Childhood Trauma in People with Psychosis: Implications for Emotion Awareness and Regulation.

Background: Emotion awareness and regulation (EAR) are critical for effective social functioning. Individuals with psychosis display ineffective EAR, contributing substantially to poor functional outcomes. Reports in non-clinical and other clinical populations have linked childhood trauma to poor EAR. However, limited information is available about the developmental origins of EAR in people with psychosis. Methods: We investigated the links between childhood trauma and EAR in 90 individuals with psychosis. Results: Ninety-one percent of the participants reported childhood trauma: 40.0% emotional abuse, 35.6% physical abuse, 21.1% sexual abuse, 46.7% emotional neglect, and 40.0% physical neglect. Higher degree of childhood trauma predicted greater difficulties in identifying and describing feelings in adulthood. Specifically, emotional abuse significantly predicted difficulties identifying feelings (β=0.48; 22% of the variance) and describing feelings (β=0.38; 23% of the variance). Notably, being female was associated with fewer difficulties describing feelings. Physical abuse, sexual abuse, and emotional and physical neglect were not significant predictors of EAR. For emotional regulation, models predicting use of suppression and cognitive reappraisal yielded trending results and no significance, respectively. Discussion: The findings highlight the critical role of childhood trauma in shaping EAR in individuals with psychosis. The authors discuss the findings' clinical, functional, and therapeutic implications.