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Psychol Med. 2018 Oct;48(13):2235-2246. doi: 10.1017/S0033291717003762. Epub 2018 Jan 14.

The association between psychotic experiences and traumatic life events: the role of the intention to harm.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES),Brasília,Brazil.
Department of Psychiatry and Psychology,School of Mental Health and Neuroscience (MHeNS),Maastricht University Medical Centre (MUMC),Maastricht,The Netherlands.
Department of Psychiatry,Federal University of São Paulo,São Paulo,Brazil.
National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq),São Paulo,Brazil.



Previous work showed traumatic life events (TLE) with intention to harm, like bullying and abuse, to be more strongly associated with psychotic experiences (PE) than other types of trauma, like accidents. However, this association is subject to reporting bias and can be confounded by demographic characteristics and by differences in dose of exposure across different trauma categories. We studied the association between TLE with and without intention to harm and PE, taking into account potential confounders and biases.


A total of 2245 children and adolescents aged 6-14 years were interviewed by psychologists. The interview included the presence of 20 PE (both self-report and psychologist evaluation). In addition, parents provided information on child exposure to trauma, mental health and PE.


Results showed no significant association between TLE without intention to harm only and PE for the three methods of assessment of PE (self-report, parent report and psychologist rating). On the other hand, there was a positive association between PE and TLE in groups exposed to traumatic experiences with intention to harm (with intention to harm only and with and without intention to harm). Results remained significant after controlling for demographic and clinical confounders, but this positive association was no longer significant after adjusting for the number of TLE.


TLE with intention to harm display a stronger association with PE than TLE without intention to harm, and this difference is likely reducible to a greater level of traumatic exposure associated with TLE with intention to harm.


Adolescent; accidents; child; child abuse; mental disorders; mental health; psychotic


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