Trauma in psychosis: an explorative study of an emerging linguistic signature

Background: The role of psychological trauma in psychotic disorders is well documented, but there is a lack of research about how traumatic experiences are reflected in the speech of patients experiencing psychosis. We present an explorative study examining associations between trauma history in patients diagnosed with psychosis, linguistic variables and clinical symptoms. Methods: We analysed data of 19 participants diagnosed with schizophrenia: symptoms measured via a semi-structured interview, trauma history reported in retrospective questionnaires and linguistic analysis of two speech samples per participant – an emotionally neutral, less structured and a more emotionally charged, semi-structured conversation. We performed correlation analyses between trauma, language markers and symptoms, hypothesis testing (LASSO, linear regression) and network analysis. Results: Our findings show that trauma (especially close interpersonal trauma) in psychosis is associated with lower levels of cognitive processing, more disfluent speech, higher verbal output, and lower expression of difficult emotions. Linguistic variables showed good predictive value of trauma history, and network analysis displayed clinically meaningful relations between variables. Discussion: Our results are consistent with theories of fragmentation, deficit of cognitive processing, and somatisation in post-traumatic states, supporting the existence of a trauma-related pathophysiological pathway in psychotic disorders, and highlighting the importance of interpersonal trauma.