The Trauma and Life Events (TALE) checklist: development of a tool for improving routine screening in people with psychosis

Abstract

Background: Best practice guidelines recommend traumatic events should be assessed in psychosis to support the identification and, when indicated, treatment of post-traumatic stress reactions. However, routine assessment in frontline services is rare, and available tools are not tailored to psychosis. Assessment obstacles include lengthy measures, a focus on single, physically threatening events, and the exclusion of psychosis-related traumas. Objective: To develop and validate a brief trauma screening tool for the identification of clinically significant traumas in people with psychosis. Method: The Trauma and Life Events (TALE) checklist was developed in conjunction with people with lived experience of trauma and psychosis, and specialist clinicians and researchers. The psychometric properties (i.e. test-retest reliability, content validity, construct validity) of the TALE were evaluated in a sample of 39 people with psychosis diagnoses. Results: The TALE displayed moderate psychometric acceptability overall, with excellent reliability and convergent validity for sexual abuse. High rates of psychosis-related trauma and childhood adversity were reported, in particular bullying and emotional neglect. A dose–response relationship between cumulative trauma, post-traumatic stress and psychosis was found. Conclusions: The TALE is the first screening tool specifically designed to meet the needs of routine trauma screening in psychosis services. The psychometric limitations highlight the challenge of developing a measure that is both sufficiently brief to be useful in clinical settings and comprehensive enough to identify all relevant adverse events. Validation of the TALE is now required across the spectrum of psychosis.

Optimising AVATAR therapy for people who hear distressing voices: study protocol for the AVATAR2 multi-centre randomised controlled trial

“… 1 Patient perceived trauma-voice links - Trauma Voice Associations Questionnaire (TVAQ) [ 44 ]. 1 Trauma history - Mini-Trauma And Life Events (TALE) checklist [ 45 ] 1 Clinical Assessment Interview for Negative Symptoms (CAINS) [ 46 ] 1 Identification of positive symptoms – Initial items from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) 2.1 [ 47 ] 1 Detailed assessment of positive symptoms - Scale for the Assessment of Positive Symptoms [ 48 ] 1 COVID-19 Impact COVID-19 Context Questionnaire to assess individual circumstances during pandemic and change in voice experiences. 1, 2, 3 a 1 = baseline, 2 = 16 weeks post-randomisation, 3 = 28 weeks post-randomisation …”

Trauma and Psychosis: A Qualitative Study Exploring the Perspectives of People with Psychosis

“…A sample of eleven participants was purposively recruited to complete semi-structured interviews as part of a larger quantitative research on post-traumatic reactions in people with psychosis. Participants were recruited if: 1) aged 16 or above; (2) able to provide informed consent; (3) experiencing psychosis as con rmed by relevant mental health professional; (4) experienced a di cult life event as de ned by the Trauma and Life Events Checklist [TALE;35]. Participants were excluded if: 1) experiencing dementia and/or other organic disorders; (2) had insu cient English to understand and complete the assessment; (3) had an intellectual disability which would impact the ability to complete the assessment.…”

Trauma-focused therapies for posttraumatic stress in psychosis

“…All interviews and assessments take place at locations of the participating mental health organisation, ideally the location that the patient regularly attends for treatment. 56 It covers all main categories of trauma (abuse and neglect) and also bullying, stressful psychotic experiences, experiences of loss, and stressful experiences in contact with mental health or criminal justice services.…”

“…22 • Revictimization: using the 8 interpersonal victimization items from the TALE. 56 Daily monitoring: to assess how post-traumatic stress and psychosis dynamically interact at baseline and post-treatment.…”