Childhood sexual abuse moderates the relationship of self-reflectivity with increased emotional distress in schizophrenia

For many diagnosed with schizophrenia, increased self-awareness is associated with an increase in distress. This link, however, does not appear to be consistent for all with schizophrenia and thus it may be that there are different factors that make one more likely to experience increased distress with increased awareness. The current study sought to explore whether having experienced trauma could be one such factor that influences the relationship between increased awareness and greater distress. We hypothesized that for those who have experienced childhood sexual abuse, increasingly complex understandings of themselves will be linked with heightened distress and symptoms of schizophrenia. This hypothesis was examined in two groups of outpatients diagnosed with schizophrenia, with one group reporting a traumatic event and another group who did not report this specific trauma. Correlation coefficients of the relationship between measures of awareness and PANSS symptom scores among the two groups were compared and supported this hypothesis, suggesting that increased awareness may be associated with increased distress particularly for those who have experienced trauma in their lives. These findings have several clinical implications, including the importance of understanding the protective role psychotic symptoms may play in the face of distress.