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Psychosocial pathways between adversity and psychosis

Research output: ThesisDoctoral Thesis

  • Josie Pearce
Publication date2016
Number of pages205
Awarding Institution
  • Lancaster University
<mark>Original language</mark>English


Meta-analytic evidence suggests that adverse experiences contribute to the development of psychosis, including paranoia and hearing voices. These adverse experiences include childhood trauma (such as physical, emotional and sexual abuse) as well as experiences such as neglect, social inequality and poverty. One adverse experience that has received less attention is discrimination. Firstly, this thesis examines and synthesises the empirical literature that has linked psychosis to discrimination related to minority group status (for example, being victimised as a result of one’s gender, ethnicity or sexual orientation). The review highlights the importance of future research utilising stronger methodological designs to help clarify the findings, however results indicate that discrimination appears to be associated with an increase in severity and incidence of psychosis, particularly in non-help seeking participants.
The second aim of this thesis was to examine psychological mechanisms that may mediate the associations between adversity and specific experiences of psychosis. For example, dissociation has been found to mediate the relationship between adversity and voices, whereas insecure attachment to mediate the relationship between adversity and paranoia. Other researchers have challenged this specificity and proposed that certain attachment styles, for example fearful attachment, might be implicated in both paranoia and voices. Therefore, using an online survey with 112 participants self-reporting psychosis, correlation and mediation analyses were conducted to examine the role of dissociation and attachment in the relationships between trauma in childhood, paranoia and voices. Findings indicate that dissociation, but not insecure attachment, mediates the relationship between trauma and voices, whereas both attachment and dissociation mediate the link between trauma and paranoia.