Interpersonal Violence and Psychotic-Like Experiences: The Mediation of Ideas of Reference, Childhood Memories, and Dissociation

Dissociation as a Mediator of Traumatic Childhood Experiences and Ideas of Reference

Ideas of reference (IR) - self-attributions about what happens in the social environment are a frequent phenomenon present in a wide variety of people with mental health disorders as well as in the nonclinical population. The purpose of this study was to find out the relationship between traumatic childhood experiences, IR and dissociative states in the nonclinical population, emphasizing the potential mediating role of dissociation between traumatic experiences and IR. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.20 years (SD = 14.08). They filled in the Juvenile Victimization Questionnaire (JVQ), the Dissociative Experiences Scale-II (DES-II) and the Referential thinking Scale (REF). The results supported the original hypotheses and showed that the participants with higher frequency of IR reported more childhood traumatic (χ² (2) = 64.33, p < .001, f = .39, 1- β = .99) and dissociative experiences (χ² (2) = 50,414, p < .001, f = .38, 1- β = .99), and that dissociative states (β = .12, p < .05; 95%CI [.07, .19]; c´ = .26, p < .001), specifically absorption (β = .09, p < .05; 95% CI [.03, .15]; c´ = .26, p < .001), mediated between traumatic childhood experiences and referential thinking. It was concluded that the relationship between traumatic experiences and IR is complex and may be mediated by variables such as dissociation.

Aberrant Salience and Disorganized Symptoms as Mediators of Psychosis

Introduction

Ideas of reference (IR) are frequent in psychopathology, mainly in psychotic disorders. The frequency of IR and preoccupation about them are related to the psychotic dimension, and to a lesser extent, to negative or emotional disorganized dimensions. Aberrant salience (AS), has been proposed as an indicator of the onset of psychosis, particularly of schizophrenia. This study analyzed the mediating role of AS, disorganized symptoms and preoccupation about IR in the relationship between IR and the psychotic dimension.

Method

The sample consisted of 330 participants (116 university students and 214 clinically active patients), 62.4% of whom were women aged 18-79. The Referential Thinking Scale, the Aberrant Salience Inventory, and the Brief Psychiatric Rating Scale were administered.

Results

Evidence of a partial mediation model showed that the relationships between IR and the psychotic dimension were mediated jointly by AS and the disorganized dimension, and preoccupation about IR no longer had a role. This relationship was significantly influenced by participant age. The variables in the model explained 54.16% of the variance.

Conclusion

The model proposed enabled a set of vulnerabilities (unusual thought content) to be predicted that could lead to a high-risk general pathological state and proneness to psychosis in particular. These findings are discussed with regard to early detection and prevention of psychosis.

Induced ideas of reference during social unrest and pandemic in Hong Kong

Ideas of reference (IOR) are often implicated in predicting psychosis onset. They have been conceptualized to present on a continuum, from oversensitive psychological reactions to delusional thoughts. It is however unknown to what extent IOR may be triggered by collective environmental stress. We obtained timely data from 9873 individuals to assess IOR in relation to trauma exposure in the 2019-2020 social unrest in Hong Kong. Two levels of IOR are distinguished: attenuated IOR (IOR-A), being the experience of feeling particularly referred to within a group; and exclusive IOR (IOR-E), the experience of feeling exclusively referred to while others are not. Logistic regressions showed that event-based rumination was a shared predictor for IOR-A (OR = 1.07, CI = 1.03-1.10) and IOR-E (OR = 1.09, CI = 1.02-1.17). For IOR-A, three categories of social unrest-related traumatic events (TEs) were significant predictors, including being attacked or having experienced sexual violence (OR = 4.14, CI = 1.93-8.85), being arrested (OR = 4.48, CI = 1.99-10.10), and being verbally abused (OR = 2.66, CI = 1.28-5.53). Being arrested was significant for IOR-E (OR = 3.87, CI = 1.03-14.52), though not when rumination was included. Education level also significantly predicted IOR-E (OR = 0.72, CI = 0.52-0.99). Further analysis revealed that rumination significantly mediated between TEs and IOR severity (β = 0.26, SE = 0.01, CI = 0.24-0.28). The findings are consistent with the hypothesis that IOR-A and IOR-E occur as levels on a continuum, but each has some distinctive correlates. Extrinsic events may play a more prominent role in IOR-A, while intrinsic factors, such as cognitive capacity, may play a more prominent role in IOR-E. The involvement of rumination across the IOR spectrum suggests an opportunity for intervention.