Psychological processes mediating the association between developmental trauma and specific psychotic symptoms in adults: a systematic review and meta-analysis

Michael A.P. Bloomfield, Tinya Chang, Maximillian J. Woodl, Laura M. Lyons, Zhen Cheng, Clarissa Bauer-Staeb, Catherine Hobbs, Sophie Bracke, Helen Kennerley, Louise Isham, Chris Brewin, Jo Billings, Talya Greene, Glyn Lewis

Research output: Contribution to journalArticlepeer-review


Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psy­chological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.

Original languageEnglish
Pages (from-to)107-123
Number of pages17
JournalWorld Psychiatry
Issue number1
StatePublished - Feb 2021

Bibliographical note

Publisher Copyright:
© 2021 World Psychiatric Association


  • Developmental trauma
  • adolescence
  • childhood
  • delusions
  • dissociation
  • hallucinations
  • paranoia
  • post-traumatic stress disorder
  • psychological processes
  • psychotic symptoms

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychiatric Mental Health


Dive into the research topics of 'Psychological processes mediating the association between developmental trauma and specific psychotic symptoms in adults: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this