Predictors of PTSD Symptoms in Response to Psychosis and Psychiatric Admission
Department of Clinical Psychology, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland. The Journal of nervous and mental disease
(Impact Factor: 1.69).
02/2009; 197(1):56-60. DOI: 10.1097/NMD.0b013e31819273a8
The experiences of psychosis and psychiatric admission have the potential to act as events precipitating posttraumatic stress disorder (PTSD) symptoms. Known risk factors for the development of PTSD symptoms in adults were identified. These included childhood trauma, current psychiatric symptoms, perceived coercion, and relationships with mental health service providers. These factors were analyzed to determine if they were important in the development of PTSD symptoms in response to psychosis and admission. We used a cross-sectional design with a sample of 47 participants recruited from a service in Northern Ireland who had experienced psychosis and been discharged from inpatient treatment within 12 months of data collection. The main outcome measure was the impact of events scale-revised. Data was subject to correlation analyses. A cut-off point of r = +/- 0.25 was used to select variables for inclusion in hierarchical regression analyses. Forty-five percent and 31% of the sample had moderate to severe PTSD symptoms related to psychosis and admission, respectively. The majority of participants identified positive symptoms and the first admission as the most distressing aspects of psychosis and admission. Childhood sexual and physical traumas were significant predictors of some PTSD symptoms. Strong association was found between current affective symptoms and PTSD symptoms. A reduced sense of availability of mental health service providers was also associated with PTSD symptoms and depression. Awareness of risk factors for the development of PTSD symptoms in response to admission and psychosis raises important issues for services and has implications for interventions provided.
Available from: Steffanie A Strathdee
- "However, research has demonstrated that victims of childhood maltreatment tend to experience multiple forms of abuse and neglect , , which individually and collectively incur adverse mental and physical health outcomes , , , , , , , . Apart from CSA, little is known about the potential impact of other forms of childhood maltreatment on HIV risk behaviour and transmission among MSM , . "
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The association between childhood sexual abuse and HIV risk among men who have sex with men (MSM) is well established. However, no studies have examined the potential impact of other forms of childhood maltreatment on HIV incidence in this population.
We explored the impact of child physical abuse (CPA) on HIV seroconversion in a cohort of gay/bisexual men aged 15 to 30 in Vancouver, Canada. Cox proportional hazard models were used, controlling for confounders.
Among 287 participants, 211 (73.5%) reported experiencing CPA before the age of 17, and 42 (14.6%) reporting URAI in the past year. After a median of 6.6 years follow-up, 16 (5.8%) participants HIV-seroconverted. In multivariate analysis, CPA was significantly associated with HIV seroconversion (adjusted hazard ratio [AHR] = 4.89, 95% confidence interval (CI): 1.65–14.48), after controlling for potential confounders.
Our study uncovered a link between childhood physical violence and HIV incidence. Results highlight an urgent need for screening of young gay and bisexual men for histories of violence, and social and structural supports to prevent HIV transmission in this population.
Available from: Peter J J Goossens
- "In future research, greater attention should be paid to PN, EN, and EA because these factors have been found to increase the risk of developing PTSD (Beattie et al., 2009; Bernet & Stein, 1999; Gaudiano & Zimmerman, 2010; Maguire et al., 2008; Sar et al., 2003). Complex PTSD and DID should be given greater attention in light of their negative influence on the course of a patient's mental illness and quality of life (Barnow et al., 2005; Read et al. 2005; Ross & Keyes, 2004; Sar et al., 2003). "
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ABSTRACT: 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 analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders.
Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25-72%), sexual abuse 37% (range 24-49%), and posttraumatic stress disorder (PTSD) 30% (range 20-47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI.
Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.
- "More intrusive forms of adversity such as physical, sexual and emotional abuse have also been postulated to have aetiological significance for psychosis (Harris, 1987). Indeed, higher rates of these types of maltreatment have been found amongst psychosis patients than neglect (Hlastala & McClellan, 2005 ; Schenkel et al. 2005), though the results are mixed (Heads et al. 1997 ; Schäfer et al. 2006 ; Beattie et al. 2009). Therefore, further exploration is required of the differential associations with clinical disorder controlling for appropriate confounders and other forms of adversity. "
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