Testing the Trauma and Social Pathways Model of Psychosis as a Predictor of Unusual Sensory Experiences

Objectives: This current study investigated a model of trauma and social pathways of psychosis in people with Unusual Sensory Experiences (USEs) in the general population. Design: The study used a cross-sectional, quantitative design, using an online survey methodology with a self-selecting sample of people reporting multi-modal unusual sensory experiences. Methods: Participants (n=149) completed a survey examining trauma exposure, dissociative experiences, attachment, social rank and 6 separate USEs. The trauma social pathways model of psychosis was tested using hierarchical linear regression models and Structured Equation Modelling (SEM). Results: Hierarchical regression analyses found that all USEs were predicted by trauma-exposure, anxious attachment, and dissociation. Social comparison and compartmentalisation only predicted one mode of hallucinations and overall neither were a strong component of the model. SEM analysis indicated that overall the model was well fitted. The SEM analysis emphasised a dual route to auditory hallucinations via disrupted attachment or trauma-exposure, mutually mediated by dissociation. Conclusion: The findings of this study underscore the importance of addressing dissociation and attachment in understanding the development of multi-modal USEs and in guiding the formulation and intervention of clinical presentations of psychosis. Additionally, fostering attachment security at a service level could improve engagement with mental health services and promote safeness through consistent, sensitive care.