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Childhood Trauma and Psychosis: The Genie is Out of the Bottle

NCJ Number
Journal of Psychological Trauma Volume: 6 Issue: 2/3 Dated: 2007 Pages: 7-20
Paul Hammersley; John Read; Stephanie Woodall; Jacqueline Dillon
Date Published
14 pages
This paper reviews the historical context and most important recent research findings regarding the link between severe childhood trauma and subsequent adult psychosis, and a case study illustrates the effectiveness of psychotherapy for trauma survivors with psychosis.
Until the 1990s, psychiatry in general and biological psychiatry in particular refused to accept the significance of trauma in the lives of individuals diagnosed with psychosis. Adverse childhood and adult life experiences were deemed irrelevant or reduced to the roles of mere triggers of an underlying biological or genetic vulnerability. This paper reviews some of the recent major studies that have helped to change this entrenched perspective. Bebbington and colleagues (2004) found that a psychosis group was 15 times more likely to have experienced sexual abuse than those without psychiatric problems. Childhood trauma was three times more strongly associated with psychosis than with adult neurosis or with drug or alcohol misuse. Janssen and colleagues (2004) found that people who had experienced childhood abuse of mild severity were twice as likely as nonabused participants to have "pathology level" psychosis, compared to 10 and 48 times for those who had suffered moderate and high severity of abuse, respectively. This is the clearest evidence to date of both the "dose-response effect" and of actual causality. Other studies reviewed are Spataro, Mullen, Burgess, Wells, and Moss (2004) and Whitfield, Dube, Felitti, and Anda (2005). The case study used as an illustration of treatment for psychosis involved an intervention that enabled the patient to express her life story and develop a warm and trusting relationship with the therapist before any direct psychotherapeutic work occurred. Therapeutic work enabled the patient to make sense of her experiences in connecting past events with current distress while developing techniques for the emotional and behavioral management of her symptoms. 20 references