School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire, UK.
Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
BMC Psychiatry. 2022 Mar 24;22(1):213. doi: 10.1186/s12888-022-03808-3.
Despite experiencing high rates of trauma and trauma-related conditions, people with psychosis are seldomly asked about possible traumatic events. While there are some barriers to discussing trauma in clinical services, research has shown that disclosure is not only possible but also beneficial to both psychotic and traumatic symptoms. The current study is the first to evaluate service users' perception of the influence of trauma on the development and maintenance of their psychotic symptoms, as well as their views on how their life and mental health have been affected by traumatic events and their disclosure (or lack of).
Eleven participants with experiences of psychosis and trauma took part in semi-structured interviews.
Consistently with previous literature, our participants reported high rates of interpersonal trauma, but had rarely had the opportunity to discuss any of these events. Using thematic analysis, we identified three major themes that have important implications for healthcare: factors that facilitate or hinder talking about trauma; consequences of talking or not; and relationship between trauma and psychosis. Participants generally benefited from talking about trauma and concerningly often associated the prolonged lack of opportunities to discuss traumatic events with negative feelings towards the self and with a deterioration of their mental health. Participants also recognised direct links between past traumas and the content and characteristics of their psychotic experiences.
Our findings highlight the importance, as perceived by service users, of discussing trauma and looking at psychosis through a "trauma lens". These results stress the need to systematically assess trauma history and traumatic symptoms in psychosis and might potentially help to overcome clinicians' worries about discussing trauma with service users. Our findings underscore the need to change current practice and implement trauma-informed approaches to understand clients' difficulties and provide support.
尽管经历了高比率的创伤和与创伤相关的状况，但精神病人很少被问及可能的创伤事件。虽然在临床服务中存在一些讨论创伤的障碍，但研究表明，披露不仅是可能的，而且对精神病和创伤症状都有益。目前的研究首次评估了服务使用者对创伤对其精神病症状的发展和维持的影响的看法，以及他们对生活和心理健康因创伤事件及其披露（或缺乏）而受到的影响的看法。
11 名有精神创伤和创伤经历的参与者参加了半结构式访谈。
与先前的文献一致，我们的参与者报告了高比率的人际创伤，但很少有机会讨论其中的任何事件。使用主题分析，我们确定了三个对医疗保健具有重要意义的主要主题：促进或阻碍谈论创伤的因素；谈论或不谈论的后果；以及创伤和精神病之间的关系。参与者通常从谈论创伤中受益，但令人担忧的是，他们经常将缺乏谈论创伤事件的机会与对自己的负面感受以及心理健康恶化联系起来。参与者还认识到过去的创伤与他们的精神病经历的内容和特征之间的直接联系。
我们的研究结果强调了服务使用者所认为的讨论创伤和通过“创伤视角”看待精神病的重要性。这些结果强调了在精神病中系统评估创伤史和创伤症状的必要性，并可能有助于克服临床医生对与服务使用者讨论创伤的担忧。我们的研究结果强调了改变当前实践和实施以理解客户困难并提供支持的创伤知情方法的必要性。
