ArticlePsychological medicine2025
The role of trauma, attachment, and voice-hearer's appraisals: a latent profile analysis in the AVATAR2 trial.
Article in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Correlates of Compliance, Appeasement and Resistance in Command Hallucinations: A Systematic Review.Clinical psychology & psychotherapyPooled it
- Psychological and behavioral mechanisms linking childhood trauma profiles to voice-related distress in schizophrenia spectrum disorders: latent class, mediation, and conditional process analyses.Psychological medicine · 2026Article
- Heterogeneity of differential atmosphere perception and its relationship with organizational silence among Chinese nurses: a cross-sectional study using latent profile analysis.Frontiers in psychology · 2025Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundThere is evidence that attachment, trauma, and voice appraisals individually impact voice hearing in psychosis, but their intersectional relationship has not been examined. The aim of this study was to identify subgroups of individuals from the intersectional relationship between these factors and examine differences between subgroups on clinical outcomes.
methodsA latent profile analysis was conducted on baseline data from the AVATAR2 trial (
resultsFour profiles were identified: 'adverse voices and relational trauma', 'low malevolent and omnipotent voices', 'adverse voices yet low relational trauma', and 'high benevolent voices'. Negative voice appraisals occurred in the presence of high and low trauma and attachment adversities. The first profile was associated with being female and/or other non-male genders and had worse voice severity and emotional distress. High adversities and worse emotional distress occurred in the presence of voice benevolence and engagement. Black and South Asian ethnicities were not associated with specific profiles.
conclusionsThe identified profiles had negative and positive voice appraisals associated with higher and lower occurrence of adversities, and different clinical outcomes. These profiles could inform detailed case formulations that could tailor interventions for voice hearers.
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