Pérdida traumática y psicosis–re-conceptualizando el rol del trauma en la psicosis

Translated title of the contribution: Traumatic loss and psychosis–reconceptualising the role of trauma in psychosis

S. Vallath*, L. Ravikanth, B. Regeer, P. C. Borba, D. C. Henderson, W. F. Scholte

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Literature suggests that the occurrence of psychological trauma (PT) from various negative life experiences beyond events mentioned in the DSM-criterion A, receives little to no attention when comorbid with psychosis. In fact, despite research indicating the intricate interplay between PT and psychosis, and the need for trauma-focused interventions (TFI), there continue to be mixed views on whether treating PT would worsen psychosis, with many practitioners hesitating to initiate treatment for this reason. This study, therefore, aimed to understand patient perspectives on the role of PT in psychosis and related treatment options. A qualitative exploratory approach was adopted using in-depth interviews with individuals experiencing psychosis. The Global Assessment of Functioning (GAF) scale was administered on a predetermined maximum variation sample resulting in two groups of participants- those with moderate-mild disability (GAF 54–80; n = 10) and those experiencing moderate-severe disability (GAF 41–57; n = 10). With the former group, a semi-structured interview schedule was used, while with the latter, owing to multiple symptoms and difficulty in cognitive processing, a structured interview schedule was used. Results from interpretative phenomenological analysis (IPA) indicated that traumatic loss was central to experienced PT, but received no attention; this often contributed to the psychotic experience and/or depression, through maintenance factors such as cognitive distortions and attenuated affective responses. Further, the experience of loss seems to be more consequential to trauma-related symptoms than the event itself. Participants opined strongly the need for TFI and the role of it in promoting recovery from psychosis.

Translated title of the contributionTraumatic loss and psychosis–reconceptualising the role of trauma in psychosis
Original languageSpanish
Article number1725322
JournalEuropean Journal of Psychotraumatology
Volume11
Issue number1
DOIs
Publication statusPublished - 31 Dec 2020

Funding

This work was supported by the Sundaram Fasteners, Centre for Social Action and Research (CSAR), The Banyan Academy of Leadership in Mental Health (BALM). The authors thank all clients and staff at the organisation of study for their inputs and cooperation in data collection. The author also thanks Mr Andrew R. Gilmoor, department of earth and life sciences, Vrije Universiteit, Amsterdam, for assisting in data analysis and coding transcripts as well as Mr Srihari Swamy, intern, for assisting the PI in some parts of the data collection process.

Keywords

  • homelessness
  • Negative life experiences
  • schizophrenia
  • trauma-focused interventions
  • traumatic loss
  • • Events are less consequential, loss experienced has more impact
  • • Therapy for traumatic loss is key to recovery and safe in psychosis
  • • “Traumatic loss” interplays with trauma related symptoms and psychosis

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