Testing the trauma and Social Pathways model of psychosis as a predictor of unusual sensory experiences

Trauma and disrupted attachment contribute to psychotic-like experiences through dissociation. A cross-sectional online survey of 149 people who report unusual sensory experiences found that trauma exposure, anxious attachment, and dissociation predicted all six types of unusual sensory experiences tested. Structural equation modeling showed a dual path to auditory hallucinations: either through disrupted attachment or trauma exposure, both mediated by dissociation. Social comparison and compartmentalization were not strong components of the model. The findings suggest that addressing adverse events, dissociation, and attachment in clinical work could improve understanding and treatment of psychosis, and that fostering attachment security in mental health services may improve engagement.

Study at a glance

Abstract

ABSTRACT Background Trauma and other adverse social experiences have been hypothesised to lead to psychotic-like experiences through disrupted attachment and dissociation. Although well grounded in the literature, the model is still to be fully validated. Methods This study tested the predictive validity of the Trauma and Social Pathways model of Psychosis, using a cross-sectional, quantitative online methodology with a self-selecting sample of people reporting multi-modal unusual sensory expereinces (USEs). Participants (n = 149) completed a survey examining trauma exposure, dissociative experiences, attachment, social rank and six separate USEs. The theoretical model was tested using hierarchical linear regression models and Structured Equation Modelling (SEM). Results Hierarchical regression analyses found that all USEs were predicted by trauma-exposure, anxious attachment, and dissociation. Social comparison and compartmentalisation were not strong components of the model. SEM analysis indicated that, overall, the model was well fitted and described a dual route to auditory hallucinations via disrupted attachment or trauma-exposure, mutually mediated by dissociation. Discussion The findings underscore the importance of addressing adverse events, dissociation and attachment in understanding the development of multi-modal USEs and in guiding the formulation and intervention of clinical presentations of psychosis. Additionally, fostering attachment security at a service level could improve engagement with mental health services.