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Childhood trauma mediates the association between ethnic minority status and more severe hallucinations in psychotic disorder

Published online by Cambridge University Press:  20 May 2014

A. O. Berg*
NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway
M. Aas
NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway
S. Larsson
Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
M. Nerhus
NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway
E. Hauff
Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway
O. A. Andreassen
NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
I. Melle
NORMENT; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
*Author for correspondence: A. O. Berg, PhD, NORMENT, K. G. Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital HF, Ullevål Hospital, Building 49, PO Box 4956 Nydalen, N-0424 Oslo, Norway.(Email:



Ethnic minority status and childhood trauma are established risk factors for psychotic disorders. Both are found to be associated with increased level of positive symptoms, in particular auditory hallucinations. Our main aim was to investigate the experience and effect of childhood trauma in patients with psychosis from ethnic minorities, hypothesizing that they would report more childhood trauma than the majority and that this would be associated with more current and lifetime hallucinations.


In this cross-sectional study we included 454 patients with a SCID-I DSM-IV diagnosis of non-affective or affective psychotic disorder. Current hallucinations were measured with the Positive and Negative Syndrome Scale (P3; Hallucinatory Behaviour). Lifetime hallucinations were assessed with the SCID-I items: auditory hallucinations, voices commenting and two or more voices conversing. Childhood trauma was assessed with the Childhood Trauma Questionnaire, self-report version.


Patients from ethnic minority groups (n = 69) reported significantly more childhood trauma, specifically physical abuse/neglect, and sexual abuse. They had significantly more current hallucinatory behaviour and lifetime symptoms of hearing two or more voices conversing. Regression analyses revealed that the presence of childhood trauma mediated the association between ethnic minorities and hallucinations.


More childhood trauma in ethnic minorities with psychosis may partially explain findings of more positive symptoms, especially hallucinations, in this group. The association between childhood trauma and these first-rank symptoms may in part explain this group's higher risk of being diagnosed with a schizophrenia-spectrum diagnosis. The findings show the importance of childhood trauma in symptom development in psychosis.

Original Articles
Copyright © Cambridge University Press 2014 

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