Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis

Bailey, Thomas Hamilton; Álvarez‐Jiménez, Mario; Garcia-Sanchez, Ana M; Hulbert, Carol; Barlow, Emma; Bendall, Sarah

doi:10.1093/schbul/sbx161

Cited by 216 publications

(182 citation statements)

References 58 publications

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“…The former may be explained by the self-blame items being less frequently endorsed compared to the negative self and world items, and the latter may be attributable to an avoidant or ‘sealed-over’ coping style, whereby people with negative symptoms may be less likely to disclose traumatic events (Tait, Birchwood, & Trower, 2003). This finding is also in line with a recent systematic review (Bailey, Alvarez-Jimenez, Garcia-Sanchez, Hulbert, Barlow & Bendall, 2018) that found only childhood neglect was associated with negative symptoms.…”

Section: Discussionsupporting

confidence: 91%

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

Carr

Hardy

Fornells-Ambrojo

2018

European Journal of Psychotraumatology

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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.

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Section: Discussionsupporting

confidence: 91%

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

Carr

Hardy

Fornells-Ambrojo

2018

European Journal of Psychotraumatology

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“…Increased research attention on psychotic symptom dimensions rather than psychotic disorder diagnostic categories has led to growing evidence for particular associations between childhood victimization trauma and positive psychotic symptoms (Ajnakina et al ., ; van Dam et al ., ; van Nierop et al ., ). A recent meta‐analysis found correlations between childhood trauma and hallucinations and delusions in groups with psychotic disorder, although these correlations were small to moderate (0.17–0.20; Bailey et al ., ). There is also high prevalence of post‐traumatic stress disorder (PTSD) in people with psychotic disorders relative to the general population (de Bont et al ., ; Steel, Doukani, & Hardy, ; Steel, Hardy, et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Testing models of post‐traumatic intrusions, trauma‐related beliefs, hallucinations, and delusions in a first episode psychosis sample

Peach

Álvarez‐Jiménez

Cropper

et al. 2018

British J Clinic Psychol

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Objective There is increasing evidence that childhood trauma may play a role in the aetiology of psychosis. Cognitive models implicate trauma‐related symptoms, specifically post‐traumatic intrusions and trauma‐related beliefs as primary mechanisms, but these models have not been extensively tested. This study investigated relationships between childhood trauma, psychotic symptoms (hallucinations and delusions), post‐traumatic intrusions, and trauma‐related beliefs while accounting for comorbid symptoms. Methods Sixty‐six people with first episode psychosis aged between 15 and 24 years were assessed for hallucinations, delusions, childhood trauma, post‐traumatic intrusions, post‐traumatic avoidance, and trauma‐related beliefs. Results Fifty‐three per cent of the sample had experienced childhood trauma, and 27% met diagnostic criteria for post‐traumatic stress disorder. Both post‐traumatic intrusions and trauma‐related beliefs mediated the relationships between childhood trauma and hallucinations, and childhood trauma and delusions. Multiple regression analyses revealed that post‐traumatic intrusions (but not childhood trauma, post‐traumatic avoidance, or trauma‐related beliefs) were independently associated with hallucination severity (β = .53, p = .01). Post‐traumatic intrusions and trauma‐related beliefs (but not childhood trauma or post‐traumatic avoidance) were independently associated with delusion severity (β = .67, p < .01 and β = .34, p < .01, respectively). Conclusions These findings support cognitive models that implicate post‐traumatic intrusions in hallucination aetiology, and post‐traumatic intrusions and trauma‐related beliefs in delusion aetiology. The results suggest that trauma and post‐traumatic stress disorder, including trauma‐related beliefs, should be addressed in the assessment and treatment of people with early psychosis. Practitioner points Trauma and post‐traumatic stress disorder, including trauma‐related beliefs, should be addressed in the assessment and treatment of people with early psychosis. Routine assessment of childhood trauma and PTSD in clinical services dealing with young people with first episode psychosis is needed. These findings support cognitive models of trauma and hallucinations and delusions.

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“…Traumatic experiences in childhood are now an acknowledged risk factor for psychotic symptoms and disorders (Bailey et al, 2018;Varese et al, 2012). In those with a psychotic disorder, associations between dissociative experiences and childhood adversity is a common finding (Braehler et al, 2013;Ross & Keyes, 2004;Sun et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Investigating the prevalence of dissociative disorders and severe dissociative symptoms in first episode psychosis

Sun

Álvarez‐Jiménez

Lawrence

et al. 2018

Early Intervention Psych

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Aim Increasing evidence suggests that childhood trauma and dissociation are associated with psychotic symptoms and disorders. Significant rates of dissociative disorders and clinical levels of dissociative symptoms are found in chronic schizophrenia. To date, no studies have examined the prevalence of these in a first episode psychosis (FEP) group. This study aimed to investigate the prevalence of dissociative disorders and symptoms in a FEP sample as well as the prevalence of severe dissociative symptoms in those with or without experiences of childhood trauma. Methods Sixty‐six young people with FEP completed a research interview which included the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) Axis I Disorders, Childhood Trauma Questionnaire and the Structured Clinical Interview for DSM‐IV Dissociative Disorders‐Revised. Results Dissociative symptoms at clinical levels were found in 36.4% of the sample. Furthermore, 13.6% of the sample met diagnostic criteria for a lifetime dissociative disorder. Significant differences in the frequency of clinical dissociative symptoms between those with or without childhood trauma were also found. Conclusions Dissociative symptoms should be routinely assessed for in early intervention settings, especially in cases where childhood trauma is disclosed or suspected. Where present, dissociative symptoms should also be incorporated into subsequent case formulation and treatment planning.

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Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis

Abstract: The results lend support for cognitive and biological theories that traumas in childhood may lead to hallucinations and delusions within psychotic disorders and have important implications for clinical practice.

Cited by 216 publications

References 58 publications

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

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

Testing models of post‐traumatic intrusions, trauma‐related beliefs, hallucinations, and delusions in a first episode psychosis sample

Investigating the prevalence of dissociative disorders and severe dissociative symptoms in first episode psychosis

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