Testing the trauma and Social Pathways model of psychosis as a predictor of unusual sensory experiences

ABSTRACT Background Trauma and other adverse social experiences have been hypothesised to lead to psychotic-like experiences through disrupted attachment and dissociation. Although well grounded in the literature, the model is still to be fully validated.

Methods: This study tested the predictive validity of the Trauma and Social Pathways model of Psychosis, using a cross-sectional, quantitative online methodology with a self-selecting sample of people reporting multi-modal unusual sensory expereinces (USEs).

Participants: (n = 149) completed a survey examining trauma exposure, dissociative experiences, attachment, social rank and six separate USEs. The theoretical model was tested using hierarchical linear regression models and Structured Equation Modelling (SEM).

Results: Hierarchical regression analyses found that all USEs were predicted by trauma-exposure, anxious attachment, and dissociation. Social comparison and compartmentalisation were not strong components of the model. SEM analysis indicated that, overall, the model was well fitted and described a dual route to auditory hallucinations via disrupted attachment or trauma-exposure, mutually mediated by dissociation.

Discussion: The findings underscore the importance of addressing adverse events, dissociation and attachment in understanding the development of multi-modal USEs and in guiding the formulation and intervention of clinical presentations of psychosis. Additionally, fostering attachment security at a service level could improve engagement with mental health services.