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Childhood trauma and cognitive biases associated with psychosis: A systematic review and meta-analysis

Croft, Jazz, Martin, David, Madley-Dowd, Paul, Strelchuk, Daniela, Davies, Jonathan, Heron, Jon, Teufel, Christoph and Zammit, Stanley 2021. Childhood trauma and cognitive biases associated with psychosis: A systematic review and meta-analysis. PLoS ONE 16 (2) , e0246948. 10.1371/journal.pone.0246948

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Abstract

Childhood trauma is associated with an increased risk of psychosis, but the mechanisms that mediate this relationship are unknown. Exposure to trauma has been hypothesised to lead to cognitive biases that might have causal effects on psychotic symptoms. The literature on whether childhood trauma is associated with psychosis-related cognitive biases has not been comprehensively reviewed. A systematic review and meta-analysis or narrative synthesis of studies examining the association between childhood trauma and the following biases: external locus of control (LOC), external attribution, probabilistic reasoning, source monitoring, top-down processing, and bias against disconfirmatory evidence. Studies were assessed for quality, and sources of heterogeneity were explored. We included 25 studies from 3,465 studies identified. Individuals exposed to childhood trauma reported a more external LOC (14 studies: SMD Median = 0.40, Interquartile range 0.07 to 0.52), consistent with a narrative synthesis of 11 other studies of LOC. There was substantial heterogeneity in the meta-analysis (I2 = 93%) not explained by study characteristics examined. Narrative syntheses for other biases showed weaker, or no evidence of association with trauma. The quality of included studies was generally low. Our review provides some evidence of an association between childhood trauma and a more external LOC, but not with the other biases examined. The low quality and paucity of studies for most of the cognitive biases examined highlights the need for more rigorous studies to determine which biases occur after trauma, and whether they mediate an effect of childhood trauma on psychosis.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Medicine
Cardiff University Brain Research Imaging Centre (CUBRIC)
Additional Information: This is an open access article distributed under the terms of the Creative Commons Attribution License
Publisher: Public Library of Science
ISSN: 1932-6203
Date of First Compliant Deposit: 5 March 2021
Date of Acceptance: 28 January 2021
Last Modified: 08 Mar 2021 10:30
URI: http://orca.cardiff.ac.uk/id/eprint/139323

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