Skip to main content
SpringerLink
Log in

Psychotic experiences in people who have been sexually assaulted

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

In recent years, there has been a call for greater awareness of the relationship between trauma and psychosis, and several studies involving patients with psychotic disorders have found a link between traumatic life experience and the development of psychosis. However, little research has examined psychotic experiences in a traumatised population.

Method

This study investigated psychotic experiences in a sample of 40 survivors of sexual assault (SA) compared to a control group without a history of sexual assault (measured using a self-report questionnaire) and examined the psychological factors that may contribute to the development of psychotic experiences in sexually traumatised individuals. In particular, the role of dissociation and cognitive factors such as post-traumatic cognitions were explored.

Results

Of the 26 sexually assaulted participants that were interviewed, 46% reported auditory hallucinations and 46% reported visual hallucinations. A significantly higher rate of psychotic phenomena (delusional ideation and predisposition to hallucinations) was found in the sexually assaulted group compared to the control group. Severity of SA trauma was significantly associated with severity of PTSD and psychotic symptomatology. Dissociation was strongly associated with all measures of psychotic phenomena and negative cognitions about the self and the world were associated with predisposition to hallucinations and delusional ideation. Regression analyses revealed that after controlling for the severity of SA trauma, dissociation and negative beliefs about the self significantly predicted delusional distress, and dissociation significantly predicted predisposition to visual hallucinations.

Conclusions

These exploratory findings support the idea that psychotic phenomena may be caused by traumatic life experiences and highlight the need for further research. The implications of these results for research and clinical practice are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agar K, Read J (2002) What happens when people disclose sexual or physical abuse to staff at a community mental health centre? Int J Ment Health Nurs 11(2):70–79

    Article  PubMed  Google Scholar 

  2. Allen JG, Coyne L (1995) Dissociation and vulnerability to psychotic experiences. J Nerv Ment Dis 183(10):615–622

    Article  PubMed  CAS  Google Scholar 

  3. Allen JG, Coyne L, Console DA (1996) Dissociation contributes to anxiety and psychoticism on the brief symptom inventory. J Nerv Ment Dis 184(10):639–641

    Article  PubMed  CAS  Google Scholar 

  4. Allen JG, Coyne L, Console DA (1997) Dissociative detachment relates to psychotic symptoms and personality decompensation. Compr Psychiatry 38(6):327–334

    Article  PubMed  CAS  Google Scholar 

  5. Bebbington PE et al (2004) Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. Br J Psychiatry 185:220–226

    Article  PubMed  Google Scholar 

  6. Bernstein EM, Putnam FW (1986) Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 174(12):727–735

    Article  PubMed  CAS  Google Scholar 

  7. Bowe SB, Morrison AP, Morley S (2008) Relationship between childhood trauma and auditory hallucinations in individuals with psychosis. Br J Clin Psychol (Submitted)

  8. Calam R, Slade P (1989) Sexual experiences and eating problems in female undergraduates. Int J Eat Disord 8(4):391–397

    Article  Google Scholar 

  9. Carlin A, Ward N (1992) Subtypes of psychiatric inpatient women who have been sexually assaulted. J Nerv Ment Dis 180:392–397

    Article  PubMed  CAS  Google Scholar 

  10. Darvez-Bamez JM et al (1995) Sexual victimisation in women with schizophrenia and bipolar disorder. Soc Psychiatry Psychiatr Epidemiol 32:78–84

    Article  Google Scholar 

  11. Davidson J (1996) Davidson trauma scale (DTS). Multi-Health Systems Inc., New York

    Google Scholar 

  12. Davidson J et al (1997) Assessment of a new rating scale for post-traumatic stress disorder. Psychol Med 27(1):153–160

    Article  PubMed  CAS  Google Scholar 

  13. Dill DL et al (1991) The reliability of abuse history reports: a comparison of two inquiry formats. Compr Psychiatry 32(2):166–169

    Article  PubMed  CAS  Google Scholar 

  14. Ehlers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38(4):319–345

    Article  PubMed  CAS  Google Scholar 

  15. Ellason JW, Ross CA (1995) Positive and negative symptoms in dissociative identity disorder and schizophrenia: a comparative analysis. J Nerv Ment Dis 183(4):236–241

    PubMed  CAS  Google Scholar 

  16. Ellason JW, Ross CA (1997) Childhood trauma and psychiatric symptoms. Psychol Rep 80:447–450

    PubMed  CAS  Google Scholar 

  17. Famularo R, Kinscherff R, Fenton T (1992) Psychiatric diagnoses of abusive mothers. A preliminary report. J Nerv Ment Dis 180(10):658–661

    Article  PubMed  CAS  Google Scholar 

  18. Foa EB et al (1999) The posttraumatic cognitions inventory (PTCI): development and validation. Psychol Assess 11(3):303–314. http://www.apa.org/journals/pas.html

    Google Scholar 

  19. Friedman S et al (2002) The incidence and influence of early traumatic life events in patients with panic disorder: a comparison with other psychiatric outpatients. J Anxiety Disord 16(3):259–272

    Article  PubMed  Google Scholar 

  20. Friedman S, Harrison G (1984) Sexual histories, attitudes and behaviour of schizophrenic women and normal women. Arch Sex Behav 13:555–567

    Article  PubMed  CAS  Google Scholar 

  21. Goff D et al (1991) Self-reports of child abuse in chronically psychotic patients. Psychiatry Res 37:73–80

    Article  PubMed  CAS  Google Scholar 

  22. Gracie A et al (2007) The association between traumatic experience, paranoia and hallucinations: a test of the predictions of psychological models. Acta Psychiatr Scand 116(4):280–289

    Article  PubMed  CAS  Google Scholar 

  23. Greenfield SF et al (1994) Childhood abuse in first-episode psychosis. Br J Psychiatry 164(6):831–834

    PubMed  CAS  Google Scholar 

  24. Haddock G et al (1999) Scales to measure dimensions of hallucinations and delusions: the psychotic symptoms rating scales (PSYRATS). Psychol Med 29:879–889

    Article  PubMed  CAS  Google Scholar 

  25. Hammersley P et al (2003) Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation. Br J Psychiatry 182:543–547

    Article  PubMed  Google Scholar 

  26. Hardy A et al (2005) Trauma and hallucinatory experience in psychosis. J Nerv Ment Dis 193(8):501–507

    Article  PubMed  Google Scholar 

  27. Haugen MC, Castillo RJ (1999) Unrecognised dissociation in psychotic outpatients and implications of ethnicity. J Nerv Ment Diss 187(12):751–754

    Article  CAS  Google Scholar 

  28. Holowka DW et al (2003) Childhood abuse and dissociative symptoms in adult schizophrenia. Schizophr Res 60(1):87–90

    Article  PubMed  Google Scholar 

  29. Hunter J (1991) A comparison of psychosocial maladjustment of adult males and females sexually molested as children. J Interpers Violence 6:205–217

    Article  Google Scholar 

  30. Janoff-Bulman R (1985) The aftermath of victimisation: rebuilding shattered assumptions. In: Figley CR (eds) Trauma and its wake. Brunner-Mazel, New York

    Google Scholar 

  31. Janssen I, Krabbendam L, Bak M, Hanssen M, Vollebergh W, de Graaf R, van Os (2004) Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand 109:38–45

    Article  PubMed  CAS  Google Scholar 

  32. Janssen I et al (2004) Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand, pp 38–45

  33. Kennerley H (1996) Cognitive therapy for dissociative symptoms associated with trauma. Br J Clin Psychol 35:325–340

    PubMed  Google Scholar 

  34. Kilcommons A, Morrison AP (2005) Relationships between trauma and psychosis: an exploration of cognitive and dissociative factors. Acta Psychiatr Scand 112(5):351–359

    Article  PubMed  CAS  Google Scholar 

  35. Larkin W, Morrison AP (2006) Trauma and psychosis: new directions for theory and therapy. Routledge, East Sussex

    Google Scholar 

  36. Launay G, Slade PD (1981) The measurement of hallucinatory predisposition in male and female prisoners. Pers Individ Dif 2:221–234

    Article  Google Scholar 

  37. Lundberg-Love P et al (1992) The long-term consequences of childhood incestuous victimization upon women’s psychological symptomatology. J Child Sex Abuse 1:81–102

    Article  Google Scholar 

  38. Merckelbach H (2000) More questions about recovered memories. Am J Psychiatry 157(8):1346–1347

    Article  PubMed  CAS  Google Scholar 

  39. Miller L, Finnerty M (1996) Sexuality, pregnancy, and childrearing among women with schizophrenia-spectrum disorders. Psychiatr Serv 47(5):502–506

    PubMed  CAS  Google Scholar 

  40. Morrison AP (2001) The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behav Cogn Psychother 29:257–276

    Google Scholar 

  41. Morrison AP (2004) Cognitive therapy for people with psychosis. In: Read J, Mosher LR, Bentall RP (eds) Models of madness. Brunner-Routledge, Hove

    Google Scholar 

  42. Morrison AP, Frame L, Larkin W (2003) Relationships between trauma and psychosis: a review and integration. Br J Clin Psychol 42:331–353

    Article  PubMed  Google Scholar 

  43. Morrison AP, Wells A, Nothard S (2000) Cognitive factors in predisposition to auditory and visual hallucinations. Br J Clin Psychol 39:67–78

    Article  PubMed  Google Scholar 

  44. Morrison AP, Wells A, Nothard S (2002) Cognitive and emotional predictors of predisposition to hallucinations in non-patients. Br J Clin Psychol 41(3):259–270

    Article  PubMed  Google Scholar 

  45. Mueser KT, et al. (1998) Trauma and posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol 66:493–499

    Article  PubMed  CAS  Google Scholar 

  46. Offen L, Waller G, Thomas G (2003) Is reported childhood sexual abuse associated with the psychopathological characteristics of patients who experience auditory hallucinations? Child Abuse Negl 27(8):919–927

    Article  PubMed  Google Scholar 

  47. Peters E et al (2008) Measuring delusional ideation: the 21-item Peters et al. delusions inventory (PDI). Schizophr Bull (in press)

  48. Peters ER, Joseph SA, Garety PA (1999) Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. delusions inventory). Schizophr Bull 25(3):553–576

    PubMed  CAS  Google Scholar 

  49. Read J (1997) Child abuse and psychosis: a literature review and implications for professional practice. Prof Psychol Res Pr 28:448–456

    Article  Google Scholar 

  50. Read J et al (2001) The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64(4):319–345

    PubMed  CAS  Google Scholar 

  51. Read J et al (2003) Sexual and physical assault during childhood and adulthood as predictors of hallucinations, delusions, and thought disorder. Psychol Psychother Theory Res Pract 76:1–22

    Article  Google Scholar 

  52. Read J, Argyle N (1999) Hallucinations, delusions, and thought disorder among adult psychiatric inpatients with a history of child abuse. Psychiatr Serv 50:1467–1472

    PubMed  CAS  Google Scholar 

  53. Read J, Fraser A (1998) Abuse histories of psychiatric inpatients: to ask or not to ask? Psychiatr Serv 49(3):355–359

    PubMed  CAS  Google Scholar 

  54. Read J, Fraser A (1998) Staff response to abuse histories of psychiatric inpatients. Aust N Z J Psychiatry 32(2):206–213

    Article  PubMed  CAS  Google Scholar 

  55. Read J, Hammersley P (2005) Child sexual abuse and schizophrenia. Br J Psychiatry 186:76 (author reply 76)

    Article  PubMed  CAS  Google Scholar 

  56. Read J, Ross CA (2003) Psychological trauma and psychosis: another reason why people diagnosed schizophrenic must be offered psychological therapies. J Am Acad Psychoanal 2003(31):1

    Google Scholar 

  57. Read J et al (2004) Childhood trauma, loss and stress. In: Read J, Mosher LRR, Bentall RP (eds) Models of madness. Bruner-Routledge, Hove

    Google Scholar 

  58. Resnick SG, Bond GR, Mueser KT (2003) Trauma and posttraumatic stress disorder in people with schizophrenia. J Abnorm Psychol 112(3):415–423

    Article  PubMed  Google Scholar 

  59. Ross CA, Anderson G, Clark P (1994) Childhood abuse and the positive symptoms of schizophrenia. Hosp Community Psychiatry 42:489–491

    Google Scholar 

  60. Ross CA, Joshi S (1992) Paranormal experiences in the general population. J Nerv Ment Dis 180(6):357–361 (discussion 362–8)

    Article  PubMed  CAS  Google Scholar 

  61. Ross CA, Joshi S (1992) Schneiderian symptoms and childhood trauma in the general population. Compr Psychiatry 33(4):269–273

    Article  PubMed  CAS  Google Scholar 

  62. Ross CA, Keyes B (2004) Dissociation and schizophrenia. J Trauma Dissociation, p. 69–83

  63. Ross CA, Norton GR, Wozney K (1989) Multiple personality disorder: an analysis of 236 cases. Can J Psychiatry 34(5):413–418

    PubMed  CAS  Google Scholar 

  64. Russell D (1983) Incidence and prevalence of intrafamilial sexual abuse of female children. Child Abuse Negl 7:133–146

    Article  PubMed  CAS  Google Scholar 

  65. Sansonnet-Hayden H et al (1987) Sexual abuse and psychopathology in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry 26(5):753–757

    Article  PubMed  CAS  Google Scholar 

  66. Scott R, Stone D (1986) MMPI profile constellations in incest families. J Consult Clin Psychol 54(3):364–368

    Article  PubMed  CAS  Google Scholar 

  67. Spataro J et al (2004) Impact of child sexual abuse on mental health: prospective study in males and females. Br J Psychiatry 184:416–421

    Article  PubMed  Google Scholar 

  68. Startup M (1999) Schizotypy, dissociative experiences and childhood abuse: relationships among self-report measures. Br J Clin Psychol 38(Pt 4):333–344

    Article  PubMed  Google Scholar 

  69. Tsai M (1979) Child molestation. J Abnorm Psychol 88:407–17

    Article  PubMed  CAS  Google Scholar 

  70. Van der Hart O, Witztum E, Friedman B (1993) From hysterical psychosis to reactive dissociative psychosis. J Trauma Stress 6(1):43–64

    Article  Google Scholar 

  71. Whitfield CL, et al. (2005) Adverse childhood experiences and hallucinations. Child Abuse Negl 29:797–810

    PubMed  Google Scholar 

  72. Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms, vol 9. Cambridge University Press, Cambridge

    Google Scholar 

  73. Wurr CJ, Partridge IM (1996) The prevalence of a history of childhood sexual abuse in an acute adult inpatient population. Child Abuse Negl 20(9):867–872

    Article  PubMed  CAS  Google Scholar 

  74. Young M et al (2001) Evaluating and overcoming barriers to taking abuse histories. Prof Psychol Res Pract 32:407–414

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Clinical Psychology, University of Liverpool, Liverpool, UK

    Aoiffe M. Kilcommons & Fiona Lobban

  2. School of Psychological Sciences, University of Manchester, Manchester, UK

    Anthony P. Morrison

  3. Psychological Services, Bolton, Salford & Trafford Mental Health Trust, Bury New Road, Prestwich, M25 3BL, UK

    Aoiffe M. Kilcommons, Anthony P. Morrison & Alice Knight

Authors
  1. Aoiffe M. Kilcommons
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony P. Morrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alice Knight
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fiona Lobban
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aoiffe M. Kilcommons.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kilcommons, A.M., Morrison, A.P., Knight, A. et al. Psychotic experiences in people who have been sexually assaulted. Soc Psychiat Epidemiol 43, 602–611 (2008). https://doi.org/10.1007/s00127-007-0303-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-007-0303-z

Key words

Search

Navigation