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Relationships between Trauma and Psychosis
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Relationships between Trauma and Psychosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 August 2019) | Viewed by 29614

Special Issue Editor

Dr. Lauren M. Ellman

E-Mail Website
Guest Editor
Psychology Department, Temple University, Philadelphia, PA 19122, USA
Interests: psychosis; schizophrenia; prodrome; prenatal risk factors; psychosis-risk; early life adversity

Special Issue Information

Dear Colleagues,

The associations between traumatic life events and the risk for psychosis have been repeatedly demonstrated in a variety of studies. A history of traumatic life events also seem to specifically increase risk for psychosis, as the association persists even when controlling for comorbid psychological symptoms. In this Special Issue, we will focus on recent advances in understanding the relationship between trauma and psychosis, including epidemiologic, psychosocial, and biological evidence that will help us understand the trauma-psychosis association.  In attempting to understand this association, we will explore the relationship between trauma and the full continuum of psychosis, from psychotic-like experiences to psychotic disorder diagnoses.

Dr. Lauren M. Ellman
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Traumatic life events
  • Psychosis
  • Schizophrenia
  • Early life adversity
  • Psychotic-like experience

Published Papers (7 papers)

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Research

17 pages, 625 KiB  
Article
Associations between Race, Discrimination, Community Violence, Traumatic Life Events, and Psychosis-Like Experiences in a Sample of College Students
by Pamela J. Rakhshan Rouhakhtar, Steven C. Pitts and Jason Schiffman
J. Clin. Med. 2019, 8(10), 1573; https://doi.org/10.3390/jcm8101573 - 01 Oct 2019
Cited by 10 | Viewed by 2974
Abstract
Self-report tools of psychosis-like experiences contribute to the understanding of psychosis and may aid in identification and prevention efforts across the severity spectrum. Current tools are likely limited by biases, leading to potential systematic health disparities. Principal component analyses in diverse samples of [...] Read more.
Self-report tools of psychosis-like experiences contribute to the understanding of psychosis and may aid in identification and prevention efforts across the severity spectrum. Current tools are likely limited by biases, leading to potential systematic health disparities. Principal component analyses in diverse samples of community participants reporting psychosis-like experiences may aid in the detection of measurement biases. The current study evaluated the fit of a two-component model for the Prime Screen, a self-report psychosis-like experiences measure, in a sample of Black (n = 82) and White (n = 162) community participants, and subsequently evaluated the relation of these components with measures of mental well-being, traumatic life experiences, community violence, and experiences of discrimination. Analyses indicated limited support for a two-component model of the Prime Screen, with four of the items showing high cross-loading across both components (“poor fit” items). Although many Prime Screen items correlated with mental well-being as expected, correlations between item scores and mental well-being were non-significant for poor fit items. Community violence emerged as a significant predictor of some individual item scores for both good and poor fit items, while discrimination predicted only some poor fit item scores. Results highlight the potential limitations of current self-report tools of psychosis-like experiences, as well as possible considerations for improvement for use in diverse populations. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
13 pages, 231 KiB  
Article
Specificity of Childhood Trauma Type and Attenuated Positive Symptoms in a Non-Clinical Sample
by Arielle Ered and Lauren M. Ellman
J. Clin. Med. 2019, 8(10), 1537; https://doi.org/10.3390/jcm8101537 - 25 Sep 2019
Cited by 15 | Viewed by 3329
Abstract
Background: Childhood traumatic experiences have been consistently associated with psychosis risk; however, the specificity of childhood trauma type to interview-based attenuated positive psychotic symptoms has not been adequately explored. Further, previous studies examining specificity of trauma to specific positive symptoms have not accounted [...] Read more.
Background: Childhood traumatic experiences have been consistently associated with psychosis risk; however, the specificity of childhood trauma type to interview-based attenuated positive psychotic symptoms has not been adequately explored. Further, previous studies examining specificity of trauma to specific positive symptoms have not accounted for co-occurring trauma types, despite evidence of multiple victimization. Methods: We examined the relationship between childhood trauma (Childhood Trauma Questionnaire) with type of attenuated positive symptom, as measured by the Structured Interview for Psychosis-risk Syndromes (SIPS) among a non-clinical, young adult sample (n = 130). Linear regressions were conducted to predict each attenuated positive symptom, with all trauma types entered into the model to control for co-occurring traumas. Results: Results indicated that childhood sexual abuse was significantly associated with disorganized communication and childhood emotional neglect was significantly associated with increased suspiciousness/persecutory ideas, above and beyond the effect of other co-occurring traumas. These relationships were significant even after removing individuals at clinical high-risk (CHR) for psychosis (n = 14). Conclusions: Our results suggest that there are differential influences of trauma type on specific positive symptom domains, even in a non-clinical sample. Our results also confirm the importance of controlling for co-occurring trauma types, as results differ when not controlling for multiple traumas. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
13 pages, 1627 KiB  
Article
Uncharted Waters: Treating Trauma Symptoms in the Context of Early Psychosis
by Johanna B. Folk, Laura M. Tully, Dawn M. Blacker, Brandi D. Liles, Khalima A. Bolden, Valerie Tryon, Renata Botello and Tara A. Niendam
J. Clin. Med. 2019, 8(9), 1456; https://doi.org/10.3390/jcm8091456 - 12 Sep 2019
Cited by 14 | Viewed by 5584
Abstract
Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, [...] Read more.
Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
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14 pages, 1070 KiB  
Article
Comparing the Role of Aberrant Salience and Dissociation in the Relation between Cumulative Traumatic Life Events and Psychotic-Like Experiences in a Multi-Ethnic Sample
by Deidre M. Anglin, Adriana Espinosa, Bassem Barada, Rona Tarazi, Ashley Feng, Rachel Tayler, Neil M. Allicock and Supriya Pandit
J. Clin. Med. 2019, 8(8), 1223; https://doi.org/10.3390/jcm8081223 - 15 Aug 2019
Cited by 5 | Viewed by 3023
Abstract
Exposure to traumatic life events (TLE) is a risk factor for psychosis. Yet, a dearth of studies examines factors linking TLE to psychosis, while considering differences in TLE frequency. This study investigated dissociation and aberrant salience as mediators and moderators of the relation [...] Read more.
Exposure to traumatic life events (TLE) is a risk factor for psychosis. Yet, a dearth of studies examines factors linking TLE to psychosis, while considering differences in TLE frequency. This study investigated dissociation and aberrant salience as mediators and moderators of the relation between three TLE groups (none, 1–3 TLE and 4+ TLE) and psychotic-like experiences (PLE) in a multi-ethnic sample of 816 emerging adults. The participants completed self-report inventories of PLE (Prodromal Questionnaire), TLE (Life Events Checklist), dissociative experiences (Dissociative Symptoms Scale), and aberrant salience (Aberrant Salience Inventory). As expected, groups with higher TLE frequency endorsed higher PLE. Parallel mediation models indicated that, while aberrant salience mediated the relation between both levels of cumulative traumatic experiences (1–3 TLE and 4+ TLE) and PLE, dissociation only mediated the relation between exposure to at least four different traumatic experiences and PLE. The moderation results showed that risk of PLE was highest among individuals with 1–3 TLE who endorsed dissociation. Our results suggest that, while aberrant salience processing explains why TLE may relate to higher psychosis risk, dissociation’s role in this relation is dependent on the number of different TLE exposures. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
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17 pages, 1197 KiB  
Article
A History of Trauma is Associated with Aggression, Depression, Non-Suicidal Self-Injury Behavior, and Suicide Ideation in First-Episode Psychosis
by Rebecca E. Grattan, Natalia Lara, Renata M. Botello, Valerie L. Tryon, Adrienne M. Maguire, Cameron S. Carter and Tara A. Niendam
J. Clin. Med. 2019, 8(7), 1082; https://doi.org/10.3390/jcm8071082 - 23 Jul 2019
Cited by 19 | Viewed by 6703
Abstract
The association between trauma and psychosis outcomes is well-established, and yet the impact of trauma on comorbid clinical symptoms—such as aggression, non-suicidal self-injury behavior (NSSIB), suicide ideation, and suicide behavior—for those with psychosis is unclear. To effectively treat those with first-episode psychosis (FEP) [...] Read more.
The association between trauma and psychosis outcomes is well-established, and yet the impact of trauma on comorbid clinical symptoms—such as aggression, non-suicidal self-injury behavior (NSSIB), suicide ideation, and suicide behavior—for those with psychosis is unclear. To effectively treat those with first-episode psychosis (FEP) and a history of trauma, we need to understand the impact of trauma on their whole presentation. FEP participants were recruited from an Early Psychosis Program (N = 187, ages 12–35, 72.2% male). Clinicians gathered history of trauma, aggression, and suicide data, and rated current symptom severity and functioning. Data was coded using clinician rated measures, self-report measures, and retrospective clinical chart review. Regression analyses examined whether trauma was associated with a history of aggression, suicidal ideation, suicide behavior, NSSIB, symptoms, and functioning. Trauma was associated with aggression, aggression severity and type of aggression (aggression towards others). Trauma was also associated with depression severity, suicide ideation, most severe suicide ideation, and NSSIB. Trauma was not associated with suicide behavior, severity of suicide behavior or psychosocial functioning. Integrating trauma treatment into FEP care could reduce rates of depression, aggression, suicide ideation, and NSSIB for those with a history of trauma. To reduce suicide attempt occurrence and improve functioning, more research is needed. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
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13 pages, 910 KiB  
Article
Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study
by Supriya Misra, Bizu Gelaye, Karestan C. Koenen, David R. Williams, Christina P.C. Borba, Diego Quattrone, Marta Di Forti, Caterina La Cascia, Daniele La Barbera, Ilaria Tarricone, Domenico Berardi, Andrei Szöke, Celso Arango, Andrea Tortelli, Lieuwe de Haan, Eva Velthorst, Julio Bobes, Miguel Bernardo, Julio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, Peter B. Jones, James B. Kirkbride, EU-GEI WP2 Group, Bart P.F. Rutten, Jim van Os, Robin M. Murray, Charlotte Gayer-Anderson and Craig Morganadd Show full author list remove Hide full author list
J. Clin. Med. 2019, 8(7), 1081; https://doi.org/10.3390/jcm8071081 - 23 Jul 2019
Cited by 9 | Viewed by 4930
Abstract
Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with [...] Read more.
Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02–28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10–8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
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14 pages, 1346 KiB  
Article
Assessing Developmental Environmental Risk Factor Exposure in Clinical High Risk for Psychosis Individuals: Preliminary Results Using the Individual and Structural Exposure to Stress in Psychosis-Risk States Scale
by Teresa Vargas, Denise S. Zou, Rachel E. Conley and Vijay A. Mittal
J. Clin. Med. 2019, 8(7), 994; https://doi.org/10.3390/jcm8070994 - 09 Jul 2019
Cited by 9 | Viewed by 2431
Abstract
Introduction: Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a [...] Read more.
Introduction: Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder. Methods: CHR individuals (n = 35) and healthy volunteers (n = 28) completed structured clinical interviews as well as our group’s newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined. Results: Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11–13 age range, and significant group differences for the 14–18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed. Discussion: Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations. Full article
(This article belongs to the Special Issue Relationships between Trauma and Psychosis)
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