Abstract
Background: Most childhood auditory vocal hallucinations (AVH) are transient yet may predict clinical outcomes. Knowledge about course and associated risk factors is essential. Methods: We followed a case–control sample from a population survey on AVH in 3870 children (7–8 years; T0) and examined associated psychopathology and risk factors after 5 years (T1), respectively, 11 years (T2). T2 was an online assessment of AVH, other psychotic experiences, psychopathology, trauma, and cannabis use. We applied a transdiagnostic network approach to psychosis. Results: At T2, 293 adolescents participated. The AVH persistence rate was 18.2% from T1 to T2 and 6.2% from T0 to T2. Participants with AVH had higher CAPE scores than participants without AVH. AVH was associated with more psychopathology and more traumatic events. The proportion at risk of PTSD was significantly higher in those with AVH compared to those without AVH. Cannabis use in the past year was not associated with AVH. The group who reported AVH twice/thrice over the 3 assessments (as opposed to those who reported AVH once) had experienced more psychotic experiences, more traumatic events, and were more at risk of PTSD compared to the group without AVH ever. The transdiagnostic network approach showed that it is possible to map transdiagnostic experiences of psychopathology as a network and that important information can be derived from this approach in comparison to regular approaches. For instance, we found that although adolescents with and without previous AVH scored equally high on positive and negative psychotic experiences as well as on depression, both qualitative and quantitative differences in network structure between the groups were apparent. Conclusion: Early childhood AVH are mostly transitory. AVH in adolescence are associated with psychopathology and traumatic events. Based on our results, large-scale programs for early AVH detection are not feasible. In youngsters reporting AVH, examining comorbid psychopathology is recommended. Given the evident association between AVH and traumatic events, it is advisable to sensitively inquire about childhood adversity in help-seeking youngsters with AVH and, if necessary, address these traumas. A network approach seems useful.