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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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“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]
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“Integrating the evidence in this area has key clinical implications as undiagnosed and untreated PTSD may lead to a more enduring and worse course of psychosis, such as increased severity of symptoms (Ross, Anderson, & Clark, 1994), decreased social functioning, prolonged distress (Bak et al., 2005), breakdown in rela…”
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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).”
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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
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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
“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 37
“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…”
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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
Emotional Abuse and Psychosis: A Recent Review of the Literature
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“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.”
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Bebbington, P., & Kuipers, E. (2003) · Wiley eBooks · doi:10.1002/9780470987353.ch31 · Cited by 33
Childhood trauma as a risk factor for psychosis: A sib-pair study
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“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., & Krabbendam, L. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn004 · Cited by 32
“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 33
“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…”
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“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).”
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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
“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 29
“Failing to ask about abuse is thought to increase distress and prevent appropriate treatment (Bak et al., 2005).”
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A cognitive behavioural perspective on the relationship between childhood trauma and psychosis
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“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
“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 28
“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
Childhood adversity and psychosis
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New directions in the conceptualization of psychotic disorders
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Pfeifer, S., Krabbendam, L., 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
“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
“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 17
“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 19
The effects of childhood trauma in patients with first-episode schizophrenia
Åok, A. (2007) · Cited by 14
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
“, 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., Desrivières, S., Flor, H., Garavan, H., Gowland, P. A., Grigis, A., Heinz, A., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1434470 · Cited by 11
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
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
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
“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
“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
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
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
Entre Psychose et Trauma: perspectives psychanalytiques
Söderström, D. (2009) · Psychothérapies · doi:10.3917/psys.093.0145 · Cited by 6
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
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
“, 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 6
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
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 6
Trauma and First‐Episode Psychosis
Bernard, M. M., Jackson, C., & Patterson, P. H. (2010) · doi:10.1002/9781444318814.ch19 · Cited by 5
Psychotherapies for the Psychoses
Shyu, T. (2009) · Journal of Mental Health · doi:10.1080/09638230902946858 · Cited by 5
Schizophrenia and Psychosocial Stresses
Bebbington, P., & Kuipers, E. (2010) · Wiley eBooks · doi:10.1002/9781444327298.ch29 · Cited by 6
Saavedra, J. (2009) · Salud Colectiva · doi:10.18294/sc.2009.262 · Cited by 4
Kapfhammer, H. (2012) · Neuropsychiatrie · doi:10.1007/s40211-012-0031-9 · Cited by 4
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
“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 5
“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
Adolescent egocentrism and psychosis
Harvey, A. M. (2013) · University of Birmingham Institutional Research Archive (University of Birmingham) · Cited by 2
Mapplebeck, C. (2010) · Nottingham ePrints (University of Nottingham) · Cited by 1
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
Arnold, C. (2011) · Scientific American Mind · doi:10.1038/scientificamericanmind0911-14 · Cited by 1
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
Saavedra, J. (2009) · Salud Colectiva · doi:10.1590/s1851-82652009000200006 · Cited by 1
“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) · Research Publications (Maastricht University) · doi:10.26481/dis.20140502fs · Cited by 1
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
Bradbury, D. A. (2026) · e-space (Manchester Metropolitan University) · doi:10.83056/mmu.32434503 · Cited by 1
Metadata
- 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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