Distressing Unusual Experiences, Childhood Adversity and Affect

Background: Developing a better psychological understanding of unusual experiences (UEs) in a child and adolescent population has become an important area of research. Presently, much of our understanding of UEs has derived from psychological models of psychosis in adults. There is now a robust evidence-base supporting the relationship between childhood adversity (CA) and psychosis in adulthood, and researchers have begun to study the psychological processes involved in this relationship. Importantly, associated psychological processes appear to differ according to the type of experience, suggesting targeted approaches for therapy development. Research is needed to test these associations, and the potential applicability of theory and therapies, in children and young people.

Aims: This study aimed to investigate specific associations between CA and distressing paranoia, voice-hearing, and visual experiences in a child and adolescent population, and consider the role of negative affect, schemas, and dissociative experiences as mediating components within this association.

Method: A cross-sectional design, using secondary data analysis was adopted. A total sample of 249 participants, aged 8-18 years, from community and inpatient Child and Adolescent Mental Health Services (CAMHS) was comprised of three smaller, original studies which had also investigated alternative psycho-social correlates of UEs. Participants completed self-report questionnaires which measured UEs, previous experiences of adversity, negative affect, beliefs about oneself and others, and dissociative experiences. Hypothesised associations and mediating relationships were tested using correlational, between groups, and regression analyses.

Results: The presence of more than one adverse experience was associated with severity of paranoia, negative affect, and negative self-evaluations. In line with hypotheses, negative affect and negative self-beliefs partially mediated the relationship between CA and distressing paranoia, and paranoia was not associated with dissociation. Contrary to hypotheses, CA was not independently associated with voice-hearing, visual experiences or dissociative experiences. Both voice-hearing and visual experiences were independently associated with negative affect, negative self-evaluations, and dissociative experiences.

Discussion: The findings support the application of adult models of paranoia and interventions that target adverse experiences, negative affect and enhance positive self-beliefs in childhood. The application of adult models of voice-hearing and visual experiences was not supported and requires further investigation. Future directions for research and clinical implications for both services and broader social initiatives are discussed.