Universität zu Köln

Schmidt, Stefanie J., Schultze-Lutter, Frauke, Bendall, Sarah ORCID: 0000-0003-1486-6190, Groth, Nicola, Michel, Chantal ORCID: 0000-0003-1165-6681, Inderbitzin, Nadja, Schimmelmann, Benno G., Hubl, Daniela and Nelson, Barnaby ORCID: 0000-0002-6263-2332 (2017). Mediators linking childhood adversities and Trauma to suicidality in individuals at risk for Psychosis. Front. Psychiatry, 8. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-0640

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Abstract

Suicidality is highly prevalent in patients at clinical high risk (CHR) for psychosis. Childhood adversities and trauma are generally predictive of suicidality. However, the differential effects of adversity/trauma-domains and CHR-criteria, i.e., ultra-high risk and basic symptom criteria, on suicidality remain unclear. Furthermore, the underlying mechanisms and, thus, worthwhile targets for suicide-prevention are still poorly understood. Therefore, structural equation modeling was used to test theory-driven models in 73 CHR-patients. Mediators were psychological variables, i.e., beliefs about one's own competencies as well as the controllability of events and coping styles. In addition, symptomatic variables (depressiveness, basic symptoms, attenuated psychotic symptoms) were hypothesized to mediate the effect of psychological mediators on suicidality as the final outcome variable. Results showed two independent pathways. In the first pathway, emotional and sexual but not physical adversity/trauma was associated with suicidality, which was mediated by dysfunctional competence/control beliefs, a lack of positive coping-strategies and depressiveness. In the second pathway, cognitive basic symptoms but not attenuated psychotic symptoms mediated the relationship between trauma/adversity and suicidality. CHR-patients are, thus, particularly prone to suicidality if adversity/trauma is followed by the development of depressiveness. Regarding the second pathway, this is the first study showing that adversity/trauma led to suicidality through an increased risk for psychosis as indicated by cognitive basic symptoms. As insight is generally associated with suicidality, this may explain why self-experienced basic symptoms increase the risk for it. Consequently, these mediators should be monitored regularly and targeted by integrated interventions as early as possible to enhance resilience against suicidality.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schmidt, Stefanie J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Bendall, Sarah UNSPECIFIED orcid.org/0000-0003-1486-6190 UNSPECIFIED Groth, Nicola UNSPECIFIED UNSPECIFIED UNSPECIFIED Michel, Chantal UNSPECIFIED orcid.org/0000-0003-1165-6681 UNSPECIFIED Inderbitzin, Nadja UNSPECIFIED UNSPECIFIED UNSPECIFIED Schimmelmann, Benno G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hubl, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Nelson, Barnaby UNSPECIFIED orcid.org/0000-0002-6263-2332 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-211064
DOI:	10.3389/fpsyt.2017.00242
Journal or Publication Title:	Front. Psychiatry
Volume:	8
Date:	2017
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-0640
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLINICAL HIGH-RISK; DEPRESSION INVENTORY-II; INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW; PSYCHOMETRIC PROPERTIES; SELF-HARM; PREDICTIVE-VALIDITY; COPING STRATEGIES; LIFETIME NUMBER; BASIC SYMPTOMS; SCHIZOPHRENIA Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21106