TY - JOUR

T1 - Dissociation mediates the relationship between childhood trauma and hallucination-proneness

AU - Varese, F.

AU - Barkus, E.

AU - Bentall, R. P.

PY - 2012/5

Y1 - 2012/5

N2 - Background. It has been proposed that the relationship between childhood trauma and hallucinations can be explained by dissociative processes. The present study examined whether the effect of childhood trauma on hallucination-proneness is mediated by dissociative tendencies. In addition, the influence of dissociative symptoms on a cognitive process believed to underlie hallucinatory experiences (i.e. reality discrimination; the capacity to discriminate between internal and external cognitive events) was also investigated.Method. Patients with schizophrenia spectrum disorders (n=45) and healthy controls (with no history of hallucinations; n=20) completed questionnaire measures of hallucination-proneness, dissociative tendencies and childhood trauma, as well as performing an auditory signal detection task.Results. Compared to both healthy and non-hallucinating clinical controls, hallucinating patients reported both significantly higher dissociative tendencies and childhood sexual abuse. Dissociation positively mediated the effect of childhood trauma on hallucination-proneness. This mediational role was particularly robust for sexual abuse over other types of trauma. Signal detection abnormalities were evident in hallucinating patients and patients with a history of hallucinations, but were not associated with pathological dissociative symptoms.Conclusions. These results are consistent with dissociative accounts of the trauma-hallucinations link. Dissociation, however, does not affect reality discrimination. Future research should examine whether other cognitive processes associated with both dissociative states and hallucinations (e. g. deficits in cognitive inhibition) may explain the relationship between dissociation and hallucinatory experiences.

AB - Background. It has been proposed that the relationship between childhood trauma and hallucinations can be explained by dissociative processes. The present study examined whether the effect of childhood trauma on hallucination-proneness is mediated by dissociative tendencies. In addition, the influence of dissociative symptoms on a cognitive process believed to underlie hallucinatory experiences (i.e. reality discrimination; the capacity to discriminate between internal and external cognitive events) was also investigated.Method. Patients with schizophrenia spectrum disorders (n=45) and healthy controls (with no history of hallucinations; n=20) completed questionnaire measures of hallucination-proneness, dissociative tendencies and childhood trauma, as well as performing an auditory signal detection task.Results. Compared to both healthy and non-hallucinating clinical controls, hallucinating patients reported both significantly higher dissociative tendencies and childhood sexual abuse. Dissociation positively mediated the effect of childhood trauma on hallucination-proneness. This mediational role was particularly robust for sexual abuse over other types of trauma. Signal detection abnormalities were evident in hallucinating patients and patients with a history of hallucinations, but were not associated with pathological dissociative symptoms.Conclusions. These results are consistent with dissociative accounts of the trauma-hallucinations link. Dissociation, however, does not affect reality discrimination. Future research should examine whether other cognitive processes associated with both dissociative states and hallucinations (e. g. deficits in cognitive inhibition) may explain the relationship between dissociation and hallucinatory experiences.

KW - Dissociation

KW - hallucinations

KW - psychosis

KW - signal detection

KW - trauma

KW - AUDITORY VERBAL HALLUCINATIONS

KW - NEGATIVE SYNDROME SCALE

KW - PSYCHOTIC SYMPTOMS

KW - THOUGHT-DISORDER

KW - COMMUNITY SAMPLE

KW - HEARING VOICES

KW - SCHIZOPHRENIA

KW - EXPERIENCES

KW - ABUSE

KW - RELIABILITY

U2 - 10.1017/S0033291711001826

DO - 10.1017/S0033291711001826

M3 - Journal article

VL - 42

SP - 1025

EP - 1036

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 5

ER -