Untangling pathways between childhood trauma and psychosis

The studies presented in this thesis aim to enhance our knowledge with regard to specific associations between types of trauma and the course of symptomatology and psychosocial functioning and to examine possible underlying mechanisms, by which childhood trauma influences the development of psychosis. Chapter 2 addresses whether being bullied in childhood is related to the development of psychotic symptoms in non-clinical and clinical samples. In chapter 3 the specificity of type of abuse and neglect in relation to different symptom domains of psychosis is discussed. Chapter 3 and 4 explore whether abuse and neglect uniquely heighten the chance of developing psychotic symptomatology in persons who are genetically vulnerable to developing psychotic symptoms. The association between abuse and neglect and course of symptoms over time of psychotic symptoms was evaluated, both in patients and in individuals with psychotic symptoms. Chapter 4 also addresses the question whether childhood abuse and neglect are predictive for transition to psychosis. Chapter 5.1 and 5.2 address the association between childhood trauma and cognitive functioning in psychosis. Chapter 6 examines whether childhood trauma - considering both type I and type II childhood trauma and childhood bullying - is associated with smaller hippocampal and amygdala volume in patients with psychosis. In chapter 7 the hypothesis that adult attachment is a mediating mechanism between childhood trauma and the development of psychosis is tested. Chapter 8 addresses the question whether personality characteristics are related to psychosocial functioning in patients with psychosis and a history of childhood trauma. In chapter 9 a summary of the previous chapters is presented, along with a general discussion of the implications, limitations and suggestions for future research