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Relational and cognitive factors in psychosis-related posttraumatic stress disorder

Gracie, A; (2013) Relational and cognitive factors in psychosis-related posttraumatic stress disorder. Doctoral thesis , UCL (University College London). Green open access

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Abstract

Research suggests that the experience of acute psychosis (symptoms and treatment) may be traumatic and precipitate posttraumatic stress disorder (PTSD), and that outcomes may be worse for people affected. The first part of this thesis reviewed studies of psychosis-related PTSD (PR-PTSD), with a particular focus on evaluating the methodologies of research, given the complexities of assessment. Three assessment factors were identified as critical to the reliability of prevalence rates (the timepoint of assessment; the assessment method; and the definition of the traumatic stressor). Sample selection biases were also identified as key to the validity of findings. Additional indicators of quality were judged to be the assessment and control of current symptoms of psychosis; measurement of the subjective meaning of trauma; and the control of co-existing variables such as distress in relation to prior trauma, and current symptoms of psychosis. The second part is an empirical paper which derived hypotheses from a cognitive interpersonal model of psychosis to test the relationship between psychosis-related PTSD and a number of relational and cognitive variables. Thirty participants with a diagnosis of Schizophrenia completed measures of childhood trauma and related PTSD, negative emotional memories, adult attachment, PTSD symptoms in relation to psychosis, fear of recurrence and depression. In addition, current symptoms of psychosis were assessed and Care Coordinators completed a measure of service engagement. Some support was found for the cognitive interpersonal model, particularly with respect to anxious attachment. Anxious attachment and fear of recurrence of psychosis were the strongest predictors of psychosis-related PTSD symptoms, after controlling for the role of current symptomatology. Childhood trauma-related PTSD was associated with PR-PTSD. There was less support for other relational variables and no relationship was found between service engagement, avoidant attachment and PR-PTSD. Part three is a critical appraisal. It assesses the empirical paper in light of the methodological recommendations made in the literature review. It also concerns participant wellbeing, which has been a priority from initial planning of the study and throughout recruitment.

Type: Thesis (Doctoral)
Title: Relational and cognitive factors in psychosis-related posttraumatic stress disorder
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity.
Keywords: Psychosis, psychosis-related PTSD, posttraumatic stress disorder, PTSD.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/1417571
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