Childhood trauma as a risk factor for the onset of subclinical psychotic experiences: Exploring the mediating effect of stress sensitivity in a cross-sectional epidemiological community study

Abstract

Childhood trauma is a risk factor for the onset of schizophrenic psychosis. Because the psychosis phenotype can be described as a continuum with varying levels of severity and persistence, childhood trauma might likewise increase the risk for psychotic experiences below the diagnostic threshold. But the impact of stressful experiences depends upon its subjective appraisal. Therefore, varying degrees of stress sensitivity possibly mediate how childhood trauma impacts in the end upon the occurrence of subclinical psychotic experiences.We investigated this research question in a representative community cohort of 1500 participants. A questionnaire, comprising five domains of physical and emotional neglect, as well as physical, emotional, and sexual abuse, was used to assess childhood trauma. Based on different symptoms of subclinical psychotic experiences, we conducted a latent profile analysis (LPA) to derive distinct profiles for such experiences. Path modeling was performed to identify the direct and indirect (via stress sensitivity) pathways from childhood trauma to subclinical psychotic experiences.The LPA revealed four classes — unaffected, anomalous perceptions, odd beliefs and behavior, and combined anomalous perceptions/odd beliefs and behavior, that – except for sexual abuse – were all linked to childhood trauma. Moreover, except for physical abuse, childhood trauma was significantly associated with stress sensitivity. Thus, our results revealed that the pathways from emotional neglect/abuse and physical neglect to subclinical psychotic experiences were mediated by stress sensitivity.In conclusion, we can state that subclinical psychotic experiences are affected by childhood traumatic experiences in particular through the pathway of a heightened subjective stress appraisal.