The Development and Testing of a Population Based Model of Social Factors as Mediators of the Trauma Psychosis Association

Abstract

Evidence has been accumulating that supports the position that it is time for a paradigm shift in how psychosis is conceptualised. The medical model is not sufficient to explain the complexity of the multiple pathways to psychosis. Psychosis, as opposed to being ‘abnormal’, can be viewed as being a continuum with ‘normal’ experiences. It can be viewed as a response to an individual’s circumstances, history, beliefs, culture and bodily capacities. One such pathway(s) to psychosis is through the influence of social and environmental factors. The association between childhood trauma and psychosis is well established. This thesis established that association in a large general population sample. It expanded further to also establish the association between social defeat and experiences of psychosis. It established those experiences of psychosis as being on a continuum and used psychotic-like-experiences (PLEs) for the study. PLEs are more prevalent in the general population and are without the confounders associated with clinical diagnosis and treatment. This thesis developed and tested a latent variable model of social factors as mediators and moderators in these relationships. It established the mediating effects of discrimination and social support and the moderating effects of loneliness. The aetiology of psychosis continues to show itself as being complex and multifactorial with many pathways to a variety of expressions. The clinical implications for these findings are clear. As understanding of the causes of psychosis expands, so too must treatment responses.

Date of Award	Apr 2018
Original language	English
Supervisor	Mark Shevlin (Supervisor), Jamie Murphy (Supervisor) & James Houston (Supervisor)