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Post-Traumatic Symptomatology and Compulsions as Potential Mediators of the Relation Between Child Sexual Abuse and Auditory Verbal Hallucinations

Published online by Cambridge University Press:  09 November 2017

Simon McCarthy-Jones Open the ORCID record for Simon McCarthy-Jones [Opens in a new window]
Simon McCarthy-Jones*
Affiliation:
Department of Psychiatry, Trinity College Dublin, Ireland
*
Address for correspondence: Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland. E-mail: s.mccarthyjones@gmail.com
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Abstract

Background: Whilst evidence is mounting that childhood sexual abuse (CSA) can be a cause of auditory verbal hallucinations (AVH), it is unclear what factors mediate this relation. Recent evidence suggests that post-traumatic symptomatology may mediate the CSA–AVH relation in clinical populations, although this hypothesis has not yet been tested in the general population. There is also reason to believe that obsessive ideation could mediate the CSA–AVH relation. Aims: To test for evidence to falsify the hypotheses that post-traumatic symptomatology, obsessions, compulsions, anxiety and depression mediate the relation between CSA and AVH in a general population sample. Method: Indirect effects of CSA on AVH via potential mediators were tested for, using a regression-based approach employing data from the 2007 Adult Psychiatric Morbidity Survey (n = 5788). Results: After controlling for demographics, IQ and child physical abuse, it was found that CSA, IQ, post-traumatic symptomatology and compulsions predicted lifetime experience of AVH. Mediation analyses found significant indirect effects of CSA on AVH via post-traumatic symptomatology [odds ratio (OR): 1.11; 95% confidence interval (CI):1.00–1.29] and compulsions (OR: 1.10, 95% CI: 1.01–1.28). Conclusions: These findings offer further support for the hypothesis that post-traumatic symptomatology is a mediator of the CSA–AVH relation. Although no evidence was found for obsessional thoughts as a mediating variable, a potential mediating role for compulsions is theoretically intriguing. This study's findings reiterate the need to ask about experiences of childhood adversity and post-traumatic symptomology in people with AVH, as well as the likely therapeutic importance of trauma-informed and trauma-based interventions for this population.

Keywords

child abusepsychosisrapeschizophreniatraumavoice-hearing
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 3 , May 2018 , pp. 318 - 331
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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