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Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control.

Bak M, Krabbendam L, Janssen I, de Graaf R, Vollebergh W, van Os J

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, the Netherlands. m.bak@sp.unimaas.nl

OBJECTIVE: Exposure to early trauma may increase the risk of dysfunctional responses to anomalous psychotic experiences resulting in psychotic symptom formation. METHOD: In a three-wave longitudinal general population study, 4045 never-psychotic individuals exposed and non-exposed to trauma before the age of 16 years, according to baseline interview were interviewed for the onset of psychotic experiences 3 years later (T2). In 36 individuals with incident psychosis at T2, assessments were made, for each psychotic experience, of i) the amount of distress associated with and ii) the degree of coping and subjective control over the experience. RESULTS: In the 16 observations of an incident psychotic experience, in the absence of distress, the baseline rate of early trauma was low (6%), whereas it was much higher in the 21 observations of an incident psychotic experience with distress [43%; odds ratio=10.0, 95% confidence interval (CI): 1.04, 96.3; P=0.046]. Similarly, coping attempts in the context of early trauma was associated with less control (reduction of 2 points on a seven-point scale, 95% CI: -4.0, -0.07). CONCLUSION: Early experience of trauma may create lasting cognitive and affective vulnerabilities to develop clinical symptoms arising out of early, non-clinical psychotic experiences.

Published 14 October 2005 in Acta Psychiatr Scand, 112(5): 360-6.
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