Auditory hallucinations, childhood sexual abuse, and limbic gray matter volume in a transdiagnostic sample of people with psychosis

Childhood sexual abuse (CSA) is a potentially unique risk factor for auditory hallucinations (AH). In a transdiagnostic sample of people with psychotic disorders, patients reported higher levels of all maltreatment types than healthy controls, but those with AH (n=41) reported greater CSA than patients without AH (NAH; n=37; t=2.21, p=.03) and controls (n=37; t=3.90, p<.001). Elevated CSA among patients was most pronounced in females with AH (sex × AH status: F=4.91, p=.009), remained significant when controlling for diagnosis, medications, and other maltreatment (F=3.88, p=.02), and correlated with current AH severity (r=.26, p=.03) but not other symptoms (p>.16). Greater CSA related to larger left amygdala gray matter volume (GMV) after accounting for AH status, diagnosis, medications, and other maltreatment (t=2.12, p=.04). Findings suggest females with AH may represent a subgroup with greater CSA, and that CSA may be linked to amygdala alterations and AH. Prospective high-risk studies integrating maltreatment and brain measures are needed to elucidate mechanisms.

Zachary B. Millman, Melissa Hwang, Valerie J. Sydnor, Benjamin E. Reid, Joshua E. Goldenberg, Jessica N. Talero, Sylvain Bouix, Martha E. Shenton, Dost Öngür, Ann K. Shinn