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Trauma and Psychosis

The Trauma and Complex Mental Health Problems Research Unit is leading a cross-ERICCA programme of research focused on understanding the relationship between early trauma and psychosis, with the overall aim of developing a new theoretical understanding and treatment approach.

Woodrow, Karatzias, Harper, Fleming & Hutton (ongoing)

  • This randomised controlled trial will use 'ecological interventionist-causal' methodology to examine whether a therapeutic approach designed to improve emotion regulation will reduce paranoia in people with psychosis. This novel experimental approach to understanding the causes of psychosis will employ 'real-time' experience sampling to examine the effects of the intervention and the relationship between emotion regulation improvements and paranoia.

Woodrow, Karatzias, Harper, Fleming & Hutton (ongoing)

  • This large study of the general population (Target N = 400) seeks to identify the key psychological and emotional mediators of the trauma-psychosis association. The first stage (N=200) will involve exploratory factor analysis, and the second (N=200) will involve confirmatory factor analysis of the previously observed model.

  • The first stage of data collection is nearly complete, and the exploratory analysis is due to commence soon.

  • The website for the study is available here.

Woodrow, Karatzias, Harper, Fleming & Hutton (ongoing)

  • This systematic review is synthesising the existing literature on the psychological and emotional mediators of the trauma-psychosis relationship, taking into account study quality and strength of evidence for causality.

  • Searches, quality assessment and initial syntheses have been completed.

  • The protocol for this review is registered here.

Karatzias, Gumley, Power & O'Grady (2007)

  • This study investigated the hypothesis that greater negative beliefs about illness and lower self-esteem will be significantly associated with the presence of anxiety or affective comorbidity in a sample of persons (n = 138) diagnosed with schizophrenia.

  • We found a strong association between personal beliefs about self and illness and comorbidity, which suggests that negative beliefs about psychotic experiences and self-esteem may be linked to the development and maintenance of anxiety and affective comorbid conditions in psychosis.

  • The paper is available here.

Gumley, Karatzias, Power, Reilly, McNay & O'Grady (2006)

  • This study tested whether participants who relapsed during the 12-month follow-up period of a randomized controlled trial would show increased negative beliefs about their illness and reduced self-esteem, in comparison to the non-relapsed participants.

  • This study also investigated whether cognitive behavioural therapy (CBT) for early signs of relapse would result in a reduction in negative beliefs about psychosis and an improvement in self-esteem at 12 months.

  • At 12 months, relapsers showed greater increase in scores for PBIQ entrapment compared with non-relapsers. In addition, after controlling for baseline covariates (treatment group and PBIQ self versus illness), relapsers also showed greater increase in scores for PBIQ self versus illness at 12 months. Furthermore, in comparison to treatment as usual, participants who received CBT showed greater improvement in PBIQ loss and in Rosenberg self-esteem.

  • Overall, this study provided evidence that relapse is associated with the development of negative appraisals of entrapment and self-blame (self vs. illness). In addition, this was the first study to show that CBT reduces negative appraisals of loss arising from psychosis and improvements in self-esteem

  • The paper is available here.

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