title: Childhood trauma mediates the association between ethnic minority status and more severe hallucinations in psychotic disorder.
abstract: BACKGROUND
  Ethnic minority status and childhood trauma are established risk factors for psychotic disorders. Both are found to be associated with increased level of positive symptoms, in particular auditory hallucinations. Our main aim was to investigate the experience and effect of childhood trauma in patients with psychosis from ethnic minorities, hypothesizing that they would report more childhood trauma than the majority and that this would be associated with more current and lifetime hallucinations.
  
  
  METHODS
  In this cross-sectional study we included 454 patients with a SCID-I DSM-IV diagnosis of non-affective or affective psychotic disorder. Current hallucinations were measured with the Positive and Negative Syndrome Scale (P3; Hallucinatory Behaviour). Lifetime hallucinations were assessed with the SCID-I items: auditory hallucinations, voices commenting and two or more voices conversing. Childhood trauma was assessed with the Childhood Trauma Questionnaire, self-report version.
  
  
  RESULTS
  Patients from ethnic minority groups (n = 69) reported significantly more childhood trauma, specifically physical abuse/neglect, and sexual abuse. They had significantly more current hallucinatory behaviour and lifetime symptoms of hearing two or more voices conversing. Regression analyses revealed that the presence of childhood trauma mediated the association between ethnic minorities and hallucinations.
  
  
  CONCLUSIONS
  More childhood trauma in ethnic minorities with psychosis may partially explain findings of more positive symptoms, especially hallucinations, in this group. The association between childhood trauma and these first-rank symptoms may in part explain this group's higher risk of being diagnosed with a schizophrenia-spectrum diagnosis. The findings show the importance of childhood trauma in symptom development in psychosis.
authors: NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine,University of Oslo,and Oslo University Hospital, Oslo,Norway.
authors: A O
authors: AO
authors: Berg
authors: NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine,University of Oslo,and Oslo University Hospital, Oslo,Norway.
authors: M
authors: M
authors: Aas
authors: Department of Research and Development, Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway.
authors: S
authors: S
authors: Larsson
authors: NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine,University of Oslo,and Oslo University Hospital, Oslo,Norway.
authors: M
authors: M
authors: Nerhus
authors: Department of Research and Development, Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway.
authors: E
authors: E
authors: Hauff
authors: NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine,University of Oslo,and Oslo University Hospital, Oslo,Norway.
authors: O A
authors: OA
authors: Andreassen
authors: NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine,University of Oslo,and Oslo University Hospital, Oslo,Norway.
authors: I
authors: I
authors: Melle
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000349:Africa / Q000208:ethnology; D000368:Aged; D001208:Asia / Q000208:ethnology; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D057566:Self Report; D055815:Young Adult