Kilcommons Aoiffe M, Morrison Anthony P, Knight Alice, Lobban Fiona
Dept. of Clinical Psychology, University of Liverpool, Liverpool, UK.
Soc Psychiatry Psychiatr Epidemiol. 2008 Aug;43(8):602-11. doi: 10.1007/s00127-007-0303-z. Epub 2008 Jun 13.
In recent years, there has been a call for greater awareness of the relationship between trauma and psychosis, and several studies involving patients with psychotic disorders have found a link between traumatic life experience and the development of psychosis. However, little research has examined psychotic experiences in a traumatised population.
This study investigated psychotic experiences in a sample of 40 survivors of sexual assault (SA) compared to a control group without a history of sexual assault (measured using a self-report questionnaire) and examined the psychological factors that may contribute to the development of psychotic experiences in sexually traumatised individuals. In particular, the role of dissociation and cognitive factors such as post-traumatic cognitions were explored.
Of the 26 sexually assaulted participants that were interviewed, 46% reported auditory hallucinations and 46% reported visual hallucinations. A significantly higher rate of psychotic phenomena (delusional ideation and predisposition to hallucinations) was found in the sexually assaulted group compared to the control group. Severity of SA trauma was significantly associated with severity of PTSD and psychotic symptomatology. Dissociation was strongly associated with all measures of psychotic phenomena and negative cognitions about the self and the world were associated with predisposition to hallucinations and delusional ideation. Regression analyses revealed that after controlling for the severity of SA trauma, dissociation and negative beliefs about the self significantly predicted delusional distress, and dissociation significantly predicted predisposition to visual hallucinations.
These exploratory findings support the idea that psychotic phenomena may be caused by traumatic life experiences and highlight the need for further research. The implications of these results for research and clinical practice are discussed.
近年来，人们呼吁提高对创伤与精神病之间关系的认识，多项涉及精神病患者的研究发现创伤性生活经历与精神病的发展之间存在联系。然而，很少有研究考察受过创伤人群的精神病体验。
本研究调查了40名性侵犯（SA）幸存者样本中的精神病体验，并与无性侵犯史的对照组进行比较（使用自我报告问卷进行测量），同时考察了可能导致性创伤个体出现精神病体验的心理因素。特别是，探讨了解离以及创伤后认知等认知因素的作用。
在接受访谈的26名性侵犯参与者中，46%报告有幻听，46%报告有幻视。与对照组相比，性侵犯组中精神病现象（妄想观念和幻觉倾向）的发生率显著更高。SA创伤的严重程度与创伤后应激障碍（PTSD）的严重程度和精神病症状显著相关。解离与所有精神病现象指标密切相关，对自我和世界的消极认知与幻觉倾向和妄想观念相关。回归分析显示，在控制SA创伤的严重程度后，解离和对自我的消极信念显著预测妄想困扰，解离显著预测幻视倾向。
这些探索性发现支持了精神病现象可能由创伤性生活经历引起的观点，并强调了进一步研究的必要性。讨论了这些结果对研究和临床实践的意义。
