Modelling the co-occurrence of psychosis-like experiences and childhood sexual abuse

Purpose
Recurrent research evidence indicates that
childhood sexual abuse (CSA) is associated with psychosis
and psychosis-like experiences (PLEs). Many individuals
however who have experienced psychosis have never been
sexually abused in childhood and many individuals who
have experienced CSA have never experienced psychosis.

Method
The current study sought to model the cooccurrence
of CSA and PLEs using data from the Adult
Psychiatric Morbidity Survey. Latent class analysis was
employed to identify distinct classes of individuals in the
general population who were characterised by the presence,
co-occurrence or absence of PLEs and/or CSA. Multinomial
logistic regression analysis was utilised to validate
membership of classes characterised by both CSA and
PLEs using a series of variables that have been proposed to
delineate the co-occurrence of these phenomena.
Results Four hypothesised classes were identified, (1) a
CSA–PLE co-occurrence class, (2) a PLE-only class, (3) a
CSA-only class and (4) a CSA and PLE free baseline class.
CSA–PLE co-occurrence was characterised by neurotic
disorder, social isolation, adult sexual molestation and a
history of post-traumatic stress disorder (PTSD). PLE
occurrence in the absence of CSA was characterised by
neurotic disorder, social isolation, a history of PTSD,
childhood physical abuse, and uniquely by discrimination
and non-sexual trauma post-16 years.

Conclusions
The findings indicated that a distinct group
of individuals in the population was characterised by the
co-occurrence of CSA and PLEs. In the absence of CSA,
individuals who experienced PLEs were likely to endure a
wide range of other, non-sexual, traumatic and adverse
experiences. The CSA–PLE co-occurrence class and its
associated psychosocial risk profile was discussed in relation
to established trauma-based perspectives of psychosis
and PLEs.