PMID- 29249990
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1664-0640 (Print)
IS  - 1664-0640 (Electronic)
IS  - 1664-0640 (Linking)
VI  - 8
DP  - 2017
TI  - Mediators Linking Childhood Adversities and Trauma to Suicidality in Individuals 
      at Risk for Psychosis.
PG  - 242
LID - 10.3389/fpsyt.2017.00242 [doi]
LID - 242
AB  - Suicidality is highly prevalent in patients at clinical high risk (CHR) for 
      psychosis. Childhood adversities and trauma are generally predictive of 
      suicidality. However, the differential effects of adversity/trauma-domains and 
      CHR-criteria, i.e., ultra-high risk and basic symptom criteria, on suicidality 
      remain unclear. Furthermore, the underlying mechanisms and, thus, worthwhile 
      targets for suicide-prevention are still poorly understood. Therefore, structural 
      equation modeling was used to test theory-driven models in 73 CHR-patients. 
      Mediators were psychological variables, i.e., beliefs about one's own 
      competencies as well as the controllability of events and coping styles. In 
      addition, symptomatic variables (depressiveness, basic symptoms, attenuated 
      psychotic symptoms) were hypothesized to mediate the effect of psychological 
      mediators on suicidality as the final outcome variable. Results showed two 
      independent pathways. In the first pathway, emotional and sexual but not physical 
      adversity/trauma was associated with suicidality, which was mediated by 
      dysfunctional competence/control beliefs, a lack of positive coping-strategies 
      and depressiveness. In the second pathway, cognitive basic symptoms but not 
      attenuated psychotic symptoms mediated the relationship between trauma/adversity 
      and suicidality. CHR-patients are, thus, particularly prone to suicidality if 
      adversity/trauma is followed by the development of depressiveness. Regarding the 
      second pathway, this is the first study showing that adversity/trauma led to 
      suicidality through an increased risk for psychosis as indicated by cognitive 
      basic symptoms. As insight is generally associated with suicidality, this may 
      explain why self-experienced basic symptoms increase the risk for it. 
      Consequently, these mediators should be monitored regularly and targeted by 
      integrated interventions as early as possible to enhance resilience against 
      suicidality.
FAU - Schmidt, Stefanie J
AU  - Schmidt SJ
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, 
      Germany.
FAU - Schultze-Lutter, Frauke
AU  - Schultze-Lutter F
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
AD  - Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine 
      University, Dusseldorf, Germany.
FAU - Bendall, Sarah
AU  - Bendall S
AD  - Orygen, The National Centre of Excellence in Youth Mental Health, University of 
      Melbourne, Melbourne, VIC, Australia.
AD  - Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, 
      Australia.
FAU - Groth, Nicola
AU  - Groth N
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
FAU - Michel, Chantal
AU  - Michel C
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
AD  - Developmental Clinical Psychology Research Unit, Faculty of Psychology and 
      Educational Sciences, University of Geneva, Geneva, Switzerland.
FAU - Inderbitzin, Nadja
AU  - Inderbitzin N
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
FAU - Schimmelmann, Benno G
AU  - Schimmelmann BG
AD  - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, 
      University of Bern, Bern, Switzerland.
AD  - University Hospital of Child and Adolescent Psychiatry, University Hospital 
      Hamburg Eppendorf, Hamburg, Germany.
FAU - Hubl, Daniela
AU  - Hubl D
AD  - University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, 
      Switzerland.
FAU - Nelson, Barnaby
AU  - Nelson B
AD  - Orygen, The National Centre of Excellence in Youth Mental Health, University of 
      Melbourne, Melbourne, VIC, Australia.
AD  - Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, 
      Australia.
LA  - eng
PT  - Journal Article
DEP - 20171120
PL  - Switzerland
TA  - Front Psychiatry
JT  - Frontiers in psychiatry
JID - 101545006
PMC - PMC5715383
OTO - NOTNLM
OT  - attenuated psychotic symptoms
OT  - basic symptoms
OT  - depression
OT  - mediation
OT  - psychosis
OT  - suicidality
EDAT- 2017/12/19 06:00
MHDA- 2017/12/19 06:01
PMCR- 2017/11/20
CRDT- 2017/12/19 06:00
PHST- 2017/06/21 00:00 [received]
PHST- 2017/11/06 00:00 [accepted]
PHST- 2017/12/19 06:00 [entrez]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2017/12/19 06:01 [medline]
PHST- 2017/11/20 00:00 [pmc-release]
AID - 10.3389/fpsyt.2017.00242 [doi]
PST - epublish
SO  - Front Psychiatry. 2017 Nov 20;8:242. doi: 10.3389/fpsyt.2017.00242. eCollection 
      2017.