Posttraumatic growth following a first episode of psychosis: a mixed methods research protocol using a convergent design

Abstract

BackgroundThe suffering people experience following a first episode of psychosis is great, and has been well-investigated. Conversely, potential positive outcomes following a first episode of psychosis have been under-investigated. One such outcome that may result from a first episode of psychosis is posttraumatic growth, or a positive aftermath following the trauma of a first psychotic episode. While posttraumatic growth has been described following other physical and mental illnesses, posttraumatic growth has received very little attention following a first episode of psychosis. To address this research gap, we will conduct a mixed methods study aimed at answering two research questions: 1) How do people experience posttraumatic growth following a first episode of psychosis? 2) What predicts, or facilitates, posttraumatic growth following a first episode of psychosis?Methods/designThe research questions will be investigated using a mixed methods convergent design. All participants will be service-users being offered treatment for a first episode of psychosis at a specialized early intervention service for young people with psychosis, as well as their case managers.. A qualitative descriptive methodology will guide data-collection through semi-structured interviews with service-users. Service-users and case managers will complete questionnaires related to posttraumatic growth and its potential predictors using quantitative methods. These predictors include the impact a first episode of psychosis on service-users’ lives, the coping strategies they use; the level of social support they enjoy; and their experiences of resilience and recovery. Qualitative data will be subject to thematic analysis, quantitative data will be subject to multiple regression analyses, and results from both methods will be combined to answer the research questions in a holistic way.DiscussionFindings from this study are expected to show that in addition to suffering, people with a first episode of psychosis may experience positive changes. This study will be one of few to have investigated posttraumatic growth following a first episode of psychosis, and will be the first to do so with a mixed methods approach.

Conceptualizing resilience in adult mental health literature: A systematic review and narrative synthesis

“…Another common theme across the included texts is the idea that resilience denotes a trajectory of bouncing back from adversity (Amering & Schmolke, ; Geanellos, ; Jordan, Malla, & Iyer, ; Kalathil et al ., ; Meyer & Mueser, ; Stotland, Mattson, & Bergeson, ; Tusaie & Dyer, ; Whitfield, ). For example, resilience has been conceptualized as ‘…regaining the former mental stability following a stressful period or event’ (Amering & Schmolke, ), ‘…plasticity, or ability to bounce back in spite of adversity’ (Tusaie & Dyer, ), and ‘…the ability to…bounce back from life's challenges’ (Stotland et al ., )…”

<p>Resilience and recovery style: a retrospective study on associations among personal resources, symptoms, neurocognition, quality of life and psychosocial functioning in psychotic patients</p>

“…Also in this case, psychotic symptomatology turns out to be a negative predictive factor, whereas resilience can be considered as a protective factor. In fact, a good opinion of one’s own capabilities, a methodic style and a positive perception of the future permit psychotic patients to go beyond symptomatology distress 25,26,30. The better the self-perception, perspectives for the future, and the ability to design and organize the routine are, the better the perception of their own quality of life will be.…”

“It’s Brought Me a Lot Closer to Who I Am”: A Mixed Methods Study of Posttraumatic Growth and Positive Change Following a First Episode of Psychosis

“…The study objective was addressed using a mixed methods convergent design (16), whereby qualitative and quantitative components were conducted separately, simultaneously, and with equal priority (17). We used mixed methods for its potential to yield a more complete understanding of positive change following FEP and to capitalize on the strengths of both qualitative and quantitative approaches.…”

“…The quantitative component of this study was guided by a post-positivistic paradigm while a constructivist paradigm guided the qualitative component (16, 17). Tensions exist in combining paradigms such as these within a single mixed methods study.…”

“…A cross-sectional survey design, whereby participants were administered questionnaires at a single time point during their follow-up, was used to carry out the quantitative component of the study. The total number of participants was based on a power calculation (16).…”