and hallucinations was partially mediated via anxious attachment; however this effect was no longer present when depression was included as a mediating variable. The findings highlight the importance of addressing and understanding childhood experiences within the context of current attachment styles in clinical interventions for patients with psychosis.
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK. Electronic address: ksitko@liverpool.ac.uk.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Sitko
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Bentall
authors.affiliation: School of Psychology, University of Ulster, Londonderry BT48 7JL, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Shevlin
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK.
authors.forename: Noreen
authors.initials: N
authors.lastname: O'Sullivan
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK.
authors.forename: William
authors.initials: W
authors.lastname: Sellwood
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000453:epidemiology / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology*; D011902:Rape / Q000523:psychology / Q000706:statistics & numerical data; D040921:Stress Disorders, Traumatic / Q000453:epidemiology* / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Delusions; Hallucinations; Indirect effects; Paranoia; Psychosis; Trauma