What impact does trauma have on the at‐risk mental state? A systematic literature review

Abstract

Identification of individuals with an at-risk mental state (ARMS) who are at a heightened risk of developing psychosis allows researchers and clinicians to identify what factors are associated with poorer outcomes and transitions to psychosis. A number of socioenvironmental factors are linked to an increase risk of developing psychosis, of which childhood trauma is widely acknowledged. The current review aims to examine what impact trauma has on the ARMS by reviewing reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology from both cross sectional and prospective design studies. A literature search was conducted for all relevant original research articles published in the English language up to December 2015 using 3 electronic databases: PsycINFO, Web of Science and PubMed. A total of 6 papers met the inclusion criteria and were included in the current review. Trauma was found to have a significant impact on the ARMS observed through reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology. Sexual trauma demonstrated the most consistent trauma variable to impact the ARMS. Individuals with an ARMS who have experienced sexual trauma are at a heightened risk of poorer outcomes and transitions to psychosis. Further prospective design studies are required to examine this observation further.

Childhood adversities in people at ultra-high risk (UHR) for psychosis: a systematic review and meta-analysis

“…Most systematic reviews were conducted on individuals with psychotic disorders (Read et al ., 2003; Morgan and Fisher, 2007; Bonoldi et al ., 2013; de Sousa et al ., 2014), or specifically in people with schizophrenia (Matheson et al ., 2013). Some reviews broadened the scope to include both psychotic disorders and any psychotic experiences (Varese et al ., 2012), while others included studies that report only the severity of psychotic experiences in the general population (van Dam et al ., 2012; Trotta et al ., 2015) or the UHR population (Fusar-Poli et al ., 2013, 2016; Kraan et al ., 2015 b ; Brew et al ., 2017).…”

Features of borderline personality disorder as a mediator of the relation between childhood traumatic experiences and psychosis-like experiences in patients with mood disorder

“…Patients with a variety of mental disorders often report CEs [32][33][34][35][36][37][38][39][40][41][42][43]. In our previous study [17], patients with mood disorders reported CEs more often than non-psychiatric individuals investigated in an earlier study [61].…”

“…The investigation was undertaken with a relatively large and representative sample of mood disorder patients recruited from specialized psychiatric care, and extensive data of self-reported symptoms and experiences was collected. Moreover, we examined a comprehensive set of self-reported data of CEs, an important factor in the aetiology of mood disorders, psychosis and BPD [32][33][34][35][36][37][38][39][40].…”

“…Childhood traumatic experiences (CEs) are an aetiological factor contributing to development of several mental disorders, including mood disorders, psychosis and BPD [32][33][34][35][36][37][38][39][40]. Both patients with BPD and UHR report CEs often, and especially sexual abuse was suggested to contribute to development of psychosis [41] and BPD [42,43].…”

Psychotherapy in people at a high risk of psychosis and those with early psychosis

“…Różne badania wskazują na związek doświadczeń urazowych z nasileniem objawów pozytywnych, afektywnych i poznawczych, a także z zaburzeniami percepcji (Loewy et al, 2019;O'Connor et al, 2019), choć nie we wszystkich badaniach zależności te są spójnie wykazywane (de Vos et al, 2019). Zwraca się uwagę, że wpływ traumy na nasilenie objawów i poziom funkcjonowania pacjenta zależy od kilku czynników: dawki (czyli ilości), jakości i przewlekłości doświadczeń urazowych (Brew et al, 2018). Doświadczenia te mogą się przyczyniać do rozwoju psychozy przez negatywne schematy postrzegania siebie i innych oraz podejrzliwość (Kilcommons i Morrison, 2005).…”