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Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review

Fornells-Ambrojo, M; Gracie, A; Brewin, CR; Hardy, A; (2016) Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review. European Journal of Psychotraumatology , 7 , Article 32095. 10.3402/ejpt.v7.32095. Green open access

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Abstract

BACKGROUND: Posttraumatic stress disorder (PTSD) in response to psychosis and associated experiences (psychosis-related PTSD, or PR-PTSD) is the subject of a growing field of research. However, a wide range of PR-PTSD prevalence rates has been reported. This may be due to definitional and methodological inconsistencies in the assessment of PR-PTSD. OBJECTIVE: The focus of the review is two-fold. (1) To identify factors that enhance, or detract from, the robustness of PR-PTSD assessment and (2) to critically evaluate the evidence in relation to these identified criteria, including the impact on PR-PTSD prevalence rates. METHODS: Four quality criteria, whose development was informed by mainstream PTSD research, were selected to evaluate findings on PR-PTSD prevalence. Two criteria related to assessment of psychosis-related stressors (participant identification of worst moments of discrete threat events; psychometrically robust trauma measure) and two focussed on PR-PTSD symptom measurement (adequate time elapsed since trauma; use of validated PTSD interview) in the context of psychosis. RESULTS: Twenty-one studies of PR-PTSD, with prevalence rates ranging from 11 to 51%, were evaluated. Fourteen studies (67%) used robust PTSD measures but PR-trauma was not specifically defined or assessed with validated measures. Eleven studies (52%) assessed PTSD before sufficient time had elapsed since the trauma. Due to significant methodological limitations, it was not possible to review PR-PTSD rates and provide a revised estimate of prevalence. CONCLUSIONS: Methodological limitations are common in existing studies of PR-PTSD prevalence. Specific recommendations for improving assessment of psychosis-related trauma are made to guide the development of this new and emerging field. The review concludes with a proposed conceptualisation of PR-PTSD in the context of current diagnostic systems. The utility of the PR-PTSD term and its theoretical underpinnings are discussed.

Type: Article
Title: Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review
Open access status: An open access version is available from UCL Discovery
DOI: 10.3402/ejpt.v7.32095
Publisher version: http://dx.doi.org/10.3402/ejpt.v7.32095
Language: English
Additional information: © 2016 Miriam Fornells-Ambrojo et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
Keywords: Social Sciences, Science & Technology, Life Sciences & Biomedicine, Psychology, Clinical, Psychiatry, Psychology, Psychosis, Trauma, Ptsd, Psychosis-Related Ptsd, Assessment, Posttraumatic-Stress-Disorder, Recent-Onset Psychosis, 1St-Episode Psychosis, Autobiographical Memory, Traumatic Reactions, Childhood Trauma, Physical Abuse, Symptoms, Schizophrenia, Illness
UCL classification: UCL
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: https://discovery.ucl.ac.uk/id/eprint/1521388
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