Self‐compassion as a mediator of the relationship between childhood sexual abuse and psychotic symptoms in clinical and non‐clinical groups

Background Previous research has shown a link between childhood sexual abuse (CSA) and more severe symptoms of psychosis. There is also evidence that self‐compassion is a key mechanism linking adverse childhood experiences and mental health problems such as post‐traumatic stress disorder and depression, but no research has examined these links in psychosis. Methods We analysed existing cross‐sectional data, including 55 individuals with psychosis and 166 individuals from the general population. Participants completed standardized measures of CSA, self‐compassion, paranoia, positive psychotic symptoms and distress linked to psychosis. Results The clinical group had higher scores on CSA and all psychosis measures, but we found no differences in self‐compassion between the groups. Higher levels of CSA correlated with lower self‐compassion and higher paranoia and positive symptoms in both groups. CSA also correlated with distress linked to psychosis in the non‐clinical group. Lower self‐compassion mediated the association between higher levels of CSA and more severe paranoia in both groups. In the non‐clinical group, lower self‐compassion also mediated the association between greater CSA and more positive psychotic symptoms and more severe distress. Conclusions This is the first study to show that self‐compassion mediates the link between CSA and both paranoia and psychotic symptoms in adulthood. Self‐compassion may therefore be an important transdiagnostic candidate target in therapy to mitigate the impact of early adversity on paranoia in both clinical and non‐clinical groups. Limitations include the small clinical sample and inclusion of a cannabis‐using non‐clinical sample, though recent cannabis use did not impact self‐compassion levels.