Evidence map›Paper›PMID 27460616›Full record

Trial reportSchizophrenia bulletin2016

Psychological Mechanisms Mediating Effects Between Trauma and Psychotic Symptoms: The Role of Affect Regulation, Intrusive Trauma Memory, Beliefs, and Depression.

Amy Hardy, Richard Emsley, Daniel Freeman, Paul Bebbington, Philippa A Garety, Elizabeth E Kuipers, Graham Dunn, David Fowler

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia bulletin, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 5 pooled it
21.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 5 syntheses or guidelines pooled it, 155 citations in OpenAlex.

  1. Pooled it
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  15. Trauma, personality structure and psychopathology: a cartography of psychodynamic constructs.Borderline personality disorder and emotion dysregulation · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Amy HardyDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; amy.hardy@kcl.ac.uk.
Richard EmsleyCentre for Biostatistics, University of Manchester, Manchester, UK;
Daniel FreemanDepartment of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK;
Paul BebbingtonUCL Mental Health Sciences Unit, University College London, London, UK;
Philippa A GaretyDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK;
Elizabeth E KuipersDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK;
Graham DunnCentre for Biostatistics, University of Manchester, Manchester, UK;
David FowlerSchool of Psychology, University of Sussex, Brighton, UK.
King's College London · GBUniversity of Manchester · GBSouth London and Maudsley NHS Foundation Trust · GBUniversity College London · GBUniversity of Sussex · GBWarneford Hospital · GB

Funding

Department of Health RP-2014-05-003Wellcome Trust 062452
6 · The paper itself

Abstract

Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis.

Indexed as

AdultAdult Survivors of Child AbuseAffectComorbidityDelusionsDepressionFemaleHallucinationsHumansMaleMemory, EpisodicMiddle AgedPsychological TraumaPsychotic DisordersRecurrenceStress Disorders, Post-Traumaticavoidancehyperarousalpsychosisreexperiencingschemavictimization

Identifiers

PMID27460616
PMCPMC4960432
OpenAlexW2505658750

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.