4.3 Trauma and Symptom Severity
The absence of a significant relationship between the retrospective assessment of trauma-exposure and symptom severity contrasts with the previous literature (Carr et al., 2018; Larkin & Read, 2008; Matheson et al., 2018; Shelvin et al., 2007). Childhood exposure to trauma also had no relationship with symptom severity, again contrasting with previous literature (Bentall et al., 2014; Humphrey et al., 2022). This finding may indicate that it is not the presence of trauma-exposure that impacts the symptomology of psychosis but possibly the appraisal and the related distress. For instance, recent research has indicated the role of complex PTSD as a potential mediator between early trauma and the development of psychosis (Mason et al., 2023). Another possible explanation for this finding is that other factors mediate the influence trauma exposure has on symptom severity. For example, attachment and cannabis-use have been shown to be mediating factors in the relationship between childhood trauma and psychosis (Humphrey et al., 2022; Kiburi et al., 2021). Finally, methodological issues with retrospective assessment of trauma-exposure based on case-histories may also have impacted the findings. This methodology does not have the advantage of being able to explore trauma-exposure experiences with participants to understand the nuances of the experiences, the impact or trauma-related symptomatology.