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J Clin Psychiatry. 2019 Apr 2;80(3). pii: 17m12088. doi: 10.4088/JCP.17m12088.

Negative Schema and Rumination as Mediators of the Relationship Between Childhood Trauma and Recent Suicidal Ideation in Patients With Early Psychosis.

Author information

1
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China.
2
Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea.
3
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
4
Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
5
Department of Psychiatry, The Catholic University of Korea, Seoul St Mary's Hospital, Seoul, Republic of Korea.
6
Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea.
7
Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea.
8
Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
9
Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea.
10
Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea.
11
Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea.
12
Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
13
Department of Psychiatry, Maeumsarang Hospital, Wanju, Jeollabuk-do, Republic of Korea.
14
Chonbuk National University Medical School, Department of Psychiatry, 20, Geonjiro Deokjin-gu, Jeonju, Jeollabuk-do 561-756 South Korea. chungyc@jbnu.ac.kr.
15
Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.

Abstract

OBJECTIVE:

High rates of childhood trauma and adult suicidality have been reported in patients who have schizophrenia. This study sought to explore mediators between childhood trauma and suicidality in adulthood to help determine therapeutic approaches.

METHODS:

This study included 314 adult patients with early psychosis who were participants in the Korean Early Psychosis Cohort Study, which was a prospective naturalistic observational cohort study started in December 2014. DSM-5 criteria were used to assign the diagnosis of schizophrenia spectrum and other psychotic disorders. Cross-sectional data obtained at baseline were used for analysis. The Early Trauma Inventory Self Report-Short Form and the Columbia Suicide Severity Rating Scale were employed to collect data on childhood trauma and suicidal ideation and attempts. Other measures were used to evaluate depression, empathy, psychopathology, and rumination.

RESULTS:

A total of 90.1% of the participants experienced at least 1 childhood traumatic event. The rates of significant` physical punishment, emotional abuse, and sexual events were 37.3%, 35.6%, and 6.4%, respectively. The rates of recent suicidal ideation and attempts were 32.0% and 10.0%, respectively. Independent predictors of recent suicidal ideation included depression, negative schema, and rumination. Furthermore, negative schema and rumination played partial or full mediating roles in the relationship between childhood trauma and recent suicidal ideation.

CONCLUSIONS:

These findings highlight the importance of performing careful evaluations of childhood trauma and suicidality and of developing effective strategies to reduce mediating factors that may be amenable to psychosocial approaches.

PMID:
30946541
DOI:
10.4088/JCP.17m12088
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