Marsh-Picksley, S; (2016) Phenomenology of Intrusive Trauma Memory in Psychosis and its Relationship with Hallucinations and Persecutory Beliefs. Doctoral thesis , UCL (University College London).

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Abstract

This thesis is presented in three parts, and is focused on developing the theoretical understanding of the role of trauma memory in psychosis. The systematic literature review investigates the relationship between psychosis symptom severity and re-experiencing of traumatic memories. 13 studies published since 1980 were identified as meeting the review criteria. Overall, findings suggest that people with more severe hallucinations and paranoia experiences report more re-experiencing of traumatic memories. However, this relationship was not seen when looking at more global symptoms of psychosis. The role of trauma memory in the development and maintenance of psychosis therefore warrants further investigation. The empirical paper (a joint project with Carr (2016), “Developing a brief trauma screening tool for use in psychosis”) explores the phenomenology of intrusive trauma memory in psychosis and investigates its relationship to hallucinations and persecutory beliefs. In line with theoretical accounts (Steel et al, 2005), it was hypothesised that increased memory fragmentation would be associated with more severe hallucinations. Twenty participants described an intrusive trauma memory and its phenomenological characteristics. Findings indicated that subjective fragmentation of intrusive memories was associated with more severe hallucinations but not persecutory beliefs, although the relationship between the two ratings of objective memory fragmentation and hallucinations were equivocal, with a negative correlation for one rating and no relationship for the other. Participants with psychosis also reported more frequent and vivid intrusions, with an increased sense of reliving, compared to non-clinical sample. The study suggests a potential role for memory fragmentation in hallucinatory experience, although the complexities of assessing memory characteristics are highlighted. The critical appraisal focuses on the experience of the research process, which includes reflections on methodological issues in memory assessment, challenges to recruitment in psychosis services and the role of the research process in the author’s professional development.

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