Abstract
BACKGROUND: Childhood trauma, cognitive biases, neuroticism, and depression have emerged as crucial risk markers for psychotic-like experiences (PLEs). However, the interplay among these variables in influencing the risk of PLEs remains largely unexplored. This study aims to investigate the effect of the complex relationship between childhood trauma, cognitive biases, neuroticism, and depression on the risk of PLEs among adolescents. METHODS: A total of 4,087 adolescents from three senior high schools were recruited for this study. We utilized the Community Assessment of Psychic Experiences to measure PLEs, the Childhood Trauma Questionnaire to assess childhood trauma, the Davos Assessment of Cognitive Biases scale to evaluate cognitive biases, the neuroticism subscale of the Neuroticism-Extraversion-Openness Personality Inventory to assess neuroticism, and the Patient Health Questionnaire to measure depression. Psychiatric diagnoses were screened using a self-report questionnaire. RESULTS: Childhood trauma, cognitive biases, neuroticism and depression were all associated with an increased risk of PLEs. Participants who had experienced childhood trauma in conjunction with depression, cognitive biases, or neuroticism exhibited a significantly higher risk of endorsing PLEs compared to those who had solely encountered childhood trauma. Path analysis revealed that cognitive biases, neuroticism and depression are significant mediators of the relationship between childhood trauma and PLEs. The model explained 44.7% of the variance in PLEs. CONCLUSIONS: Our study highlights cognitive biases, neuroticism, and depression as key mediators linking childhood trauma to PLEs, recognizing the complex interplay among these factors is crucial and should be integrated into clinical screening and therapeutic strategies to mitigate the risk of PLEs.