eprintid: 10205564 rev_number: 24 eprint_status: archive userid: 699 dir: disk0/10/20/55/64 datestamp: 2025-03-05 08:08:31 lastmod: 2025-03-05 08:08:31 status_changed: 2025-03-05 08:08:31 type: article metadata_visibility: show sword_depositor: 699 creators_name: Melegkovits, Eirini Aikaterini creators_name: Tang, Rui creators_name: Pounds, Olivia creators_name: Ashcroft, Katie creators_name: Jung, Paul creators_name: Kennerley, Helen creators_name: Fonagy, Peter creators_name: Bloomfield, Michael title: The experience and role of dissociation in psychosis following developmental trauma: A systematic review ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D05 divisions: F66 keywords: Abuse, Dissociation, Hallucination, Trauma, Psychosis note: Under a Creative Commons license https://creativecommons.org/licenses/by/4.0/ abstract: Developmental trauma (DT), defined as abuse or neglect before age 18, is linked with elevated risk and poorer outcomes in psychosis. This systematic review aimed to elucidate the relationship between DT and dissociation in psychosis and discern the potential mediating role of dissociation in the link between DT and psychotic manifestations. Our study protocol was pre-registered with PROSPERO (CRD42022330026). We adopted broad criteria, including a variety of methodologies exploring dissociation post-DT in individuals exhibiting psychosis or psychotic features. Risk of bias was assessed for all included studies. Our review incorporated 40 studies, totalling 6941 participants. A significant moderate association was observed between DT and dissociation (r = 0.33 (95 %CI: 0.28–0.38)), underscored by dose-response effects. Sexual and emotional abuse demonstrated the most robust associations with dissociation. Individuals with psychosis and DT reported elevated dissociation relative to their non-traumatized counterparts. Dissociation mediated the link between DT and positive psychotic symptoms, notably hallucinations, across clinical and general populations. Five studies pinpointed dissociation's mediating role in tying DT to paranoia and delusional ideation. The review delves into clinical considerations, emphasizing screening for psychotic and dissociative symptoms in DT survivors, and outlining dissociation management strategies. Future research, employing longitudinal, qualitative, and experimental approaches, remains paramount. date: 2025-02 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/j.cpr.2025.102564 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2365747 doi: 10.1016/j.cpr.2025.102564 lyricists_name: Fonagy, Peter lyricists_id: PFONA04 actors_name: Fonagy, Peter actors_name: Farrar, Clare actors_id: PFONA04 actors_id: CFARR38 actors_role: owner actors_role: impersonator full_text_status: public publication: Clinical Psychology Review article_number: 102564 issn: 0272-7358 citation: Melegkovits, Eirini Aikaterini; Tang, Rui; Pounds, Olivia; Ashcroft, Katie; Jung, Paul; Kennerley, Helen; Fonagy, Peter; Melegkovits, Eirini Aikaterini; Tang, Rui; Pounds, Olivia; Ashcroft, Katie; Jung, Paul; Kennerley, Helen; Fonagy, Peter; Bloomfield, Michael; - view fewer <#> (2025) The experience and role of dissociation in psychosis following developmental trauma: A systematic review. Clinical Psychology Review , Article 102564. 10.1016/j.cpr.2025.102564 <https://doi.org/10.1016/j.cpr.2025.102564>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205564/13/Fonagy_1-s2.0-S0272735825000303-main.pdf