Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder

Abstract

In light of recent studies indicating a relationship between child abuse and the positive symptoms of schizophrenia, this study investigated the hypotheses that childhood sexual and physical abuse are related to hallucinations, delusions, and thought disorder in adults, and that those relationships are greater in those who have suffered abuse during adulthood as well as childhood. In 200 community mental-health-centre clients, the clinically evaluated symptomatology of the 92 clients whose les documented sexual or physical abuse at some point in their lives was compared with that of the 108 for whom no abuse was documented. In the 60 patients for whom child abuse was documented, hallucinations (including all six subtypes), but not delusions, thought disorder or negative symptoms, were signi cantly more common than in the nonabused group. Adult sexual assault was related to hallucinations, delusions, and thought disorder. In linear regression analysis, a combination of child abuse and adult abuse predicted hallucinations, delusions, and thought disorder. However, child abuse was a signi cant predictor of auditory and tactile hallucinations, even in the absence of adult abuse. Possible psychological and neurobiological pathways from abuse to symptoms are discussed, along with research and clinical implications.Investigating whether child abuse (CA) is related to mental-health problems in adulthood is important theoretically, but also has crucial clinical implications in terms of the accuracy of formulations and the comprehensiveness of treatment planning. The range of adult disorders for which studies seem to indicate that CAor neglect may have a causal role includes: depression, anxiety disorders, post-traumatic stress disorder (PTSD), eating disorders, substance abuse, sexual dysfunction, personality disorders, and dissociative disorders (Beitchman et al

Are psychotic experiences among detained juvenile offenders explained by trauma and substance use?

“…While most research has focused on the impact of abuse (Bernstein et al, 2003), the current study indicates that screening for a history of emotional and physical neglect may be important because the outcomes associated with neglect may differ from those associated with abuse. The current study could not replicate the often reported relationship between physical/sexual abuse and psychotic symptomatology (Read et al, 2003;Shevlin et al, 2007), possibly due to the low prevalence rates or underreporting of these types of abuse in the current sample (Cohen et al, 1996).…”

“…Support for this theory stems from a recent study that found that negative schematic beliefs about others are particularly associated with paranoia-related symptoms (Gracie et al, 2007). However, because mapping the relationship between specific types of abuse/neglect and specific types of psychotic experiences is still in its infancy, further research is warranted (Kilcommons and Morrison, 2005;Read et al, 2003). In addition, further investigation on this type of maltreatment is warranted because emotional abuse may have more damaging effects than sexual or physical abuse (Chapman et al, 2004;Kaplan et al, 1999).…”

Destigmatising schizophrenia: does changing terminology reduce negative attitudes?

“…An alternative approach is to associate schizophrenia with evidence from psychosocial research which has found that trauma (Read et al, 2003), hallucinogenic drug use (Hall, 2006) and stress-sensitivity (Myin-Germeys et al, 2005) are significant risk factors. Approaches using cognitive therapy have found such associations valuable in directing formulation-based therapeutic interventions (Kingdon & Turkington, 2005).…”

Affective Politics, Debility and Hearing Voices: Towards a Feminist Politics of Ordinary Suffering

“…Women who hear voices and have a history of childhood and/ or adult sexual victimization [a common combination; (101)] are likely to suffer a threefold prejudice against testimony given by them. First, sexism has led to the testimony of women historically being viewed with suspicion in the legal realm (102).…”