Trauma and social pathways to psychosis: Examining the role of attachment, social rank and dissociation in a clinical sample.

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Shelley Grady, Niall Crowley, Seamus Scott, Charles Ifegwu Ndukwe, Rebecca Donohoe, Keith Gaynor
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Abstract

Objectives: The trauma and social pathways model of psychosis proposes interactions between trauma, attachment, social rank and dissociation in pathways to psychosis, though this model has yet to be empirically investigated. The primary aim of this study was to examine the overall predictive value of the trauma and social pathways model using regression analysis. A secondary aim was to delineate hypothesized pathways between trauma and positive symptoms of psychosis using serial mediation analysis.

Method: This was a cross-sectional study of people attending mental health services for a psychosis-related diagnosis (N = 71). Measures of trauma, positive symptoms of psychosis, attachment, social comparison and dissociation were completed.

Results: A model of recurrent trauma, insecure attachment, social rank and dissociation predicted 23.2% of the variance in positive symptoms of psychosis. Recurrent trauma, attachment and dissociation contributed significantly to the model, while social rank did not. Further, serial mediation analysis indicated that the sequence of disorganized attachment and dissociation fully mediated the relationship between recurrent trauma and positive symptoms.

Conclusions: Results provide preliminary support for the trauma and social pathways model of psychosis, specifically as it relates to recurrent trauma, insecure attachment and dissociation. Results did not support the social rank component of this model, however. These findings provide clear targets for the development of next-wave psychological interventions that focus on trauma-related variables in psychosis. Future studies should replicate these findings with a larger clinical sample, and consider a measure of shame to further elucidate social processes in pathways to psychosis.

创伤和精神病的社会途径:在临床样本中研究依恋、社会等级和分离的作用。
目的:精神病的创伤和社会途径模型提出了创伤、依恋、社会等级和解离在精神病发病途径中的相互作用,但这一模型尚未得到实证研究。本研究的主要目的是通过回归分析来检验创伤和社会路径模型的总体预测价值。次要目的是利用序列中介分析法来界定创伤与精神病阳性症状之间的假设路径:这是一项横断面研究,研究对象是因精神病相关诊断而接受精神健康服务的人(N = 71)。研究人员完成了对创伤、精神病阳性症状、依恋、社会比较和分离的测量:一个由反复出现的创伤、不安全依恋、社会等级和分离组成的模型预测了 23.2% 的精神病阳性症状变异。反复出现的创伤、依恋和解离对该模型有显著贡献,而社会等级则没有。此外,序列中介分析表明,无序依恋和解离的序列完全中介了复发性创伤和阳性症状之间的关系:结论:研究结果初步支持了精神病的创伤和社会路径模型,特别是与反复创伤、不安全依恋和解离有关的部分。然而,研究结果并不支持该模式中的社会等级部分。这些发现为下一轮心理干预措施的开发提供了明确的目标,即关注精神病中与创伤相关的变量。未来的研究应该在更大的临床样本中重复这些发现,并考虑采用羞耻感的测量方法,以进一步阐明精神病发病途径中的社会过程。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
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