Abstract
Exposure to traumatic life events (TLE) is a risk factor for psychosis. Yet, a dearth of studies examines factors linking TLE to psychosis, while considering differences in TLE frequency. This study investigated dissociation and aberrant salience as mediators and moderators of the relation between three TLE groups (none, 1–3 TLE and 4+ TLE) and psychotic-like experiences (PLE) in a multi-ethnic sample of 816 emerging adults. The participants completed self-report inventories of PLE (Prodromal Questionnaire), TLE (Life Events Checklist), dissociative experiences (Dissociative Symptoms Scale), and aberrant salience (Aberrant Salience Inventory). As expected, groups with higher TLE frequency endorsed higher PLE. Parallel mediation models indicated that, while aberrant salience mediated the relation between both levels of cumulative traumatic experiences (1–3 TLE and 4+ TLE) and PLE, dissociation only mediated the relation between exposure to at least four different traumatic experiences and PLE. The moderation results showed that risk of PLE was highest among individuals with 1–3 TLE who endorsed dissociation. Our results suggest that, while aberrant salience processing explains why TLE may relate to higher psychosis risk, dissociation’s role in this relation is dependent on the number of different TLE exposures.
Highlights
IntroductionStudies consistently find that exposure to traumatic life events (TLE) is an important environmental risk factor in the development of psychosis [1,2]
The results showed that the relationship between exposure to traumatic life events (TLE) and psychotic-like experiences (PLE) was mediated by aberrant salience, regardless of TLE frequency, and mediated and moderated by dissociation differentially by TLE frequency
Individuals who experienced a high number of different traumatic life events were more likely than those with no trauma to report a higher number of PLE, in part because they experienced more dissociation
Summary
Studies consistently find that exposure to traumatic life events (TLE) is an important environmental risk factor in the development of psychosis [1,2]. For an extensive review on this relationship, see Gibson et al [3]. This relationship has been demonstrated across the entire psychotic spectrum, including for psychotic-like experiences (PLE) [4,5,6]. A study conducted by Croft, Heron, Teufel, et al [2] showed that, up to the age of 17 years, exposure to any trauma across several developmental periods studied was associated with increased odds of psychotic experiences at age 18. The results suggested an increase in effect size with exposure to a greater number of trauma types (e.g., three or more types of trauma exposure was associated with a 4.7-fold increase in odds of psychotic experiences) [2]
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