Aberrant salience mediates the interplay between emotional abuse and positive symptoms in schizophrenia

• Published in: Comprehensive psychiatry 2024-08, Vol.133, p.152496, Article 152496
• Main Authors: de Filippis, Renato, Aloi, Matteo, Liuzza, Marco Tullio, Pugliese, Valentina, Carbone, Elvira Anna, Rania, Marianna, Segura-Garcia, Cristina, De Fazio, Pasquale
• Format: Article
• Language: English
• Subjects: Adult; Adverse childhood experiences; Adverse Childhood Experiences - psychology; Antipsychotics; Child & adolescent psychiatry; Cronbach's alpha; Cross-Sectional Studies; Discriminant analysis; Emotional abuse; Emotional Abuse - psychology; Ethics; Female; Humans; Hypotheses; Informed consent; Male; Mediation analysis; Middle Aged; Psychiatric Status Rating Scales; Psychiatrists; Psychopathology; Psychosis; Psychotic disorders; Psychotic Disorders - diagnosis; Psychotic Disorders - psychology; Psychotropic drugs; Quantitative psychology; Risk factors; Schizophrenia; Schizophrenia - diagnosis; Schizophrenia - physiopathology; Schizophrenia spectrum and other psychotic disorders; Schizophrenic Psychology; Sex crimes; Sexual abuse; Sociodemographics; Surveys and Questionnaires
• ISSN: 0010-440X; 1532-8384; 1532-8384
• DOI: 10.1016/j.comppsych.2024.152496

Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia. We approached 241 adults suffering from schizophrenia spectrum disorders (SSDs), who have been in the unit for at least 12 consecutive months, excluding the diagnosis of dementia, and recent substance abuse disorder, and cross-sectional evaluated through the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire Short-Form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). We tested a path-diagram where AS mediated the relationship between CTA and psychosis, after verifying each measure one-dimensionality through confirmatory factor analysis. The final sample comprised 222 patients (36.9% female), with a mean age of 42.4 (± 13.3) years and an average antipsychotic dose of 453.6 (± 184.2) mg/day (chlorpromazine equivalents). The mean duration of untreated psychosis was 1.8 (± 2.0) years while the mean onset age was 23.9 (± 8.2) years. Significant paths were found from emotional abuse to ASI total score (β = 0.39; p