The impact of attachment style and childhood trauma on psychosis

The aim of this thesis is to gain more knowledge and understanding about the impact of attachment style and childhood trauma on psychosis.
In the first part of this thesis, we focus on potential mechanisms underlying the association between attachment style and vulnerability to psychosis and broaden the perspective from symptomatic recovery to social functioning and personal recovery. Focusing on underlying mechanisms, we demonstrate that attachment style is associated with self-disturbance and that sensitivity of the behavioural inhibition system (BIS) plays a mediating role in the relationship between attachment style and psychotic experiences in individuals with different levels of vulnerability for psychosis. Focusing on outcome, we uncover associations between attachment style and social functioning across psychosis vulnerability levels and its relevance to a broader scope of recovery in individuals remitted from their first episode of psychosis. When exploring potential sex-differences in attachment style and its impact on recovery outcomes, we found no significant sex effect.
The second part explores mechanisms underlying the association between childhood trauma and psychosis, and further examines the association between childhood trauma and high-occurrence of tobacco smoking in psychosis. Findings revealed a mediating effects of self disturbance and negative self schemas on the relationship between childhood trauma and psychotic experiences. Childhood trauma was also associated with tobacco smoking in both patients and healthy controls, although this relationship appeared largely driven by cannabis use.
Overall, this thesis highlights the importance of addressing attachment style, childhood trauma, and related constructs in individuals experiencing psychosis and those with an increased vulnerability.