NCJ Number
210029
Journal
Journal of Trauma Practice Volume: 3 Issue: 2 Dated: 2004 Pages: 73-95
Date Published
2004
Length
23 pages
Annotation
This literature review focused on empirical research pertinent to postpsychotic posttraumatic stress disorder (PTSD) reactions and links between psychosis, trauma, and PTSD.
Abstract
Results are presented from case reports and empirical studies, followed by a discussion of findings on treatment strategies and implications. From the literature, it is clear that the links between psychosis, PTSD, and trauma are complex. Reflecting this finding, this article reviews topics that include the misdiagnosis of PTSD as psychosis, the high rate of trauma within the population of persons with severe mental illness (SMI), issues in the assessment of trauma within the SMI population, and the concept that trauma can induce psychosis. Most of the discussion, however, reviews the literature on postpsychotic PTSD. Research in this area is still in its infancy. Since the earliest theoretical paper emerged some 27 years ago, relatively few details have become clear. Recent research, however, has replicated several findings. No relationship has been found between postpsychotic PTSD and involuntary versus voluntary status, number of hospitalizations, age, gender, or severity of psychosis. This suggests that the severity of the stressor may not be a critical issue, but rather that there may be a cumulative effect from the stresses surrounding hospitalization, which can lead to PTSD-type symptoms. Five of the six empirical studies conducted have reported that between 35 percent and 67 percent of their sample have met criteria for PTSD due to psychosis and/or hospitalization, suggesting that the experience of psychosis and/or hospitalization may lead to PTSD-type symptoms. Recent studies also suggest that overall distress caused by psychosis and/or hospitalization is a major factor in developing postpsychotic PTSD. Several treatment strategies for postpsychotic PTSD are discussed, as well as proposed treatment implications from the empirical literature. Suggestions are offered for future research. 71 references