Cumulative Effects of Stressful Childhood Experiences on Delusions and Hallucinations

Kristina H. Muenzenmaier, Azizi A. Seixas, Andres R. Schneeberger, Dorothy M. Castille, Joseph Battaglia, Bruce G. Link

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


The association between stressful childhood experiences (SCE) and psychotic symptoms is still not clearly understood, and different causal pathways have been proposed. Generalized estimating equation modeling was used to test the dose–response relationship between SCE and delusions and hallucinations at baseline and follow-up periods and the possible confounding effects of dissociation on this relationship. The prevalence of SCE in individuals with psychotic disorders was high, with more co-occurring SCE categories being positively associated with more types of delusions and hallucinations. Each additional SCE was associated with a 1.20 increase in the incidence rate ratio (95% confidence interval [CI; 1.09, 1.32]) for hallucinations and a 1.19 increase (CI [1.09, 1.29]) for delusions, supporting a dose–response association. After we controlled for the mediating effects of dissociative symptoms at follow-up, SCE remained independently associated with delusions. We propose that cumulative SCE can result in complex trauma reactions that present with a broad range of symptomatology, including dissociative, posttraumatic stress disorder, and psychotic symptoms.

Original languageEnglish (US)
Pages (from-to)442-462
Number of pages21
JournalJournal of Trauma and Dissociation
Issue number4
StatePublished - Aug 8 2015


  • dissociation
  • psychosis
  • schizophrenia
  • severe mental illness
  • trauma

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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