# The Occurrence of and Distress From Pathogenic Beliefs: Examining Pathways From Childhood Adversity to Psychopathology

## TL;DR

This study shows how harmful beliefs formed from childhood trauma can lead to mental health issues and how measuring both the presence and distress of these beliefs can improve treatment.

## Contribution

The study introduces the concept of reactivity in pathogenic beliefs and validates the PBS-21 for assessing both occurrence and distress separately.

## Key findings

- Both occurrence and distress of pathogenic beliefs mediate the link between childhood adversity and psychopathology.
- Reactivity to pathogenic beliefs moderates the relationship between adverse parenting and psychological distress.
- Assessing both occurrence and distress can improve treatment outcome measurement in therapy.

## Abstract

Pathogenic beliefs are dysfunctional beliefs that impede the pursuit of adaptive goals, which have been shown as key pathways between early childhood trauma and psychopathology. This study examined whether the occurrence of pathogenic beliefs and the distress from having pathogenic beliefs, which were assessed through the latest version of the pathogenic belief scale (PBS‐21) separately, would both mediate the childhood adversity‐outcome relationship, and whether reactivity of pathogenic beliefs (standardized difference between distress and occurrence) moderates them.

A total of 390 adult participants with prior psychotherapy experience were recruited from the United Kingdom online. Participants completed self‐report measures assessing perceived adverse parenting, psychopathology (depression, anxiety, general distress and interpersonal problems) and pathogenic beliefs (occurrence, distress and reactivity).

Both occurrence and distress of pathogenic beliefs fully mediated the relationship between adverse parenting and depressive/anxiety symptoms and general distress, and partially mediated interpersonal problems. Reactivity significantly moderated the pathway from adverse parenting to pathogenetic beliefs. Individuals who reported more adverse parenting and were categorized as having higher reactivity were more likely to develop pathogenic beliefs and experience greater psychological distress.

These findings align with prior research showing that pathogenic beliefs are key in the association between childhood adversity and psychopathology. The study supports the validity of the PBS‐21 and demonstrates the value of assessing the occurrence of pathogenic beliefs and the distress from having these beliefs separately. Reactivity to pathogenic beliefs may serve as a clinically meaningful marker for identifying individuals with resilience and tailoring interventions accordingly.

The subjective meanings attributed to early adverse experiences may be more predictive of subsequent psychopathology than the experiences themselves. In evaluating early traumatic or adverse events, clinicians need to evaluate and understand how the patient interpreted those events.A full understanding of pathogenic beliefs requires the clinician to evaluate both the occurrence of these beliefs and the distress associated with them, thereby allowing for the assessment of reactivity. The relationship between early adverse events and psychopathology tends to be stronger in individuals with high pathogenic belief reactivity, and these individuals may be more likely to benefit from interventions that reduce the distress associated with them.Assessing both the occurrence and distress associated with pathogenic beliefs can potentially provide more precise treatment outcome measurement. At the beginning of therapy, a patient who reported the occurrence of particular pathogenic beliefs and a high degree of distress associated with them may at the end of therapy still report being aware of the beliefs (occurrence) but feel little if any distress connected with them.

The subjective meanings attributed to early adverse experiences may be more predictive of subsequent psychopathology than the experiences themselves. In evaluating early traumatic or adverse events, clinicians need to evaluate and understand how the patient interpreted those events.

A full understanding of pathogenic beliefs requires the clinician to evaluate both the occurrence of these beliefs and the distress associated with them, thereby allowing for the assessment of reactivity. The relationship between early adverse events and psychopathology tends to be stronger in individuals with high pathogenic belief reactivity, and these individuals may be more likely to benefit from interventions that reduce the distress associated with them.

Assessing both the occurrence and distress associated with pathogenic beliefs can potentially provide more precise treatment outcome measurement. At the beginning of therapy, a patient who reported the occurrence of particular pathogenic beliefs and a high degree of distress associated with them may at the end of therapy still report being aware of the beliefs (occurrence) but feel little if any distress connected with them.