Understanding the trauma of first‐episode psychosis

Abstract

The diagnosis of PTSD does not appear to capture all aspects of the distress of FEP. Traumagenic distress appears explained by incorporating a range of negative emotions, viewing the impact of FEP as ongoing rather than contained to the acute episode, and recognizes disruption of the individual's views of the self, others and the world.

Understanding Adaptation to First Episode Psychosis Through the Creation of Images

“…Psychosis results in multiple losses of reality, identity, hope, security, and relationships [5][6][7][8]. The experience and reoccurrence of psychosis is associated with the development of posttraumatic stress disorder (PTSD) due to the traumatic impact of psychotic symptoms, medication side effects, and hospital admissions [9].…”

“…The experience and reoccurrence of psychosis is associated with the development of posttraumatic stress disorder (PTSD) due to the traumatic impact of psychotic symptoms, medication side effects, and hospital admissions [9]. Even in the absence of an official PTSD diagnosis, an initial episode of psychosis can be experienced as traumatic [8], even beyond the acute psychotic episodes [5]. This trauma and loss is especially problematic as FEP typically occurs during late adolescence or early adulthood, disrupting psychosocial development, identity formation, independence, and relationships [10].…”

Recovery and adaptation after first-episode psychosis: The relevance of posttraumatic growth

“…Dunkley, Bates, & Findlay, 2013;Spaniol, Wewiorski, Gagne, & Anthony, 2002). Traumatic events can shatter the person's assumptions about the self and world and trauma symptoms are the by-products of a rebuilding process (Jackson & Iqbal, 2000;Janoff-Bulman, 1992).…”

“…Traumatic events can shatter the person's assumptions about the self and world and trauma symptoms are the by-products of a rebuilding process (Jackson & Iqbal, 2000;Janoff-Bulman, 1992). The unpredictability and intense distress of psychosis can precipitate many negative responses including: loss, disconnection (Dunkley et al, 2013), denial (Andresen, Oades, & Caputi 2003), avoidance, escaping (Thornhill, Clare, & May, 2004), and sealing-over (McGlashan, Docherty, & Siris, 1976). It can disrupt beliefs about the self and life (Dunkley et al, 2013) and create a need to rebuild a sense of meaning and coherence (Antonovsky, 1988).…”

“…The unpredictability and intense distress of psychosis can precipitate many negative responses including: loss, disconnection (Dunkley et al, 2013), denial (Andresen, Oades, & Caputi 2003), avoidance, escaping (Thornhill, Clare, & May, 2004), and sealing-over (McGlashan, Docherty, & Siris, 1976). It can disrupt beliefs about the self and life (Dunkley et al, 2013) and create a need to rebuild a sense of meaning and coherence (Antonovsky, 1988). From Janoff-Bulman's (1992) shattered assumptions theory, it is the new material from the trauma of psychosis that is integrated, assimilated or worked through during recovery.…”