title: Childhood trauma, PTSD, and psychosis: Findings from a highly traumatized, minority sample.
abstract: Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public, urban hospital (N=328, >90% African American). Psychotic disorders were measured using the MINI International Neuropsychiatric Interview, PTSD was measured using the Clinician Administered PTSD Scale, child abuse was measured with the Childhood Trauma Questionnaire, and lifetime trauma exposure was measured with the Traumatic Events Inventory. Logistic regression analyses showed that both child abuse and current PTSD were statistically significant predictors of psychotic disorder beyond the effects of lifetime trauma load. When PTSD symptom clusters were examined, avoidance and numbing symptoms showed unique association with psychotic disorder independent of demographic variables and trauma exposure. Using bootstrapping techniques, we found a full indirect effect of PTSD on the association between child abuse and, suggesting a particularly important role of PTSD symptoms in relation to psychotic disorder in the presence of early life trauma. Because this is a cross-sectional study, continued research is needed to determine causality of such models. Identifying co-occurring psychosis and PTSD, particularly in populations with high levels of trauma exposure, is critical and will likely aid in more successful treatment interventions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States. Electronic address: adpower@emory.edu.
authors.forename: Abigail
authors.initials: A
authors.lastname: Powers
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
authors.forename: Negar
authors.initials: N
authors.lastname: Fani
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
authors.forename: Dorthie
authors.initials: D
authors.lastname: Cross
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States; Division of Depression and Anxiety, Harvard University, United States.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Ressler
authors.affiliation: Atlanta VA Medical Center, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
authors.forename: Bekh
authors.initials: B
authors.lastname: Bradley
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D001741:Black or African American; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D011618:Psychotic Disorders / Q000523:psychology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D014504:Urban Health
keywords: Child abuse; Posttraumatic stress disorder; Psychosis; Psychotic disorder; Trauma