Background and Hypothesis Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. Study Design We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. Study Results In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. Conclusions Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.

中文翻译：

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童年逆境和成年早期的精神病经历：认知和精神病理学中介

背景和假设 童年逆境通常被描述为精神病经历事件的潜在原因，但其潜在机制尚不清楚。我们的目的是研究认知和精神病理因素在童年逆境与成年早期精神病经历之间的关系中的中介作用。研究设计 我们分析了雅芳父母和儿童纵向研究的数据，这是一项基于人群的大型队列研究。对从出生到 11 岁的童年逆境进行前瞻性测量，在大约 16 岁时评估中介因素（焦虑、抑郁、外部控制点 [LoC]、阴性症状），并在 18 岁和 24 岁时评估精神病经历。通过反事实 g 计算公式检查中介作用。研究结果 总共有 7% 的参与者在成年早期有过疑似或明确的精神病经历。童年逆境与更多的精神病经历有关（OR 调整 = 1.34，95% CI = 1.21；1.49），并且这种关联部分是通过所有检查的中介因素介导的（介导比例：19.9%）。在对每个中介因素的单独分析中，发现焦虑、抑郁、外部 LoC 和阴性症状都可以调节逆境和事件精神病经历之间的联系。考虑潜在的混杂因素并没有改变我们的结果。结论 我们的研究表明，认知偏差和情绪症状可能是早期生活逆境与精神病经历发展之间的因果关系。未来的研究应该确定哪些中介因素最容易改变，并且最有可能降低发生精神病经历的风险。