Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control
Open accessAbstract
Objective: Exposure to early trauma may increase the risk of dysfunctional responses to anomalous psychotic experiences resulting in psychotic symptom formation. Method: In a three‐wave longitudinal general population study, 4045 never‐psychotic individuals exposed and non‐exposed to trauma before the age of 16 years, according to baseline interview were interviewed for the onset of psychotic experiences 3 years later (T2). In 36 individuals with incident psychosis at T2, assessments were made, for each psychotic experience, of i) the amount of distress associated with and ii) the degree of coping and subjective control over the experience. Results: In the 16 observations of an incident psychotic experience, in the absence of distress, the baseline rate of early trauma was low (6%), whereas it was much higher in the 21 observations of an incident psychotic experience with distress [43%; odds ratio = 10.0, 95% confidence interval (CI): 1.04, 96.3; P = 0.046]. Similarly, coping attempts in the context of early trauma was associated with less control (reduction of 2 points on a seven‐point scale, 95% CI: −4.0, −0.07). Conclusion: Early experience of trauma may create lasting cognitive and affective vulnerabilities to develop clinical symptoms arising out of early, non‐clinical psychotic experiences.
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Psychosis itself can function as an adverse event for individuals with psychotic disorders.
“several studies have suggested that psychosis itself can function as an AE for individuals with PDs [5–8], resulting in similarly poor outcomes.”
From Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial (2024) · cites this paper as [7]
The Introduction and Trauma and distress sections examine whether early trauma is associated with distress during psychotic experiences in a general-population sample. They do not say that psychosis itself functions as an adverse event for people with psychotic disorders or that it leads to similarly poor outcomes. I searched for psychosis as a traumatic or adverse event and for outcomes attributed to it. (LLM, conf=0.73)
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“In addition, exposure to early trauma predisposes individuals to experience more emotional distress in association with psychotic experiences and reduced perceived control over these experiences (Bak et al., 2005).”
BackgroundAuditory hallucinations in childhood: associations with adversity and delusional ideation
Bartels‐Velthuis, A. A., van de Willige, G., Jenner, J. A., Wiersma, D., & van Os, J. (2011) · Psychological Medicine · doi:10.1017/s0033291711001590 · Cited by 40 · see citing works
“These findings concur with previous work, showing that exposure to adversity affects distress and locus of control associated with psychotic experiences (Bak et al. 2005), and work indicating that greater level of adversity and T ab le 3.”
ResultPsychosis risk as a function of age at onset
Köhler, S., van Os, J., de Graaf, R., Vollebergh, W., Verhey, F. R. J., & A, L. K. M. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0171-6 · Cited by 37 · see citing works
“Main effects of risk factors on the broad psychosis outcome in NEMESIS have been described in other reports [4, 21, 30, 34, 35, 62, 66].”
BackgroundSelf-citationSevere childhood trauma and clinical and neurocognitive features in schizotypal personality disorder
Velikonja, T., Velthorst, E., McClure, M. M., Rutter, S., Calabrese, W. R., Rosell, D., Koenigsberg, H. W., Goodman, M., New, A. S., Hazlett, E. A., et al. (2019) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13032 · Cited by 38 · see citing works
“Childhood traumatic experiences can also contribute to the appraisals of psychological, perceptual, or bodily experiences as being more powerful (78) or outside the individual’s control (79).”
BackgroundChildhood trauma and substance use underlying psychosis: a systematic review
Setién‐Suero, E., Suárez‐Pinilla, P., Ferro, A., Tabarés‐Seisdedos, R., Crespo‐Facorro, B., & Ayesa‐Arriola, R. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1748342 · Cited by 36 · see citing works
“Whereas an early risk factor may be related to neurodevelopmental disturbances, such as structural and neurochemical abnormalities in the brain (Bak et al., 2005; Ucok et al., 2007), subsequent environmental risk factors acting later may be considered not only as potential aetiological risk factors…”
BackgroundAre psychotic experiences among detained juvenile offenders explained by trauma and substance use?
Colins, O. F., Vermeiren, R. R. J. M., Vreugdenhil, C., Schuyten, G., Broekaert, E., & Krabbendam, A. A. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.08.013 · Cited by 34 · see citing works
Emotional Abuse and Psychosis: A Recent Review of the Literature
Ackner, S., Skeate, A., Patterson, P. H., & Neal, A. (2013) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2013.837132 · Cited by 33 · see citing works
“They employed a NEMESIS questionnaire within an interview format (Bak et al., 2005) and found that EA was considerably more prevalent in the schizophrenia sample, at 17.”
BackgroundMethodResultInfluentialSchizophrenia and Psychosocial Stresses
Bebbington, P., & Kuipers, E. (2003) · Wiley eBooks · doi:10.1002/9780470987353.ch31 · Cited by 33 · see citing works
Childhood trauma as a risk factor for psychosis: A sib-pair study
Barrigón, M. L., DÍAZ, F. J., Manuel Gurpegui, A., Ferrín, M., Salcedo, M. D., Moreno-Granados, J. M., Cervilla, J. A., & Ruíz-Veguilla, M. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.08.017 · Cited by 31 · see citing works
“This dichotomous definition was used before by both Janssen et al. (2004) and Bak et al. (2005), and we used this definition to allow comparison across studies.”
InfluentialPfeifer, S., van Os, J., Hanssen, M., Delespaul, P., & A, L. K. M. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn004 · Cited by 31 · see citing works
“The fact that the liability measured with the CFQ is individual specific rather than shared with relatives in the same family suggests that this aspect of metacognition is associated with individual-level environmental exposures such as developmental trauma.(49,52)”
BackgroundMultiple measures of HPA axis function in ultra high risk and first-episode schizophrenia patients
Nordholm, D., Rostrup, E., Mondelli, V., Randers, L., Nielsen, M. Ø., Wulff, S., Nørbak-Emig, H., Broberg, B. V., Krakauer, K., Dazzan, P., et al. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.03.015 · Cited by 30 · see citing works
“described, life events might enhance the risk of developing psychosis and studies show that there is a significant association between the two (Bak et al., 2005;Rubino et al., 2009), but the direction of causality cannot be inferred and the high levels of perceived stress and life events may partially be due to recall…”
Backgroundvan Zelst, C. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn113 · Cited by 30 · see citing works
Shevlin, M. E., McAnee, G., Bentall, R. P., & Murphy, J. (2014) · Psychosis · doi:10.1080/17522439.2014.980308 · Cited by 29 · see citing works
“Importantly, attributional bias disturbances have also frequently been identified in relation to each of the paranoia linked adversities in the current model (Bak et al., 2005).”
BackgroundBelli, S. R. (2009) · Personality and Individual Differences · doi:10.1016/j.paid.2009.01.016 · Cited by 28 · see citing works
Daily stressor sensitivity, abuse effects, and cocaine use in cocaine dependence
Waldrop, A. E., Back, S. E., Brady, K. T., Upadhyaya, H. P., McRae‐Clark, A. L., & Saladin, M. E. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.07.006 · Cited by 28 · see citing works
“In fact, early experience of trauma may create lasting cognitive and affective vulnerabilities to develop a variety of severe clinical symptoms (Bak et al., 2005).”
BackgroundAsking about trauma: the experiences of psychological therapists in early intervention services
Toner, J., Daiches, A., & Larkin, W. (2012) · Psychosis · doi:10.1080/17522439.2012.697484 · Cited by 27 · see citing works
“Failing to ask about abuse is thought to increase distress and prevent appropriate treatment (Bak et al., 2005).”
BackgroundCohen, C. I., Palekar, N., Barker, J., & RAMIREZ, P. M. (2011) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318211817e · Cited by 27 · see citing works
A cognitive behavioural perspective on the relationship between childhood trauma and psychosis
Morrison, A. P. (2009) · Epidemiology and Psychiatric Sciences · doi:10.1017/s1121189x00000245 · Cited by 25 · see citing works
“A large, prospective study of the general population (Bak et al., 2005) found that there is a high prevalence of trauma in people who have psychotic experiences associated with distress, whereas those without distress had a low prevalence of trauma.”
BackgroundChildhood psychological trauma and psychosis
A, L. K. M. (2008) · Psychological Medicine · doi:10.1017/s0033291708002705 · Cited by 23 · see citing works
“Empirical support for this claim comes from the study by Bak et al. (2005) who showed that in individuals with anomalous psychotic-like experiences, prior exposure to trauma in childhood and adolescence was associated with less subjective control over these experiences and greater level of…”
ResultRisk factors at the low end of the psychosis continuum: Much the same as at the upper end?
Wulf Rössler, A., Vetter, S., Müller, M., Gallo, W. T., Haker, H., Kawohl, W., Lupi, G. A., & Ajdacic‐Gross, V. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2011.02.019 · Cited by 23 · see citing works
“Most recent research has focused on traumatic experiences in amore narrow sense, that is, singular severely traumatizing events (Bebbington et al., 2004; Janssen et al., 2004; Bak et al., 2005; Read et al., 2005; Bendall et al., 2008; Shevlin et al., 2008).”
BackgroundBarriers to the early identification and intervention of early psychosis among young rural males
Wilson, R. L., Cruickshank, M., & Lea, J. (2010) · RUNE (Research UNE) · Cited by 22 · see citing works
Childhood adversity and psychosis
Fisher, H. L., & Craig, T. (2008) · Cambridge University Press eBooks · doi:10.1017/cbo9780511544064.007 · Cited by 21 · see citing works
New directions in the conceptualization of psychotic disorders
Kroll, J. (2007) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3282f08759 · Cited by 19 · see citing works
Pfeifer, S., A, L. K. M., Myin‐Germeys, I., Derom, C. A., Wichers, M., Jacobs, N., Thiery, E. W., & van Os, J. (2009) · Psychosis · doi:10.1080/17522430903197384 · Cited by 18 · see citing works
“At the psychological level, exposure to CA may form dysfunctional metacognitive skills which hamper coping with anomalous psychotic-like experiences, increasing the risk for true psychotic symptom formation (Bak et al., 2005).”
BackgroundRössler, W., Angst, J., Gamma, A., Haker, H., Stulz, N., Merikangas, K., & Ajdacic-Gross, V. (2010) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-010-0123-0 · Cited by 18 · see citing works
“Cluster analysis within a subgroup-guided approach [5, 40] remains to be conducted as a next step in order to describe not only the most typical patterns but also subgroups with less frequent patterns.”
BDNF Val66Met and spontaneous dyskinesias in non-clinical psychosis
Mittal, V. A., Smolen, A., Dean, D. J., Pelletier‐Baldelli, A., Lunsford‐Avery, J. R., & Smith, A. K. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.06.018 · Cited by 16 · see citing works
“The base rates, outcome, and precipitating psychological and environmental factors have received a good deal of attention (Janssen et al., 2004; Bak et al., 2005; Scott et al., 2008; Morgan et al., 2009; Nishida et al., 2010; Skinner et al., 2011; Ahmed et al., 2012), and an important next step in progressing this lin…”
BackgroundMillman, Z. B., Weintraub, M. J., Bentley, E., DeVylder, J., Mittal, V. A., Pitts, S. C., Thompson, E., Demro, C., Reeves, G. M., & Schiffman, J. E. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.12.006 · Cited by 16 · see citing works
The effects of childhood trauma in patients with first-episode schizophrenia
Åok, A. (2007) · Cited by 14 · see citing works
Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories
Nixon, B., & Quinlan, E. (2021) · Violence Against Women · doi:10.1177/10778012211014558 · Cited by 12 · see citing works
“, 2001), and thus women may be left to deal with the psychological sequalae of abuse without trauma treatment (Ahrens et al., 2010; Bak et al., 2005; Read et al., 2001, 2005).”
BackgroundFazio, L., Raio, A., Banaschewski, T., Bokde, A. L. W., Desriviéres, S., Flor, H., Garavan, H., Gowland, P., Grigis, A., Heinz, A., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1434470 · Cited by 11 · see citing works
Psychotic experiences in the context of depression: The cumulative role of victimization
Nam, B., Hilimire, M. R., Schiffman, J. E., & DeVylder, J. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.07.023 · Cited by 10 · see citing works
Effects of childhood trauma on facial recognition of fear in psychosis
Brañas, A., Lahera, G., Barrigón, M. L., Canal‐Rivero, M., & Ruíz-Veguilla, M. (2022) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2022.01.001 · Cited by 10 · see citing works
DeVylder, J., Wang, J. S., Oh, H. Y., & Lukens, E. P. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.08.008 · Cited by 9 · see citing works
“Further, many studies do not control for co-occurring post-traumatic stress disorder (PTSD), which commonly produces symptoms resembling psychosis (Bak et al., 2005; Scott et al., 2007; Braakman et al., 2009).”
BackgroundEarly trauma and serious mental illness: what role does spirituality play?
Starnino, V. R., & Sullivan, W. P. (2016) · Mental Health Religion & Culture · doi:10.1080/13674676.2017.1320368 · Cited by 9 · see citing works
“Early trauma is defined here as traumatic experiences that occur in childhood and/or adolescence, prior to, or coinciding with, the onset of serious mental illness (e.g., childhood emotional, physical, and/or sexual abuse; sudden loss of a caregiver; Bak et al., 2005).”
BackgroundInside out : on stereotype awareness, childhood trauma and stigma in psychosis
van Zelst, C. (2014) · doi:10.26481/dis.20141202cz · Cited by 9 · see citing works
Giugliano, M., Contrada, C., Foglia, L., Francese, F., Romanò, R., Iacono, M. D., Fausto, E. D., Esposito, M., Azzara, C., Bilotta, E., et al. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.805435 · Cited by 7 · see citing works
The heritability of delusional‐like experiences
Varghese, D., Wray, N. R., Scott, J. G., Williams, G. M., Najman, J. M., & McGrath, J. J. (2012) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2012.01905.x · Cited by 7 · see citing works
Entre Psychose et Trauma: perspectives psychanalytiques
Söderström, D. (2009) · Psychothérapies · doi:10.3917/psys.093.0145 · Cited by 6 · see citing works
Efectos del trauma infantil en el reconocimiento de la expresión facial de miedo en psicosis
Brañas, A., Lahera, G., Barrigón, M. L., Canal‐Rivero, M., & Ruíz-Veguilla, M. (2019) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2019.01.005 · Cited by 6 · see citing works
Enduring Effects of Early Life Traumas on Adult Suicidal Ideation
Yıldız, M., Orak, U., & Aydogdu, R. (2022) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-022-00482-1 · Cited by 8 · see citing works
“, 2005) and with early life trauma (Bak et al., 2005; Shaw & Krause, 2002).”
BackgroundCheng, P., Liu, Z., Sun, M., Zhang, W., Guo, R., Hu, A., & Long, Y. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.180 · Cited by 5 · see citing works
Fonseca‐Pedrero, E., Pérez‐Albéniz, A., Sierra, J. O., & Inchausti, F. (2021) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.26916 · Cited by 5 · see citing works
Trauma Exposure, Schizophrenia Symptoms, and the Stress Vulnerability Model
Fleming, M. P., & Martin, C. R. (2016) · Springer eBooks · doi:10.1007/978-3-319-08359-9_40 · Cited by 5 · see citing works
Trauma and First‐Episode Psychosis
Bernard, M. M., Jackson, C., & Patterson, P. H. (2010) · doi:10.1002/9781444318814.ch19 · Cited by 5 · see citing works
Psychotherapies for the Psychoses
Shyu, T. (2009) · Journal of Mental Health · doi:10.1080/09638230902946858 · Cited by 5 · see citing works
Schizophrenia and Psychosocial Stresses
Bebbington, P., & Kuipers, E. (2010) · Wiley eBooks · doi:10.1002/9781444327298.ch29 · Cited by 6 · see citing works
Saavedra, J. (2009) · Salud Colectiva · doi:10.18294/sc.2009.262 · Cited by 4 · see citing works
Kapfhammer, H. (2012) · Neuropsychiatrie · doi:10.1007/s40211-012-0031-9 · Cited by 4 · see citing works
Cannabis and Psychosis: A Review of the Risk Factors Involved
Amar, M. B. (2020) · American Journal of Plant Sciences · doi:10.4236/ajps.2020.1112139 · Cited by 3 · see citing works
“A vast body of scientific literature suggests that the experience of childhood trauma, physical or psychological, including bullying and sexual abuse, is a risk factor for the development of schizophrenia [119] [120] [128] [129] [130] [131] [132] or psychotic symptoms [70] [72] [75] [77] [84] [133]-[141].”
BackgroundYou, Z., You, R., Zheng, J., Wang, X., Zhang, F., Li, X., & Zhang, L. (2024) · Current Psychology · doi:10.1007/s12144-024-06421-7 · Cited by 2 · see citing works
“Moreover, a growing body of scholarly inquiry reveals that individuals who report childhood trauma also demonstrate lower levels of perceived control compared to those without such experiences (Bak et al., 2005 ; He et al., 2018).”
MENTAL HEALTH: YOUNG PEOPLE'S KNOWLEDGE, BELIEFS, ATTITUDES AND WISHES
Webster, A. M. (2015) · University of Birmingham Institutional Research Archive (University of Birmingham) · Cited by 2 · see citing works
Adolescent egocentrism and psychosis
Harvey, A. M. (2013) · University of Birmingham Institutional Research Archive (University of Birmingham) · Cited by 2 · see citing works
Mapplebeck, C. (2010) · Nottingham ePrints (University of Nottingham) · Cited by 1 · see citing works
Patterson, V. C., Tibbo, P. G., Stewart, S. H., Town, J., Crocker, C. E., Ursuliak, Z., Lee, S., Morrison, J., Abidi, S., Dempster, K., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06050-1 · Cited by 1 · see citing works
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Trauma Exposure, Schizophrenia Symptoms and the Stress Vulnerability Model
Fleming, M. P., & Martin, C. R. (2015) · Springer eBooks · doi:10.1007/978-3-319-08613-2_40-1 · Cited by 1 · see citing works
Saavedra, J. (2009) · Salud Colectiva · doi:10.1590/s1851-82652009000200006 · Cited by 1 · see citing works
“Otro grupo de investigadores (27,28) consideran que las experiencias traumáticas provocan importantes distorsiones cognitivas y perceptivas, esquemas cognitivos distorsionados sobre uno mismo y el mundo, además de problemas en la adquisición de habilidades sociales necesarias para el contacto personal.”
BackgroundThe hallucinatory-delusional state : a crucial connection in the psychosis symptom network
Smeets, F. (2014) · doi:10.26481/dis.20140502fs · Cited by 1 · see citing works
The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences
Isaac, K. S. (2017) · CUNY Academic Works (City University of New York) · Cited by 1 · see citing works
Bradbury, D. A. (2026) · e-space (Manchester Metropolitan University) · doi:10.83056/mmu.32434503 · Cited by 1 · see citing works
- Authors
- Bak, M., Krabbendam, L., Janssen, I., de Graaf, R., Vollebergh, W., & van Os, J.
- Affiliations
- Maastricht University (NL)
- Trimbos Institute (NL)
- Corresponding author
- Bak, M.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2005-10-12
- Volume
- 112
- Issue
- 5
- Pages
- 360-366
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2152217001
- Cited by
- 118
- References
- 40
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 7
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- early childhood trauma, psychotic experiences, transition to psychosis, emotional distress, coping, perceived control, psychosis vulnerability, anomalous experiences, emotional vulnerability
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Child, Emotions, Female, Humans, Internal-External Control, Longitudinal Studies, Male, Perception, Psychotic Disorders, Risk Factors, Wounds and Injuries
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