The interplay between childhood trauma, cognitive biases, psychotic-like experiences and depression and their additive impact on predicting lifetime suicidal behavior in young adults

Abstract

BackgroundChildhood trauma, psychosis risk, cognition, and depression have been identified as important risk markers for suicidal behaviors. However, little is known about the interplay between these distal and proximal markers in influencing the risk of suicide. We aim to investigate the interplay between childhood trauma, cognitive biases, psychotic-like experiences (PLEs) and depression in predicting suicidal behaviors in a non-clinical sample of young adults.MethodsIn total, 3495 young adults were recruited to an online computer-assisted web interview. We used the Prodromal Questionnaire to assess PLEs. Childhood trauma was assessed with the Traumatic Experience Checklist (three items) and Childhood Experience of Care and Abuse Questionnaire (CECA.Q, three items). Cognitive biases were assessed with a short version of the Davos Assessment of Cognitive Biases Scale. Suicidality, psychiatric diagnoses, and substance use were screened with a self-report questionnaire.ResultsChildhood trauma, as well as PLEs, was associated with an approximately five-fold increased risk of suicidal thoughts and plans as well as suicide attempts. Participants with depression were six times more likely to endorse suicidal behaviors. Path analysis revealed that PLEs, depression and cognitive biases are significant mediators of the relationship between trauma and suicidal behaviors. The model explained 44.6% of the variance in lifetime suicidality.ConclusionsCognitive biases, PLEs, and depression partially mediate the relationship between childhood trauma and suicidal behaviors. The interplay between distal and proximal markers should be recognized and become part of clinical screening and therapeutic strategies for preventing risk of suicidality.

The interplay between childhood trauma, cognitive biases, and cannabis use on the risk of psychosis in nonclinical young adults in Poland

“…We assessed emotional abuse, emotional neglect, and bullying with three items from the TEC, while sexual harassment and sexual abuse were assessed by three items from the CECA.Q. A detailed description of selected items was provided elsewhere [5]. Sample questions from the TEC are: "When you were a child or a teenager, have you ever felt emotionally neglected (e.g., being left alone, insufficient affection) by your parents, brothers, or sisters?"…”

“…We included two subscales that assess attention to threat biases (items 6, 7, 24, and 29) and safety behaviors-behavioral coping strategies (items 27, 31, 33, 34, and 35). These subscales have been proven to be best predictors of psychosis risk (for more detailed information about the chosen items see [5]). Sample questions from the DACOBS-18 are: "People cannot be trusted," "Things went wrong in my life because of other people," "People make my life miserable," "People treat me badly for no reason," "People I do not know are dangerous," or "I do not go out after dark," "I do not answer phone calls, to be on the safe side," "I always sit near the exit to be safe," "I do not answer phone calls, to be on the safe side," "There is usually only one explanation for a single event."…”

“…PLEs have been found to occur in 5-8% of nonclinical populations [2]. They have been associated with impairments in functioning [3], help-seeking behaviors [3,4], psychiatric diagnoses [3,4], self-harm thoughts and behaviors [5,6], as well as increased suicidality [3,7]. Moreover, PLEs have been linked to risk for developing a psychotic disorder and with many of the same risk factors as psychotic disorder, such as exposure to traumatic life events or cannabis use [2].…”

Prevalence, dimensionality and clinical relevance of self‐disturbances and psychotic‐like experiences in Polish young adults: a latent class analysis approach.

“…There is a growing body of research indicating that SD are present not only in schizophrenia patients (Kean, 2009;Kean, 2010;Saks, 2007), but also in people who are at high clinical risk for psychosis (Davidsen, 2009;Nelson, Thompson, & Yung, 2012) and, in substantially attenuated form, in the non-clinical population (Gaweda et al, 2019a;Gaweda et al, 2019b;Koren, Lacoua, Rothschild-Yakar, & Parnas, 2016;Torbet, Schulze, Fiedler, & Reuter, 2015). They may also appear, but to a reduced degree, in other clinical populations such as panic disorder (Madeira et al, 2017) and depersonalisation disorder (Sass, Pienkos, Nelson, & Medford, 2013).…”

ResilienCity: Resilience and Psychotic-Like Experiences 10 Years After L’Aquila Earthquake

“…iPQ-16 is a 16items self-report instrument that explores the presence/absence of 16 PLEs, including perceptual aberrations/hallucinations, unusual thought content/delusions, and two negative symptoms, and their associated psychological distress score on a four-point likert scale ranging from 0 to 48. Although the iPQ-16 was originally designed as a screening tool for individuals at Ultra-High Risk in help-seeking populations, several studies have used this instrument in non-help-seeking samples as a measure of PLEs (15,(23)(24)(25). We used the distress scale as recommended by Savill et al, (26) for non-help-seeking populations, using a cut-off of ≥11 as recommended by Pelizza et al (27) according to the Italian field test.…”