Modelling the emergence of hallucinations: early acquired vulnerabilities, proximal life stressors and maladaptive psychological processes

The study aimed to expand upon existing findings on the vulnerability to psychosis by examining synergistic models of hallucination
emergence. Hypothesised vulnerability factors were separated into three stages of vulnerability; early acquired and enduring
vulnerabilities (heredity, childhood trauma, early cannabis use), proximal life stressors (life hassles) and psychological
appraisals/coping (metacognitions/experiential avoidance).

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

Path analyses in the non-clinical sample indicated that experiences of childhood emotional trauma, in combination with subsequent
experiences of life hassles, best predicted vulnerability to both hallucinations in general and auditory hallucinations specifically.
This pathway was partially mediated by negative metacognitions. The models were then replicated in the clinical sample, with
two notable differences: (1) childhood sexual trauma replaced childhood emotional trauma as the best enduring predictor in
the clinical model. (2) Experiential avoidance replaced metacognitions as the best cognitive predictor of hallucinations.

The study’s findings highlighted how vulnerability to hallucinations can occur developmentally across time, with early acquired
vulnerability factors, combining additively with more proximal day-to-day factors and cognitive style, to propel a person
further towards the formation of hallucinations.