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Psychotic experiences and PTSD: exploring associations in a population survey

Published online by Cambridge University Press:  20 May 2015

S. Alsawy ,
L. Wood ,
P. J. Taylor  and
A. P. Morrison
S. Alsawy
Affiliation:
University of Manchester, School of Psychological Sciences, Manchester, UK
L. Wood*
Affiliation:
University of Manchester, School of Psychological Sciences, Manchester, UK North East London Foundation Trust, Inpatient and Acute Psychology Services, Essex, UK
P. J. Taylor
Affiliation:
University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
A. P. Morrison
Affiliation:
University of Manchester, School of Psychological Sciences, Manchester, UK Greater Manchester West NHS Foundation Trust, Psychosis Research Unit, Prestwich Hospital, Manchester, UK
*
*Address for correspondence: Dr L. Wood, North East London Foundation Trust, Inpatient and Acute Psychology Services, Goodmayes Hospital, Barley Lane IG3 8XJ, Essex, UK. (Email: lisawood3@nhs.net)
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Abstract

Background

Extensive evidence has shown that experiencing a traumatic event and post-traumatic stress disorder (PTSD) are associated with experiences of psychosis. However, less is known about specific PTSD symptoms and their relationship with psychotic experiences. This study aimed to examine the relationship between symptoms of PTSD with paranoia and auditory hallucinations in a large-scale sample.

Method

The Adult Psychiatric Morbidity Survey (APMS) was utilized to examine the prevalence of lifetime trauma, symptoms of PTSD, and experiences of paranoia and auditory hallucinations (n = 7403).

Results

There were significant bivariate associations between symptoms of PTSD and psychotic experiences. Multiple logistic regression analyses indicated that reliving and arousal symptoms were significant predictors for paranoia while reliving, but not arousal symptoms, also significantly predicted auditory hallucinations. A dose-response relationship was found, the greater the number of PTSD symptoms, the greater the odds were of experiencing both paranoia and hallucinations.

Conclusions

These findings illustrate that symptoms of PTSD are associated with increased odds of experiencing auditory hallucinations and paranoia. Overlaps appear to be present between the symptoms of PTSD and psychotic experiences. Increasing awareness of this association may advance work in clinical practice.

Keywords

Auditory hallucinationsparanoiapopulation surveypsychosisPTSD
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 13 , October 2015 , pp. 2849 - 2859
Copyright
Copyright © Cambridge University Press 2015 

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References

Adetunji, B, Mathews, M, Williams, A, Budur, K, Mathews, M, Mahmud, J (2005). Use of antipsychotics in the treatment of Post-Traumatic Stress Disorder. Psychiatry (Edgmont) 2, 43–47.Google ScholarPubMed
Andrew, EM, Gray, NS, Snowden, RJ (2008). The relationship between trauma and beliefs about hearing voices: a study of psychiatric and non-psychiatric voice hearers. Psychological Medicine 38, 1409–1417.CrossRefGoogle ScholarPubMed
Bebbington, P, Jonas, S, Kuipers, E, King, M, Cooper, C, Brugha, T, Meltzer, H, McManus, S, Jenkins, R (2011). Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England. British Journal of Psychiatry 199, 29–37.CrossRefGoogle ScholarPubMed
Bebbington, P, Nayani, T (1995). The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research 5, 11–19.Google Scholar
Bechdolf, A, Thompson, A, Nelson, B, Cotton, S, Simmons, MB, Amminger, GP, Leicester, S, Francey, SM, McNab, C, Krstev, H, Sidis, A, McGorry, PD, Yung, AR (2010). Experience of trauma and conversion to psychosis in an ultra-high risk (prodromal) group. Acta Psychiatrica Scandinavia 121, 377–384.CrossRefGoogle Scholar
Bentall, R, de Sousa, P, Varese, F, Wickham, S, Sitko, K, Haarmans, M (2014). From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology 49, 1011–1022.CrossRefGoogle ScholarPubMed
Bentall, R, Wickham, S, Shelvin, M, Varese, F (2012). Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 adult psychiatric morbidity survey. Schizophrenia Bulletin 38, 734–740.CrossRefGoogle ScholarPubMed
Bentall, RP, Corcoran, R, Howard, R, Blackwood, N, Kinderman, P (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review 21, 1143–1192.CrossRefGoogle ScholarPubMed
Bird, V, Premkumar, P, Kendall, T, Whittington, C, Mitchell, J, Kuipers, E (2010). Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review. British Journal of Psychiatry 197, 350–356.CrossRefGoogle ScholarPubMed
Brewin, CR, Rose, S, Andres, B, Green, J, Tata, P, McEvedy, C, Turner, S, Foa, EB (2002). Brief screening instrument for post-traumatic stress disorder. British Journal of Psychiatry 181, 158–162.CrossRefGoogle ScholarPubMed
Buckley, PF, Miller, BJ, Lehrer, DS, Castle, DJ (2009). Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin 35, 383–402.CrossRefGoogle ScholarPubMed
Butler, RW, Mueser, KT, Sprock, J, Braff, DL (1996). Positive symptoms of psychosis in posttraumatic stress disorder. Biological Psychiatry 39, 839–844.CrossRefGoogle ScholarPubMed
Cornblatt, B, Lencz, T, Obuchowski, M (2002). The schizophrenia prodrome: treatment and high-risk perspectives. Schizophrenia Research 54, 177–186.CrossRefGoogle ScholarPubMed
Cromby, J, Harper, D (2005). Paranoia and social inequality. Clinical Psychology Forum 153, 17–21.CrossRefGoogle Scholar
de Bont, PAJM, van den Berg, DPG, dvan der Vleugel, BM, de Roos, C, Mulder, CL, Becker, ES, de Jongh, A, van der Gaag, M, van Minnen, A (2013). A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis. Trials 14, 1–19.CrossRefGoogle ScholarPubMed
Ehlers, A, Clark, D (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.CrossRefGoogle ScholarPubMed
Field A (2000). Discovering Statistics Using SPSS for Windows: Advanced Techniques for Beginners. London: Sage Publications.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP) Biometrics Research: New York.Google Scholar
Freeman, D, McManus, S, Brugha, T, Meltzer, H, Jenkns, R, Bebbington, P (2011). Concomitants of paranoia in the general population. Psychological Medicine 41, 923–936.CrossRefGoogle ScholarPubMed
Freeman, D, Stahl, D, McManus, S, Meltzer, H, Brugha, T, Wiles, N, Bebbington, P (2012). Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking. Social Psychiatry and Psychiatric Epidemiology 47, 1195–1203.CrossRefGoogle ScholarPubMed
Freeman, D, Startup, H, Myers, E, Harvey, A, Geddes, J, Yu, L, Zaiwalla, Z, Luengo-Fernandez, R, Foster, R, Lister, R (2013). The effects of using cognitive behavioural therapy to improve sleep for patients with delusions and hallucinations (the BEST study): study protocol for a randomized controlled trial. Trials 14, 214.CrossRefGoogle ScholarPubMed
Gilbert, P (2010). Compassion Focused Therapy. Routledge: Hove.CrossRefGoogle Scholar
Goodman, L, Rosenberg, SD, Mueser, KT, Drake, RE (1997). Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophrenia Bulletin 23, 685–696.CrossRefGoogle ScholarPubMed
Habets, P, Marcelis, M, Gronenschild, E, Drukker, M, van Os, J (2011). Reduced cortical thickness as an outcome of differential sensitivity to environmental risks in schizophrenia. Biological Psychiatry 69, 487–494.CrossRefGoogle ScholarPubMed
Hamner, MB, Faldowski, RA, Ulmer, HG, Frueh, BC, Huber, MG, Arana, GW (2003). Adjunctive risperidone treatment in post-traumatic stress disorder: a preliminary controlled trial of effects on comorbid psychotic symptoms. Journal of Clinical Psychopharmacology 18, 1–8.Google ScholarPubMed
Heim, C, Newport, DJ, Heit, S, Graham, YP, Wilcox, M, Bonsall, R (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592–597.CrossRefGoogle ScholarPubMed
Honig, A, Romme, MA, Ensink, BJ, Escher, SD, Pennings, MH, deVries, MW (1998). Auditory hallucinations: a comparison between patients and nonpatients. Journal of Nervous and Mental Disease 186, 646–651.CrossRefGoogle ScholarPubMed
IBM Corp (2011). IBM SPSS Statistics for Windows , Version 20.0. IBM Corp: Armonk, NY.Google Scholar
Jackson, C, Trower, P, Reid, I, Smith, J, Hall, M, Townend, M, Barton, K, Jones, J, Ross, K, Russell, R, Newton, E, Dunn, G, Birchwood, M (2009). Improving psychological adjustment following a first episode of psychosis: a randomised controlled trial of cognitive therapy to reduce post psychotic trauma symptoms. Behaviour Research and Therapy 47, 454–462.CrossRefGoogle ScholarPubMed
Janssen, I, Krabbendam, L, Bak, M, Hanssen, M, Vollebergh, W, de Graaf, R, van Os, J (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica 109, 38–45.CrossRefGoogle ScholarPubMed
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C, Cannon, M (2008). Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378–382.CrossRefGoogle ScholarPubMed
Kingdon, D, Ashcroft, K, Bhandari, B, Gleeson, S, Warikoo, N, Symons, M, Taylor, L, Lucas, E, Mahendra, R, Ghosh, S, Mason, A, Badrakalimuthu, R, Hepworth, C, Read, J, Mehta, R (2010). Schizophrenia and borderline personality disorder: similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma. Journal of Nervous & Mental Disease 198, 399–403.CrossRefGoogle ScholarPubMed
Larkin, W, Morrison, A (2007). Trauma and Psychosis: New Directions for Theory and Therapy. Routledge: Sussex.CrossRefGoogle Scholar
Lawrence, C, Jones, J, Cooper, M (2010). Hearing voices in a non-psychiatric population. Behavioural and Cognitive Psychotherapy 38, 363–373.CrossRefGoogle Scholar
Luby, ED, Frohman, CE, Grisell, JL, Lenzo, JE, Gottlieb, JS (1959). Sleep deprivation: effects on behavior, thinking, motorperformance and biological energy transfer systems. Psychosomatic Medicine 3, 182–192.Google Scholar
McManus, S, Meltzer, H, Brugha, T, Bebbington, P (2007). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. The NHS information Centre: London.Google Scholar
Menard, S (1995). Applied Logistic Regression Analysis: Sage University Series on Quantitative Applications in the Social Sciences. Sage: Thousand Oaks, CA.Google Scholar
Morrison, AP (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy 29, 257–276.CrossRefGoogle Scholar
Morrison, AP, Frame, L, Larkin, W (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology 42, 331–351.CrossRefGoogle ScholarPubMed
Morrison, AP, Stewart, S, French, P, Bentall, RP, Birchwood, M, Byrne, RE, Davies, L, Fowler, D, Gumley, AI, Jones, PB, Lewis, SW, Murray, G, Patterson, P, Dunn, G (2011). Early Detection and Intervention Evaluation for people at high-risk of psychosis-2 (EDIE-2): trial rationale, design and baseline characteristics. Early Intervention in Psychiatry 5, 24–32.CrossRefGoogle ScholarPubMed
Moskowitz, A, Schafer, I, Dorahy, MJ (2011). Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology. Wiley Blackwell: London.Google Scholar
Mueser, KT, Goodman, LB, Trumbetta, SL, Rosenberg, SD, Osher, FC, Vidaver, R, Auciello, P, Foy, DW (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology 66, 493–399.CrossRefGoogle ScholarPubMed
Nemeroff, CB (2004). Neurobiological consequences of childhood trauma. Journal of Clinical Psychiatry 65, 18–28.Google ScholarPubMed
NICE (2005). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care . National Institute for Clinical Excellence: London.Google Scholar
Pepper, H, Agius, M (2009). Phenomenology of PTSD and psychotic symptoms. Psychiatria Danubina 21, 82–84.Google ScholarPubMed
Pivac, N, Knezevic, J, Kozaric-Kovacic, D, Dezeljin, M, Rak, D, Matijevic, T, Pavelic, J, Muck-Seler, D (2007). Monoamine oxidase (MAO) intron 13 polymorphism and platelet MAO-B activity in combat-related posttraumatic stress disorder. Journal of Affective Disorders 103, 131–138.CrossRefGoogle ScholarPubMed
Read, J, Argyle, N (1999). Hallucinations, delusions, and thought disorder among adult psychiatric patients with a history of child abuse. Psychiatric Services 50, 1467–1472.CrossRefGoogle ScholarPubMed
Read, J, Hammersley, P, Rudegeair, T (2007). Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment 13, 101–110.CrossRefGoogle Scholar
Read, J, van Os, J, Morrison, A, Ross, C (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.CrossRefGoogle ScholarPubMed
Rogers, WH (1993). sg17: regression standard errors in clustered samples. Stata Technical Bulletin 13, 19–23.Google Scholar
Romme, MAJ, Escher, ADMAC (1989). Hearing voices. Schizophrenia Bulletin 15, 209–216.CrossRefGoogle ScholarPubMed
Scott, J, Chant, D, Andrews, G, Martin, G, McGrath, J (2007). Association between trauma exposure and delusional experiences in a large community-based sample. British Journal of Psychiatry 190, 339–343.CrossRefGoogle Scholar
Shelvin, M, Houston, JE, Dorahy, MJ, Adamson, G (2008). Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British psychiatric morbidity survey. Schizophrenia Bulletin 34, 193–199.Google Scholar
Spiegel, D (2006). Trauma, dissociation and memory. Annals of the New York Academy of Sciences 821, 225–237.CrossRefGoogle Scholar
StataCorp (2011). Stata Statistical Software: Release 12. StataCorp LP: College Station, TX.Google Scholar
Van den Berg, DPG, De Bont, PAJM, van der Vleugel, BM, De Roos, C, De Jongh, A, Van Minnen, A, Van der Gaag, M (2015). Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry 72, 259–267.CrossRefGoogle ScholarPubMed
van der Vleugel, BM, van den Berg, DPG, Staring, ABP (2012). Trauma, psychosis, post-traumatic stress disorder and the application of EMDR. Supplemento alla Rivista di Psichiatria 47, 33–38.Google ScholarPubMed
van Rossum, I, Dominguez, M-d-G, Lieb, R, Wittchen, H-U, van Os, J (2009). Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophrenia Bulletin 37, 561–571.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, K, van Os, J, Bentall, RP (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 11, 1–11.Google Scholar
Varghese, D, Scott, J, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, McGrath, J (2009). Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophrenia Bulletin 37, 389–393.CrossRefGoogle ScholarPubMed
Waters, F, Allen, P, Aleman, A, Fernyhough, C, Woodward, T, Badcock, JC, Barkus, E, Johns, L, Varese, F, Menon, M, Vercammen, A, Laroi, F (2012). Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated Model of cognitive mechanisms. Schizophrenia Bulletin 38, 683–692.CrossRefGoogle ScholarPubMed