title: Cumulative Effects of Stressful Childhood Experiences on Delusions and Hallucinations.
abstract: The association between stressful childhood experiences (SCE) and psychotic symptoms is still not clearly understood, and different causal pathways have been proposed. Generalized estimating equation modeling was used to test the dose-response relationship between SCE and delusions and hallucinations at baseline and follow-up periods and the possible confounding effects of dissociation on this relationship. The prevalence of SCE in individuals with psychotic disorders was high, with more co-occurring SCE categories being positively associated with more types of delusions and hallucinations. Each additional SCE was associated with a 1.20 increase in the incidence rate ratio (95% confidence interval [CI; 1.09, 1.32]) for hallucinations and a 1.19 increase (CI [1.09, 1.29]) for delusions, supporting a dose-response association. After we controlled for the mediating effects of dissociative symptoms at follow-up, SCE remained independently associated with delusions. We propose that cumulative SCE can result in complex trauma reactions that present with a broad range of symptomatology, including dissociative, posttraumatic stress disorder, and psychotic symptoms.
authors.affiliation: a Bronx Psychiatric Center, Albert Einstein College of Medicine , Bronx , New York , USA.
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Muenzenmaier
authors.forename: Azizi A
authors.initials: AA
authors.lastname: Seixas
authors.forename: Andres R
authors.initials: AR
authors.lastname: Schneeberger
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Castille
authors.forename: Joseph
authors.initials: J
authors.lastname: Battaglia
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Link
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology; D003702:Delusions / Q000175:diagnosis* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D018570:Risk Assessment; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*; D040921:Stress Disorders, Traumatic / Q000175:diagnosis* / Q000523:psychology*
keywords: dissociation; psychosis; schizophrenia; severe mental illness; trauma