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Prevalence rates for physical abuse, sexual abuse, and PTSD by disorder and gender. BD, bipolar disorder; SSD, schizophrenia spectrum disorder; SMI, severe mental illness.
Source publication
Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice.
To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI.
We conducted a systematic review of four databases (1980-2010) and then described and an...
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Introduction
Childhood trauma is not restricted to abuse or neglect and other potentially traumatic experiences need to be pondered in practice and research. The study aimed to collect validity evidence of a new measure of exposure to a broad range of potentially traumatic experiences, the Childhood Interpersonal Trauma Inventory (CITI), by evaluat...
Objective:
The comorbidity of alcohol and substance use disorders among persons with bipolar disorder is elevated, as indicated by epidemiological and clinical studies. Following alcohol use, cannabis is the most frequently used and abused illicit substance among bipolar individuals, and such use may lead to comorbid cannabis use disorders (CUD)....
Citations
... It is important to underline that traumatic events and early-life adverse experiences may similarly alter predictive coding across different psychiatric conditions. If it is true that individuals with mental disorders are more prone to traumatic experiences (Mauritz et al., 2013), traumas in childhood or adolescence increase the likelihood of developing a psychiatric disorder (Copeland et al., 2018). The predictive coding framework proposed that a shared feature in PTSD-related and schizophrenia-related hallucinations is the overweighting of prior beliefs over sensory stimuli. ...
... A primary concern is the potential for exploitationoffenders potentially may feel coerced into participation, particularly if the programme offers perceived benefits such as reduced sentences or enhanced access to support services (Johnston, 2019). Additionally, asking offenders to reflect on, or revisit, past traumas could jeopardise their mental health recovery, with the potential for leading to heightened symptomatic presentations, increased vulnerability to relapse, and challenges to the overall recovery of a mentally disordered, or psychiatrically ill individual; especially when not handled within a trauma informed framework (Mauritz et al., 2013;Grubaugh et al., 2011). ...
... Furthermore, engagement approaches must incorporate mechanism to address any harm that may arise during participation, such as access to psychiatric and psychological care services, in line with any ongoing treatment plansthis is with the intention of minimising the impact of, or risk of, re-traumatisation. Safeguards such as continuous psychological care, support for managing stressors, and alignment with existing treatment plans help mitigate harm and ensure a supportive environment conducive to rehabilitation, and engagement with precrime approaches (Mauritz et al., 2013;Grubaugh et al., 2011). ...
... Structural issues, such as poverty and inadequate access to mental health care often exacerbate these risks, and failing to address them undermines the long-term efficacy of precrime approaches (Johnston, 2019). Furthermore, stigmatisation arising from identifying individuals based solely on criminogenic profiles, offender-identified, or otherwise, is a recognised challenge in criminological and rehabilitative practices (Hodgins et al., 2007;Mauritz et al., 2013;Sampson & Laub, 2019). Research highlights stigmatisation can hinder the efficacy of intervention programmes by creating resistance and mistrust among targeted communities and populations (Hodgins et al., 2007); Mauritz et al., 2013). ...
Mentally disordered and psychiatrically ill offenders represent a unique subset of the offender population, characterised by complex criminogenic risk factors, heightened vulnerability, and recurring interactions with both the criminal justice and mental health systems. This literature review critically examines the feasibility of incorporating such offenders into precrime operations as a rehabilitative method, drawing on interdisciplinary research from criminology, forensic psychology, and psychiatry. The review analyses the intersection of psychiatric illness, and criminal behaviour, evaluating how offender insights may be leveraged to enhance early intervention strategies, while supporting their rehabilitation. Central fo this discussion is an exploration of criminogenic risk, offender cognition, and the way in which psychiatric symptoms influence patterns of offending and recidivism.
Through an extensive review of existing literature, this review identified both the potential benefits and challenges of integrating mentally disordered offenders into precrime initiatives. Potential benefits include the utilisation of lived-experiences to improve identification of at-risk individuals/groups of individuals to improve risk assessments, inform preventative interventions, and develop rehabilitation strategies tailored to the needs of high-risk individuals. however, ethical and practical concerns – such as the risk of coercion, evidential integrity, and the potential for re-traumatisation – pose significant barriers to implementation. Within this, the role of clinical criminology is examined in-depth with a focus on its capacity to bridge gaps between forensic psychiatry, offender management, and crime prevention.
Furthermore, this review explores the application of established offender rehabilitation frameworks, including the Risk-Need-Responsivity model, to offender-led precrime approaches.
The findings of this review suggest that structured offender participation in precrime efforts could provide a novel approach to reducing reoffending rates, and improving public safety, provided that appropriate safeguards are met, mental health support systems are integrated, and that interdisciplinary oversights are in place. This review contributed to the ongoing research on offender rehabilitation, preventative justice and precrime by advocating for evidence-based, ethically sounds models of clinical criminology that balance security and rehabilitation imperatives. By positioning offender perspectives as a valuable, yet underutilised, resource, this review highlights the need for further empirical research to assess the viability, effectiveness, and ethical implications of such an approach within contemporary criminal justice frameworks.
... Various researchers argue that trauma is inescapable and needs to be considered in all clinical settings (Kessler et al., 1995). Trauma leads to ongoing risk for developing additional psychiatric illnesses such as posttraumatic stress disorder (PTSD), a disorder resulting from imagined or actual threats to a person's life or welfare resulting in distressing thoughts, feelings, or dreams associated with the threats and efforts to avoid cues associated with the trauma (APA, 2024) and depression (Mauritz et al., 2013). Lane et al. explained how trauma resulting from neighborhood violence is rooted in the long history of urban renewal, the Rockefeller drug laws, and the de-industrialization that helped devastate communities of color . ...
This article focuses on the impact of trauma experienced by individuals, families and groups, and neighborhoods in Rochester and Syracuse, New York. Using the levels of analysis put forward in Bronfenbrenner’s ecological systems theory (i.e., individual, family, and community), we argue that trauma operates at each of those levels. This mixed-methods study reviews the findings of seven previously published studies (with data collection ranging from 2000 to 2019), each of which addresses trauma among low-income residents. Specific methods include secondary analyses of births, qualitative interviews of persons who delivered a baby within the past two years, a community survey of residents living in high-crime areas, and secondary birth data to document the impact of socio-ecological risk factors on the trauma of birthing persons, their children, and their partners. Individuals and families living in high-risk neighborhoods (e.g., where residents experience frequent gun shots, racially disproportionate incarceration, and poverty) had more negative health outcomes including posttraumatic stress disorder, intrauterine growth restriction, and depression. Interventions focused on community-based practices that address individual, family, and community-level trauma must also address the multiple risk factors for trauma located in the environmental and social stressors.
... In addition, higher levels of anger are also associated with a higher prevalence of victimization (33,51,52). Patients with SMI also often have a history of trauma in their childhood (53,54). Having a history of traumatic events, particularly childhood abuse, could lead to higher levels of anger and consequently increased victimization and perpetration of DVA (55,56). ...
Introduction
Domestic violence and abuse (DVA) are prevalent among persons with severe mental illness (SMI), being involved as victim, perpetrator, or both.
Aims
To assess rates of DVA victimization and perpetration in patients with SMI. We also aimed to assess whether DVA victimization was associated with DVA perpetration, and whether this was mediated by dispositional anger in patients with SMI. Lastly, we aimed to examine whether gender moderated the associations between DVA victimization and perpetration.
Methods
We conducted a nation-wide survey on victimization in patients with SMI. In 942 patients DVA perpetration of physical assault and victimization of physical assault, sexual coercion or psychological aggression over the past year were assessed using the revised Conflict Tactics Scale. Anger was assessed using the dispositional anger reactions scale. Correlation and mediation analyses were conducted, followed by a moderated mediation to assess whether effects of anger differed between men and women.
Results
The prevalence rate of perpetration of physical assault was 22%, for victimization 27% and 52% for both. We found a strong positive correlation between perpetrated physical assault and victimization of mild physical assault and between both the perpetration and victimization of severe physical assault. Anger mediated the link between being a victim of psychological aggression and being a perpetrator of DVA. Women were more likely to perpetrate violence if they were victims of mild physical assault compared to men. Other moderation effects by gender were not observed.
Conclusion and implications
This study reveals persistent high DVA rates among patients with SMI. Overall, anger had no mediating effect on the association between victimization and perpetration of violence, except for psychological aggression and perpetration of DVA. This study emphasizes the importance of routine violence discussions in SMI care while taking context into account. However, further research on underlying mechanisms and interventions to improve discussions and care for victims and/or perpetrators of DVA is necessary.
... Individuals with serious mental illness experience higher rates of lifetime trauma exposure and posttraumatic stress disorder (PTSD) than those in the general population (de Vries et al., 2019;Mauritz et al., 2013;Zammit et al., 2018). Trauma exposure and PTSD are associated with more severe symptoms, higher rates of comorbid substance use and medical disorders, increased acute care service utilization for physical comorbidities, and worse overall functioning (Aas et al., 2016;Alameda et al., 2021;Lu et al., 2008;Tomassi et al., 2017). ...
Objective: We examined the feasibility and clinical outcomes of implementing a brief intervention for treating posttraumatic stress disorder (PTSD) in persons with serious mental illness receiving services at a large, urban community mental health agency. The Brief, Relaxation, Education and Trauma Healing (BREATHE) program is a standardized, three-session intervention that targets PTSD symptoms through teaching breathing retraining and personalized psychoeducation about trauma and PTSD. Method: A total of 60 clinicians were trained in the BREATHE intervention throughout the agency, which was offered to 233 clients who screened positive for probable PTSD. Self-report assessments of PTSD and depressive symptom severity were obtained before the first session, after the third session, and at a 3-month follow-up. Participant satisfaction was assessed in a brief survey. Results: Of the 233 clients offered the BREATHE program, 211 (91%) accepted and attended at least one session. Most participants attended all three BREATHE sessions (59%) or two sessions (32%), with completers reporting high levels of satisfaction with the program. Participants showed clinically significant improvements in PTSD and depression symptoms from pretreatment to posttreatment and the 3-month follow-up. Conclusions and Implications for Practice: This brief intervention for PTSD was feasible to implement in a large agency serving a diverse population of persons with serious mental illness, showed high client acceptability in terms of participation and satisfaction, and was associated with significant reductions in PTSD and depressive symptoms. Further research is needed to evaluate the impact of the BREATHE program for treating PTSD in this population.
... Congratulations on this award. integrating scalable psychological interventions in eight countries Cloitre et al., 2013Cloitre et al., , 2014Dierkhising et al., 2013;Kessler et al., 2017;Lagdon et al., 2014;Lewis et al., 2020;Lewis et al., 2020;Mauritz et al., 2013;Miller & Najavits, 2012;Olff, 2015Olff, , 2017Schnyder et al., 2015;Sijbrandij et al., 2017;Southwick et al., 2014;van de Schoot et al., 2015. Figure 6. ...
The European Journal of Psychotraumatology (EJPT) was launched in 2010. In this editorial, we review the journal's developments over the past 15 years, and discuss some of the current ethical challenges in scientific publishing, including the impact of generative AI. How can we responsibly use these new technologies? Additionally, we present 15 years of journal metrics, highlight past and upcoming special issues on 'hot topics,' and are pleased to announce awards for the best paper and best reviewer of 2023, recognizing two outstanding recipients.
... Rates of trauma exposure are higher amongst people accessing mental health services, with estimates suggesting that roughly half have experienced physical abuse, whilst over a third have experienced sexual abuse [24]. As services become increasingly aware of the importance of trauma-informed approaches to health and social care [25] MHWs are being encouraged to explicitly ask clients about potential traumatic experiences [26] Greater exposure to client trauma/distress is associated with higher CF in MHWs [10]which in turn is associated with a range of adverse outcomes including poor job satisfaction, absenteeism and poor patient care [27,28]. ...
Consistently engaging with client distress can negatively impact mental health workers (MHWs). This has been described by the concept of empathy-based stress (EBS) (which encompasses burnout; secondary traumatic stress; compassion fatigue and vicarious trauma). Previous reviews of interventions to reduce EBS have not addressed MHWs as a distinct group, despite evidence suggesting they are particularly vulnerable to it. In the context of rising demand for mental health services, it is especially important to understand how to mitigate the impact of EBS on MHWS. This scoping review therefore aimed to identify and describe available interventions to reduce or prevent EBS in MHWs. A systematic scoping review of the literature between 1970 and 2022 was undertaken using five electronic databases. A total of 51 studies were included, which varied significantly with regards to: interventions used; study methodology and theoretical underpinnings. Studies were grouped according to the level at which they aimed to intervene, namely: individual; team or organisational. The review concluded that most studies intervened at the level of the individual, despite the proposed causes of EBS being predominantly organisational. Furthermore, theoretical links to the origins of EBS were largely unclear. This suggests a lack of empirical evidence from which organisations employing MHWs can draw, to meaningfully prevent or reduce EBS in their staff. A dedicated research agenda is outlined to address this, and, other pertinent issues in the field and signifies a call for more theoretically grounded research.
... There is an established link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia, schizoaffective disorder and bipolar disorder (Grubaugh et al., 2011;Mauritz et al., 2013). Many studies have shown that trauma exposure, often defined as exposure to actual or threatened death, serious injury or sexual violence (American Psychiatric Association, 2013), poses a significant risk for the development of SMHCs (Read et al., 2005;Varese et al., 2012;Woolway et al., 2022). ...
Background
There is a strong link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia and bipolar disorder. The majority of research in the field has focused on childhood trauma as a risk factor for developing an SMHC and on samples from high-income countries. There is less research on having an SMHC as a risk factor for exposure to traumatic events, and particularly on populations in low- and middle-income countries (LMICs).
This scoping review aimed to synthesize the nature and extent of research on traumatic events that adults with SMHCs face in LMICs. It was conducted across five databases: PubMed, Embase, PsycINFO, Web of Science Core Collection and Africa-Wide Information/NiPad in December 2023 and by hand searching citation lists.
Findings
The database search returned 4,111 articles. After removing duplicates and following a rigorous screening process, 51 articles met criteria for inclusion. There was one case study, one mixed methods study, 12 qualitative studies and 37 quantitative studies. Ten countries were represented, with the most studies from India (n = 19), Ethiopia (n = 9) and China (n = 6). Schizophrenia was the most studied type of SMHC. Of the trauma exposures, more than 76% were on interpersonal violence, such as sexual and physical violence. Of the studies on interpersonal violence, more than 23% were on physical restraint (e.g., shackling) in the community or in hospital settings. There were no studies on man-made or natural disasters.
Implications
Much of our data in this population are informed by a small subset of countries and by certain types of interpersonal violence. Future research should aim to expand to additional countries in LMICs. Additional qualitative research would likely identify and contextualize other trauma types among adults with SMHCs in LMICs.
... For example, when observing the mother-infant dyad at its earliest stages, research has found that a mother's history of interpersonal trauma exposure negatively impacts aspects of maternal functioning such as prenatal attachment (Schwerdtfeger & Goff, 2007). In this case, interpersonal trauma can be described as traumatic experiences that occur within relationships in childhood and adulthood, e.g., emotional and physical abuse and neglect, and sexual abuse (Mauritz et al., 2013). Including attachment insecurity, other mental health factors that may be associated with interpersonal trauma exposure can include depression (Fowler et al., 2013). ...
Domestic violence (DV) is still a silent public health pandemic globally, more so during the COVID-19 pandemic. Domestic abuse has a well-documented impact on women and its potential transgenerational consequences for their children. However, the influence of DV on a survivor's experience as a parent is rarely studied, especially in developing nations. Through a systematic review, this study aimed to examine and synthesise current global research on DV survivors' experiences regarding their parenting capacities. The objective was to understand how DV survivors perceive how their parenting capacities were impacted by the experience of DV. Five databases were searched between the periods 2010 to 2020. Fourteen studies met the inclusion criteria. Through a thematic analysis of the included articles, three core themes emerged: first, the mothers’ state of psychosocial and physical health, exacerbated or associated with the DV experience, holds association with their perceived capacity within a parental role. Second, the influence of DV on motherhood is not necessarily predictive of negative parenting practices but somewhat contingent on the mothers’ ability to mobilise supportive internal and external resources, which are often restricted and disrupted by the abusive partner. Last, decisions to leave the abusive partner are complex and subjectively reasoned by the mothers, with a common intention to protect the family. These findings suggest that more comprehensive support and preventative interventions are needed in local communities to create supportive environments that are accessible to mothers who parent in the context of DV.
... Moderate and severe effects might be explained by the rarity of mental health challenges occurring in isolation. Many individuals, especially those who have experienced trauma, experience co-occurring mental health challenges (Gatz et al., 2007;Mauritz et al., 2013;Stinson et al., 2016;Zarse et al., 2019). ...
To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14 days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457–6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115–1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.
