Routes to psychotic symptoms: trauma, anxiety and psychosis-like experiences

A social factor that has gained recent attention in understanding psychosis is trauma. In the current study the association of a history of trauma with persecutory ideation and verbal hallucinations was tested in the general public. Further, putative mediation variables including anxiety, depression and illicit drug use were examined. In a cross-sectional study, 200 members of the UK general public completed self-report questionnaires. A history of trauma was significantly associated with both persecutory ideation and hallucinations. Severe childhood sexual abuse and non-victimization events were particularly associated with psychotic-like experiences. The association of trauma and paranoia was explained by levels of anxiety. The association of trauma and hallucinations was not explained by the mediational variables. The study indicates that trauma may impact non-specifically on delusions via affect but that adverse events may work via a different route in the occurrence of hallucinatory experience. These ideas require tests in longitudinal designs.