The perspectives of people with psychosis about participating in trauma-related research

Cunningham, Twylla; Shannon, Ciarán; Crothers, Ivor; Hoy, Katrina; Fitzsimmons, Carly; McCann, Riona; O’Hare, John; Mulholland, Ciaran

doi:10.1080/17522439.2016.1145729

Cited by 5 publications

(7 citation statements)

References 5 publications

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“…This may be due to clinicians’ beliefs about the biological aetiology of mental illness , the lack of awareness of the adverse effects of social factors and life experiences on adult functioning , or concerns that questioning service users about potentially traumatic events may lead to further distress and aggravation of symptoms . However, research indicates that most trauma survivors, including those who received diagnoses of SMIs, do not experience any aggravation in their mental health when asked about past traumatic experiences, and positively evaluate the opportunity of talking about these experiences .…”

Section: Discussionmentioning

confidence: 99%

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Rafiq

Campodonico

Varese

2018

Acta Psychiatr Scand

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The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a metaanalytic review Objective: Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. Method: A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random-effects meta-analysis. Results: The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small-to-moderate range. Conclusion: These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma-focused therapies) to manage and resolve these difficulties. Summations• Small-to-moderate relationship between childhood trauma and dissociation across SMIs. • Medium relationship between childhood trauma and dissociation in schizophrenia-spectrum disorders.• All forms of childhood traumatic experiences (e.g. sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) were found to be associated with dissociation in people diagnosed with SMI. Considerations• Only three studies were found eligible for the bipolar sample (i.e. low power); therefore, no strong conclusions can be drawn regarding the association between childhood trauma and dissociative experiences in bipolar disorder.• The relationship between childhood trauma and dissociation in SMI requires further corroboration using longitudinal designs to determine causality and directionality.• No firm conclusions can be drawn regarding which specific traumatic experience is most strongly associated with dissociation, as the studies included in the analysis were not independent (i.e. effects for sexual abuse and physical abuse estimated from the same sample of participants). 509Acta Psychiatr Scand 2018: 138: 509-525

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Section: Discussionmentioning

confidence: 99%

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Rafiq

Campodonico

Varese

2018

Acta Psychiatr Scand

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“…Training programmes should present the research showing that most service users are not distressed by being asked about violence and abuse (Cunningham et al . ; Department of Health ; Lothian & Read ; Scott et al . ).…”

Section: Relevance To Clinical Practicementioning

confidence: 97%

Do adult mental health services identify child abuse and neglect? A systematic review

Read

Harper

Tucker

et al. 2017

Int J Mental Health Nurs

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Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required.

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“…However, Cromer, Freyd, Binder, DePrince, & Becker-Blease, 2006 ) found that questions about traumatic events are perceived as more important and cause less stress than other personal questions. Similarly, Cunningham et al ( 2017 ) showed that patients perceive answering questions about trauma as no more or less distressing than answering any other question. The majority of patients with traumatic events (69%) associate their traumatic experience with their mental illness, yet only 17% perceive that this association is also seen by mental health professionals (Lothian & Read, 2002 ).…”

Section: Introductionmentioning

confidence: 94%

Trauma assessment in outpatient psychotherapy and associations with psychotherapist’s gender, own traumatic events, length of work experience, and theoretical orientation

Lueders¹,

Sander²,

Leonhard³

et al. 2022

European Journal of Psychotraumatology

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Background Traumatic events are strongly associated with mental health problems. At present, traumatic events and trauma-specific needs are commonly underdetected in therapeutic settings. Many mental health professionals lack key competencies for trauma inquiry and treatment. Objective In this study, we aimed to investigate the everyday practices of dealing with traumatic events in outpatient psychotherapy in Germany as well as the influence of the therapist’s gender, own traumatic events, length of professional experience, and theoretical orientation. Method A total of 148 outpatient psychotherapists completed a purpose-designed online questionnaire. Therapists rated barriers and attitudes towards trauma assessment, possible requirements for enquiring about trauma, and practical aspects of trauma assessment. Results Barriers reported in previous studies, e.g. fear of offending the patient or exacerbating their psychological state, could not be confirmed in our sample. Overall, participating therapists felt confident in engaging with traumatic events and considered enquiring about trauma important in all patients. Group differences were found for therapist’s gender, own traumatic events, length of work experience, and theoretical orientation. Conclusions Our results suggest that trauma training lowers barriers and raises therapists’ self-confidence in dealing with patients´ traumatic experiences. Therapists’ characteristics effecting trauma assessment should be considered during training. Due to the increasing demand for psychotherapy, especially considering people with severe mental illness affected by traumatic events, trauma training should be obligatory for all mental health professionals.

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The perspectives of people with psychosis about participating in trauma-related research

Cited by 5 publications

References 5 publications

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Do adult mental health services identify child abuse and neglect? A systematic review

Trauma assessment in outpatient psychotherapy and associations with psychotherapist’s gender, own traumatic events, length of work experience, and theoretical orientation

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