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This study examined between-group differences in mediation by psychological and behavioral variables in profile\u2013distress associations, with potential moderation by gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104437_sec40\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study derived childhood trauma profiles via latent class analysis of Childhood Trauma Questionnaire (CTQ) scores from 266 voice-hearing Challenge trial participants with schizophrenia-spectrum diagnoses. Mediation analyses (structural equation modeling with bootstrapped 95% confidence intervals for indirect effects) tested between-group differences in indirect effects of negative voice content, persecutory beliefs about voices, voice power, voice relating style, negative self\/other beliefs, emotion regulation, depression, and sleep disturbances in the association between childhood trauma profiles (exposure) and voice-related distress (outcome), with gender as a moderator. Hypotheses were preregistered on the Open Science Framework. Reporting followed AGReMA-guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104437_sec41\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three childhood trauma profiles were established: (1) \u2018variable severity\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0160), (2) \u2018severe neglect and emotional abuse\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a084), and (3) \u2018severe poly-trauma\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a022). Significant between-group differences in indirect effects were observed for persecutory beliefs about voices (1\u00a0&lt;\u00a03), voice power (1\u00a0&lt;\u00a03), and sleep disturbances (1\u00a0&lt;\u00a02). Age-adjustment revealed a between-group difference in indirect effect of negative self-beliefs (1\u00a0&lt;\u00a03). No moderation by gender was found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104437_sec42\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first investigation of mediators and moderators of childhood trauma profiles and voice-related distress in clinical voice-hearers. Findings suggest that trauma profiles may provide indicators of mediators potentially relevant to inform individualized formulation and therapy planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726104437","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:11:23Z","timestamp":1780913483000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Psychological and behavioral mechanisms linking childhood trauma profiles to voice-related distress in schizophrenia spectrum disorders: latent class, mediation, and conditional process analyses"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2788-5642","authenticated-orcid":false,"given":"Mads Juul","family":"Christensen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jk5qe80","id-type":"ROR","asserted-by":"publisher"}],"name":"Aalborg University 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