Melegkovits Eirini Aikaterini, Mason Ava, Reid Jordan, Akooly Hind, Jung Paul, Bloomfield Michael
Division of Psychiatry, University College London, London, UK.
Eur J Psychotraumatol. 2025 Dec;16(1):2472473. doi: 10.1080/20008066.2025.2472473. Epub 2025 Mar 11.
Among individuals with psychotic experiences, those with a history of developmental trauma face greater symptom severity and worse clinical outcomes compared to those without. Dissociation constitutes a prominent, characteristic of this group's clinical presentation, whose nuances and associated characteristics remain however understudied in psychosis research. We aimed to address this gap by conducting a qualitative study to investigate the phenomenology, context, and impact of dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma. 25 UK-based participants with a history of developmental trauma and meeting criteria for subclinical psychosis, based on the CAPE-15, were recruited via social media. Participants attended semi-structured interviews online, which were transcribed verbatim and analysed with thematic analysis by two researchers. Thematic analysis yielded the following themes: (1) Phenomenology of Dissociation; (2) Context of Dissociation; (3) Impact of Dissociation; (4) Dissociation and Psychotic-like Phenomena. Participants described experiences of detachment and compartmentalisation, which when experienced were confusing and often distressing. Dissociation was linked to affective experiences, their history of developmental trauma and psychotic-like experiences. This study elucidates the complex and varied nature of dissociative experiences in individuals with subclinical psychosis with a history of developmental trauma. These findings highlight the need for further research to understand the manifestation of dissociation in this population and the links with distress and other aspects of psychopathology. Importantly, it is essential to use this understanding to inform the development of interventions and improve clinical recognition and management.
在有精神病体验的个体中，有发育性创伤史的个体与没有该病史的个体相比，面临更严重的症状和更差的临床结局。解离是该群体临床表现的一个突出特征，然而在精神病研究中，其细微差别和相关特征仍未得到充分研究。我们旨在通过开展一项定性研究来填补这一空白，以调查亚临床精神病且有发育性创伤史的个体中解离体验的现象学、背景及影响。通过社交媒体招募了25名来自英国、有发育性创伤史且根据CAPE - 15符合亚临床精神病标准的参与者。参与者参加了在线半结构化访谈，访谈内容逐字转录，并由两名研究人员进行主题分析。主题分析得出以下主题：(1) 解离的现象学；(2) 解离的背景；(3) 解离的影响；(4) 解离与类精神病现象。参与者描述了分离和 compartmentalisation（此处原文可能有误，推测为“ compartmentalization”，意为“分隔”）的体验，这些体验在经历时令人困惑且往往痛苦。解离与情感体验、他们的发育性创伤史以及类精神病体验有关。本研究阐明了有发育性创伤史的亚临床精神病个体中解离体验的复杂多样性质。这些发现凸显了进一步研究的必要性，以了解该人群中解离的表现及其与痛苦和精神病理学其他方面的联系。重要的是，必须利用这一认识为干预措施的制定提供信息，并改善临床识别和管理。
