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PTSD as a mediator of the relationship between trauma and psychotic experiences

Strelchuk, Daniela, Hammerton, Gemma, Wiles, Nicola, Croft, Jazz, Turner, Katrina, Heron, Jonathan and Zammit, Stanley 2020. PTSD as a mediator of the relationship between trauma and psychotic experiences. Psychological Medicine 10.1017/S0033291720004821

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Background Traumatic experiences are associated with a higher risk of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. This study aims to examine whether post-traumatic stress disorder (PTSD) symptoms mediate the relationship between trauma and psychotic experiences (PEs). Methods We used data from the Avon Longitudinal Study of Parents and Children to examine whether: PTSD symptoms mediate the relationships between (a) childhood trauma and adolescent PEs (study of adolescent PEs; n = 2952), and (b) childhood/adolescent trauma and PEs in early adulthood (study of adult PEs; n = 2492). We examined associations between variables using logistic regression, and mediation using the parametric g-computation formula. Results Exposure to trauma was associated with increased odds of PEs (adolescent PEs: ORadjusted 1.48, 95% CI 1.23–1.78; adult PEs: ORadjusted 1.57, 95% CI 1.25–1.98) and PTSD symptoms (adolescent PTSD: ORadjusted 1.59, 95% CI 1.31–1.93; adult PTSD: ORadjusted 1.50, 95% CI 1.36–1.65). The association between PTSD symptoms and PE was stronger in adolescence (ORadjusted 4.63, 95% CI 2.34–9.17) than in adulthood (ORadjusted 1.62, 95% CI 0.80–3.25). There was some evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent PEs (proportion mediated 14%), though evidence of mediation was weaker for adult PEs (proportion mediated 8%). Conclusions These findings are consistent with the hypothesis that PTSD symptoms partly mediate the association between trauma exposure and PEs. Targeting PTSD symptoms might help prevent the onset of psychotic outcomes.

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Medicine
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (
Publisher: Cambridge University Press
ISSN: 0033-2917
Date of First Compliant Deposit: 15 December 2020
Date of Acceptance: 16 November 2020
Last Modified: 16 Dec 2020 10:45

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