Trauma and psychosis: a qualitative study exploring the perspectives of people with psychosis on the influence of traumatic experiences on psychotic symptoms and quality of life

Abstract

Background Despite experiencing high rates of trauma and trauma-related conditions, people with psychosis are seldomly asked about possible traumatic events. While there are some barriers to discussing trauma in clinical services, research has shown that disclosure is not only possible but also beneficial to both psychotic and traumatic symptoms. The current study is the first to evaluate service users’ perception of the influence of trauma on the development and maintenance of their psychotic symptoms, as well as their views on how their life and mental health have been affected by traumatic events and their disclosure (or lack of). Methods Eleven participants with experiences of psychosis and trauma took part in semi-structured interviews. Results Consistently with previous literature, our participants reported high rates of interpersonal trauma, but had rarely had the opportunity to discuss any of these events. Using thematic analysis, we identified three major themes that have important implications for healthcare: factors that facilitate or hinder talking about trauma; consequences of talking or not; and relationship between trauma and psychosis. Participants generally benefited from talking about trauma and concerningly often associated the prolonged lack of opportunities to discuss traumatic events with negative feelings towards the self and with a deterioration of their mental health. Participants also recognised direct links between past traumas and the content and characteristics of their psychotic experiences. Conclusions Our findings highlight the importance, as perceived by service users, of discussing trauma and looking at psychosis through a “trauma lens”. These results stress the need to systematically assess trauma history and traumatic symptoms in psychosis and might potentially help to overcome clinicians’ worries about discussing trauma with service users. Our findings underscore the need to change current practice and implement trauma-informed approaches to understand clients’ difficulties and provide support.

Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis

“…The results of our meta-analysis suggest that it would be beneficial to systematically assess CM in routine care as a standard practice in (mental) health settings (Neill & Read, 2022 ). Clinicians should ask about all types of CM experiences (Read, Hammersley, & Rudegeair, 2007 ; Read et al, 2018 ), implement meaningful measures for its detection and provide effective service responses (Campodonico, Varese, & Berry, 2022 ). Extra-training on CM and its social consequences for (mental) health professionals supporting those with PD is indicated.…”

Recovery journey of schizophrenic patients in Chinese culture:A Qualitative Study of Experiences

“…Previous studies have suggested that developing schizophrenia is a traumatic experience for patients [27,28,29]. Some studies have linked traumatic experiences to psychotic symptoms and treatment experiences [30], while others have linked traumatic experiences to shame [31,32].…”

Coping and Growth in Psychosis: Positive Pathways Following Trauma

“…This study was embedded in the larger quantitative study from which participants were recruited from, which has received NHS Research Ethics Committee and Health Research Authority approval (reference number: 18/NW/0469). This study involved the same participants from a qualitative study which focused on service users' perspectives on the influence of traumatic experiences on psychotic symptoms and quality of life (Campodonico, Varese, & Berry, 2022). Participants were approached via phone and offered the opportunity to be included in a qualitative follow-up after participating in the quantitative study.…”