Synergistic pathways to delusions: enduring vulnerabilities, proximal life stressors and maladaptive psychological coping.

AIM: We sought to extend findings on the vulnerability to psychosis by investigating multifactorial pathways to delusions. Risk factors assessed spanned across early acquired vulnerabilities (heredity, childhood trauma, early cannabis use), proximal life stressors (life hassles, methamphetamine use) and psychological coping (experiential avoidance).

METHODS

Participants were recruited to a non-clinical sample (n = 133) or a clinical sample of psychosis patients (n = 100).

RESULTS

Path analyses indicated three distinct pathways predicting vulnerability to delusions in the non-clinical sample: (i) childhood emotional trauma combined with subsequent experiences of life hassles; (ii) heredity in combination with experiential avoidance; and (iii) early cannabis use combined with proximal methamphetamine use. The first pathway was partially mediated by experiential avoidance. The model was largely replicated in the clinical sample, with childhood sexual trauma replacing emotional trauma in the model.

CONCLUSION

The study demonstrated that vulnerability to delusions can be usefully predicted by a synergistic model incorporating early-acquired vulnerability factors, proximal day-to-day factors and cognitive styles.