PTSD as a mediator of the relationship between trauma and psychotic experiences

Daniela Strelchuk*, Gemma L Hammerton, Nicola J Wiles, Jazz Croft, Katrina M Turner, Jon E Heron, Stanley Zammit

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
52 Downloads (Pure)


Traumatic experiences are associated with a higher risk of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. This study aims to examine whether PTSD symptoms mediate the relationship between trauma and psychotic experiences (PEs).

We used data from the Avon Longitudinal Study of Parents and Children to examine whether: PTSD symptoms mediate the relationships between a) childhood trauma and adolescent PEs (study of adolescent PEs; n = 2,952), and b) childhood/adolescent trauma and PEs in early adulthood (study of adult PEs; n = 2,492). We examined associations between variables using logistic regression, and mediation using the parametric g-computation formula.

Exposure to trauma was associated with increased odds of PEs (adolescent PEs: ORadjusted = 1.48, 95%CI 1.23, 1.78; adult PEs: ORadjusted = 1.57, 95%CI 1.25, 1.98) and PTSD symptoms (adolescent PTSD: ORadjusted = 1.59, 95%CI 1.31, 1.93; adult PTSD: ORadjusted = 1.50, 95%CI 1.36, 1.65). The association between PTSD symptoms and PE was stronger in adolescence (ORadjusted = 4.63, 95% CI, 2.34, 9.17) than in adulthood (ORadjusted = 1.62, 95%CI 0.80, 3.25). There was some evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent PEs (proportion mediated 14%), though evidence of mediation was weaker for adult PEs (proportion mediated 8%).

These findings are consistent with the hypothesis that PTSD symptoms partly mediate the association between trauma exposure and PEs. Targeting PTSD symptoms might help prevent the onset of psychotic outcomes.
Original languageEnglish
JournalPsychological Medicine
Early online date14 Dec 2020
Publication statusE-pub ahead of print - 14 Dec 2020


  • trauma
  • PTSD
  • psychotic experiences
  • mediation
  • longitudinal


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