- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04481217
Cognitive Factors Mediating the Relationship Between Childhood Trauma and Auditory Hallucinations in Schizophrenia (HADITRYOS)
The Mediating Role of Dissociative Symptoms and Early Maladaptive Schemas in the Relationship Between Childhood Trauma and Auditory Hallucinations in Schizophrenia
BACKGROUND It is demonstrated that strong associations between trauma suffered in childhood and having schizophrenia, and more specifically to experience acoustic-verbal hallucinations (AVH). A second generation of research is currently examining the cognitive and affective processes likely to play a mediating role in this association. These mediators appear to include early maladaptive personality patterns and dissociative experiences. Although these factors have most often been explored separately, recent research indicates that they could be associated, and thus contribute to AVH. More specifically, another study has shown that the association between childhood trauma and predisposition to AVH is not direct but depends on cognitive factors including the impact of violence suffered during childhood on early maladaptive schemas and dissociation. However, this study was carried out on a non-clinical sample of subjects with a predisposition to AVH.
OBJECTIVES: testing a structural model of AVH, childhood trauma, early maladaptive schemas and dissociative symptoms in large multicentric sample of inpatients diagnosed with schizophrenia and AVH (n=350). Secondary objectives are (i) test in the model the role of all the early patterns described by Jeffrey Young instead of targeting only the schemes that are part of the model tested in previous study as the one by Bortolon and colleagues, (ii) compare the quality of the adjustment of the confirmatory model to the quality of the adjustment of the exploratory model.
METHODS: one single visit in which subjects will receive self-reported questionnaires (Childhood trauma questionnaire, The Young schema questionnaire short form, Dissociative experiences scale, Launay-Slade hallucination scale and Cardiff Anomalous Perceptions Scale.
ANALYSES: Structural equation model performed additional analysis using Partial Least Squares Structural Equation Modelling. The primary endpoint corresponds to significant associations between the variables. The quality of the model will be assessed using a fit quality measure. The secondary endpoints are significant associations between the different variables (p <0.05) and the model quality assessed with a quality measure of the fit.
MAIN HYPOTHESIS: the association between childhood trauma and predisposition to AVH is not direct, but depends on the impact of violence suffered during childhood on early maladaptive schemas and dissociative symptoms in patients with schizophrenia.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
BACKGROUND A first generation of research has demonstrated strong associations between trauma suffered in childhood (physical, psychological and sexual violence) and having schizophrenia, and more specifically to experience "hearing voices" (acoustic-verbal hallucinations, AVH).
A second generation of research is currently examining the cognitive and affective processes likely to play a mediating role in this association. These mediators appear to include early maladaptive personality patterns and dissociative experiences. Although these factors have most often been explored separately, recent research indicates that they could be associated, and thus contribute to AVH. More specifically, another study has shown that the association between childhood trauma and predisposition to AVH is not direct but depends on cognitive factors including the impact of violence suffered during childhood on early maladaptive schemas (for example, interpersonal functioning centred on "subjugation", "abandonment", "vulnerability") and dissociation. However, this study was carried out on a non-clinical sample of subjects with a predisposition to AVH OBJECTIVES Here, aim is at testing a structural model of AVH, childhood trauma, early maladaptive schemas and dissociative symptoms in large sample of patients diagnosed with schizophrenia and AVH (n=350).
Secondary objectives are (i) to carry out exploratory analyzes which will allow investigators to test in the model the role of all the early patterns described by Jeffrey Young instead of targeting only the schemes that are part of the model tested in previous study as the one by Bortolon and colleagues, (ii) compare the quality of the adjustment of the confirmatory model to the quality of the adjustment of the exploratory model.
METHODS
A cross-sectional, multicenter design (3 centres) will be performed. Patients included will be diagnosed with schizophrenia or schizoaffective disorder, and experience AVH at the time of the inclusion (n= 350). All will be inpatients. The study consists of one single visit in which the subjects will receive all the self-reported questionnaires to be completed:
- General information sheet (socio-demographic and clinical data)
- Questionnaire on traumatic childhood experiences: Childhood trauma questionnaire
- Questionnaire on early maladaptive schemas: The Young schema questionnaire short form
- Questionnaire about dissociative experiences: Dissociative experiences scale
- Questionnaire on hallucinations: Launay - Slade hallucination scale and Cardiff Anomalous Perceptions Scale.
All questionnaires have been validated in French. ANALYSES Structural equation model performed additional analysis using Partial Least Squares Structural Equation Modelling (PLS-SEM).
The primary endpoint corresponds to significant associations (significance threshold <0.05) between the variables as in the model described by Bortolon and colleagues. The quality of the model (both measurement and structural model) will be assessed using a fit quality measure.
The secondary endpoints are significant associations between the different variables (p <0.05) and the model quality assessed with a quality measure of the fit.
HYPOTHESES It's hypothesized that the association between childhood trauma and predisposition to AVH is not direct, but depends on the impact of violence suffered during childhood on early maladaptive schemas (for example, interpersonal functioning centred on "subjugation", "abandonment", "vulnerability") and dissociative symptoms in patients with schizophrenia.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Clément DONDE
- Phone Number: +33 (0)4 76 76 39 86
- Email: cdondecoquelet@chu-grenoble.fr
Study Locations
-
-
-
La Tronche, France, 38700
- Recruiting
- Grenoble University Hospital
-
Contact:
- Clément DONDÉ, MD PhD
- Email: cdondecoquelet@chu-grenoble.fr
-
Saint-Étienne, France
- Recruiting
- CHU St Etienne
-
Contact:
- Eric FAKRA, Pr
- Phone Number: +33 (0)4 77 82 88 52
- Email: Eric.Fakra@chu-st-etienne.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
- Schizophrenia or schizo-affective disorder
- Auditory hallucinations
- Fluent in French
- Gave informed consent
Exclusion Criteria:
- Agitation or suicide risk
- Involuntary Hospitalization
- Neurologic condition
- No informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Schizophrenia
Patients included will be diagnosed with schizophrenia or schizoaffective disorder, and experience AVH at the time of the inclusion (n= 350).
All will be inpatients.
|
age; gender; education; highest diploma; job; marital status; living place
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Auditory hallucinations measured by the Launay-Slade Hallucination Scale
Time Frame: Baseline
|
The auditory hallucinations measured by the Launay-Slade Hallucination Scale, which is a self-report scale developed to measure predisposition to hallucinations. Three items were designed to measure verbal hallucinations, which are measured using a 5-point Likert scale, from 0 to 4 (0 = "definitely does not apply to me," 1 = "possibly does not apply to me," 2 = "unsure," 3 = "possibly applies to me," and 4 = "definitely applies to me"). |
Baseline
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Defensive dissociation assessed by the Dissociative experiences scale (DES)
Time Frame: Baseline
|
Defensive dissociation assessed by the Dissociative experiences scale (DES).
The DES is a 28-item developed to measure dissociative experiences.
Respondents are asked to rate how often they experienced each of the 28 described situation compared to other people.
The scale was composed of 11 boxes that the participants had to tick (from "much less than others" to "much more than others").
|
Baseline
|
Early maladaptive schema "Abandonment", which is measured by the young schema questionnaire short form (SQ-SF)
Time Frame: Baseline
|
The early maladaptive schema "Abandonment", which is measured by the young schema questionnaire short form (SQ-SF).
The SQ-SF is a 75-item, self-report inventory designed to measure 15 EMS proposed by Young.
Each item is rated on a 6-point scale (from 1 = "completely untrue of me" to 6 = "describes me perfectly").
Higher scores indicate a greater presence of a maladaptive schema for the respondent.
|
Baseline
|
The early maladaptive schema "Self-sacrifice", which is measured by the young schema questionnaire short form (SQ-SF)
Time Frame: Baseline
|
The early maladaptive schema "Self-sacrifice", which is measured by the young schema questionnaire short form (SQ-SF).
The SQ-SF is a 75-item, self-report inventory designed to measure 15 EMS proposed by Young.
Each item is rated on a 6-point scale (from 1 = "completely untrue of me" to 6 = "describes me perfectly").
Higher scores indicate a greater presence of a maladaptive schema for the respondent.
|
Baseline
|
The early maladaptive schema "Vulnerability", which is measured by the young schema questionnaire short form (SQ-SF)
Time Frame: Baseline
|
The early maladaptive schema "Vulnerability", which is measured by the young schema questionnaire short form (SQ-SF).
The SQ-SF is a 75-item, self-report inventory designed to measure 15 EMS proposed by Young.
Each item is rated on a 6-point scale (from 1 = "completely untrue of me" to 6 = "describes me perfectly").
Higher scores indicate a greater presence of a maladaptive schema for the respondent.
|
Baseline
|
The early maladaptive schema "Subjugation", which is measured by the young schema questionnaire short form (SQ-SF)
Time Frame: Baseline
|
The early maladaptive schema "Subjugation", which is measured by the young schema questionnaire short form (SQ-SF).
The SQ-SF is a 75-item, self-report inventory designed to measure 15 EMS proposed by Young.
Each item is rated on a 6-point scale (from 1 = "completely untrue of me" to 6 = "describes me perfectly").
Higher scores indicate a greater presence of a maladaptive schema for the respondent.
|
Baseline
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003 Feb;27(2):169-90. doi: 10.1016/s0145-2134(02)00541-0.
- Daalman K, Diederen KM, Derks EM, van Lutterveld R, Kahn RS, Sommer IE. Childhood trauma and auditory verbal hallucinations. Psychol Med. 2012 Dec;42(12):2475-84. doi: 10.1017/S0033291712000761. Epub 2012 Apr 16.
- Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, Read J, van Os J, Bentall RP. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 2012 Jun;38(4):661-71. doi: 10.1093/schbul/sbs050. Epub 2012 Mar 29.
- Williams J, Bucci S, Berry K, Varese F. Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clin Psychol Rev. 2018 Nov;65:175-196. doi: 10.1016/j.cpr.2018.05.009. Epub 2018 Jun 2.
- Bortolon C, Seille J, Raffard S. Exploration of trauma, dissociation, maladaptive schemas and auditory hallucinations in a French sample. Cogn Neuropsychiatry. 2017 Nov;22(6):468-485. doi: 10.1080/13546805.2017.1387524. Epub 2017 Oct 12.
- Evans GJ, Reid G, Preston P, Palmier-Claus J, Sellwood W. Trauma and psychosis: The mediating role of self-concept clarity and dissociation. Psychiatry Res. 2015 Aug 30;228(3):626-32. doi: 10.1016/j.psychres.2015.04.053. Epub 2015 Jun 11.
- Bell V. A community of one: social cognition and auditory verbal hallucinations. PLoS Biol. 2013 Dec;11(12):e1001723. doi: 10.1371/journal.pbio.1001723. Epub 2013 Dec 3.
- Bentall RP, Slade PD. Reality testing and auditory hallucinations: a signal detection analysis. Br J Clin Psychol. 1985 Sep;24 ( Pt 3):159-69. doi: 10.1111/j.2044-8260.1985.tb01331.x.
- Laroi F, Marczewski P, Van der Linden M. Further evidence of the multi-dimensionality of hallucinatory predisposition: factor structure of a modified version of the Launay-Slade Hallucinations Scale in a normal sample. Eur Psychiatry. 2004 Feb;19(1):15-20. doi: 10.1016/S0924-9338(03)00028-2.
- Cottraux J, & Blackburn IM. Psychothérapies cognitives des troubles de la personnalité. NPG Neurologie-Psychiatrie-Gériatrie. 2007; 7(37), 41.
- Larøi F, Billieux J, Defeldre A-C, Ceschi, G, Van der Linden M. Factorial structure and psychometric properties of the French adaptation of the Dissociative Experiences Scale (DES) in non-clinical participants. Revue Européenne de Psychologie Appliquée/European Review of Applied Psychology. 2013; 63(4): 203-208.
- Launay G, Slade P. The measurement of hallucinatory predisposition in male and female prisoners. Personality and Individual Differences. 1981; 2(3): 221-234.
- Mauchand P, Lachenal-Chevallet K, Cottraux J. [Empirical validation of the Young Schema Questionnaire-Short Form (YSQ-S2) in borderline personality disorder and control subjects]. Encephale. 2011 Apr;37(2):138-43. doi: 10.1016/j.encep.2010.04.014. Epub 2010 Jul 3. French.
- Briere J, Scott C. Assessment of trauma symptoms in eating-disordered populations. Eat Disord. 2007 Jul-Sep;15(4):347-58. doi: 10.1080/10640260701454360.
- Darves-Bornoz JM, Degiovanni A, Gaillard P. Validation of a French version of the Dissociative Experiences Scale in a rape-victim population. Can J Psychiatry. 1999 Apr;44(3):271-5. doi: 10.1177/070674379904400308.
- Garrison JR, Moseley P, Alderson-Day B, Smailes D, Fernyhough C, Simons JS. Testing continuum models of psychosis: No reduction in source monitoring ability in healthy individuals prone to auditory hallucinations. Cortex. 2017 Jun;91:197-207. doi: 10.1016/j.cortex.2016.11.011. Epub 2016 Nov 22.
- Johns LC, Kompus K, Connell M, Humpston C, Lincoln TM, Longden E, Preti A, Alderson-Day B, Badcock JC, Cella M, Fernyhough C, McCarthy-Jones S, Peters E, Raballo A, Scott J, Siddi S, Sommer IE, Laroi F. Auditory verbal hallucinations in persons with and without a need for care. Schizophr Bull. 2014 Jul;40 Suppl 4(Suppl 4):S255-64. doi: 10.1093/schbul/sbu005.
- Perona-Garcelan S, Carrascoso-Lopez F, Garcia-Montes JM, Ductor-Recuerda MJ, Lopez Jimenez AM, Vallina-Fernandez O, Perez-Alvarez M, Gomez-Gomez MT. Dissociative experiences as mediators between childhood trauma and auditory hallucinations. J Trauma Stress. 2012 Jun;25(3):323-9. doi: 10.1002/jts.21693. Epub 2012 May 15.
- Perona-Garcelan S, Garcia-Montes JM, Cuevas-Yust C, Perez-Alvarez M, Ductor-Recuerda MJ, Salas-Azcona R, Gomez-Gomez MT. A preliminary exploration of trauma, dissociation, and positive psychotic symptoms in a Spanish sample. J Trauma Dissociation. 2010;11(3):284-92. doi: 10.1080/15299731003786462.
- Pilton M, Varese F, Berry K, Bucci S. The relationship between dissociation and voices: A systematic literature review and meta-analysis. Clin Psychol Rev. 2015 Aug;40:138-55. doi: 10.1016/j.cpr.2015.06.004. Epub 2015 Jun 16.
- Wright DB, Loftus EF. Measuring dissociation: comparison of alternative forms of the dissociative experiences scale. Am J Psychol. 1999 Winter;112(4):497-519.
- Wright MO, Crawford E, Del Castillo D. Childhood emotional maltreatment and later psychological distress among college students: the mediating role of maladaptive schemas. Child Abuse Negl. 2009 Jan;33(1):59-68. doi: 10.1016/j.chiabu.2008.12.007. Epub 2009 Jan 23.
- Young JE. Cognitive therapy for personality disorders : A schema-focused approach. Professional Resource Press/Professional Resource Exchange. 1999.
- Young JE, Brown G. Young schema questionnaire short form. New York: Cognitive Therapy Centre. 1998.
- Young JE, Klosko, JS, Weishaar, ME. Schema therapy : A practitioner's guide. 2005.
- Hair Jr JF, Hult GTM, Ringle C, Sarstedt M. A primer on partial least squares structural equation modeling (PLS-SEM). Sage publications. 2016.
- First MB, Spitzer RL, Gibbon M, Williams JB, et al. Structured clinical interview for DSM-IV axis I disorders. New York: New York State Psychiatric Institute. 1995.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. 2013.
- Bernstein DP, Ahluvalia T, Pogge D, Handelsman L. Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry. 1997 Mar;36(3):340-8. doi: 10.1097/00004583-199703000-00012.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 38RC20.055
- 2020-A00452-37 (Other Identifier: ID RCB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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