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An Exploration of the Links between Trauma and Delusional Ideation in Secure Services

Published online by Cambridge University Press:  16 September 2008

Clare Calvert*
Affiliation:
Leeds Partnerships Foundation NHS Trust, UK
Warren Larkin
Affiliation:
Lancashire Care NHS Trust, UK
Lorna Jellicoe-Jones
Affiliation:
Lancashire Care NHS Trust, UK
*
Reprint requests to Clare Calvert, Leeds Partnerships Foundation NHS Trust - Clinical Psychology Newsam Centre, Seacroft Hospital York Road Leeds LS14 6WB, UK. E-mail: clare.calvert@leedspft.nhs.uk

Abstract

Relationships between trauma symptoms and delusional ideation were explored in a forensic sample. A between-subjects design compared low and high trauma scoring patients on measures of delusional ideation and paranoia. A within-subjects design examined associations between trauma-related cognitions, delusional ideation and paranoia. Thirty-four participants were recruited from a number of secure units. Participants' “worst trauma” was identified using a self-report analogue scale. Self-report measures of trauma symptoms, trauma-related beliefs, delusions and paranoia were completed. Thirteen patients scored above the cut-off on the trauma measure, indicating a high rate of trauma symptoms. The most frequently cited worst traumas were committing an offence and the experience of psychosis. Correlational analyses revealed positive associations between traumatization and intensity of delusional ideation and paranoia. Trauma-related negative cognitions about the self were positively associated with level of delusional ideation, associated distress, and preoccupation. Negative cognitions about the world were associated with paranoia. Findings provide some evidence for associations between traumatization and delusional ideation and paranoia in this population. Future research should aim to replicate and extend the study, using a larger sample size and diagnostic measures of post-traumatic stress disorder (PTSD).

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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References

Barnard, G. W., Hankins, G. C. and Robbins, L. (1992). Prior life trauma, post-traumatic stress symptoms, sexual disorders, and character traits in sex offenders: an exploratory study. Journal of Traumatic Stress, 5, 393420.Google Scholar
Bentall, R. P. (1990). The syndromes and symptoms of psychosis: or why you can't play twenty questions with the concept of schizophrenia and hope to win. In Bentall, R. P. (Ed.), Reconstructing Schizophrenia (pp. 2360). London: Routledge.Google Scholar
Bentall, R. P. (1994). Cognitive biases and abnormal beliefs: towards a model of persecutory delusions. In David, A. S. and Cutting, J. (Eds.), The Neuropsychology of Schizophrenia (pp. 337360). London: Erlbaum.Google Scholar
Blake, D., Weathers, F., Nagy, L., Kaloupek, D., Klauminzer, G., Charney, D. and Keane, T. (1990). Clinician-Administered PTSD Scale (CAPS). Boston: National Centre for Posttraumatic Stress Disorder, Behavioural Science Division.Google Scholar
Bowe, S., Morrison, A. P. and Morley, S. (2002). The Worst Memories Scale. Cited in The Relationship between Past Childhood Trauma and Auditory Hallucinations in Individuals with Psychosis. Unpublished. University of Leeds, School of Medicine.Google Scholar
Breslau, N. (2002). Epidemiologic studies of trauma, posttraumatic stress disorder, and other psychiatric disorders. Canadian Journal of Psychiatry, 47, 923929.Google Scholar
Breslau, N., Davis, G., Andreski, P. and Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216222.Google Scholar
Briere, J. (1992). Child Abuse Trauma: theory and treatment of the lasting effects. Thousand Oaks, CA: Sage Publications.Google Scholar
Chisholm, B., Freeman, D. and Cooke, A. (2006). Identifying potential predictors of traumatic reactions to psychotic episodes. British Journal of Clinical Psychology, 45, 545559.CrossRefGoogle ScholarPubMed
Davidson, J. R. T., Book, S. W., Colket, J. T., Tupler, L. A., Roth, S., David, D., Hertzberg, M., Mellman, T., Beckham, J. C., Smith, R. D., Davison, R. M., Katz, R. and Feldman, M. E. (1997). Assessment of a new self-rating scale for post-traumatic stress disorder. Psychological Medicine, 27, 153160.Google Scholar
Della Femina, D., Yaeger, D. and Lewis, D. (1990). Child abuse: adolescent records vs. adult recall. Child Abuse and Neglect, 14, 227231.Google Scholar
Department of Health (2002). Women's Mental Health: into the mainstream. London: DOH.Google Scholar
Dill, D., Chu, J. and Grob, M. (1991). The reliability of abuse history reports: a comparison of two inquiry formats. Comprehensive Psychiatry, 32, 166169.Google Scholar
Ehlers, A. and Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319345.Google Scholar
Ehlers, A. and Steil, R. (1995). Maintenance of intrusive memories in posttraumatic stress disorder: a cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217249.CrossRefGoogle ScholarPubMed
Fenigstein, A. and Vanable, P. A. (1992). Paranoia and self-consciousness. Journal of Personality and Social Psychology, 62, 129138.CrossRefGoogle ScholarPubMed
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F. and Orsillo, S. M. (1999). The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychological Assessment, 11, 303314.Google Scholar
Frame, L. and Morrison, A. P. (2001). Causes of posttraumatic stress disorder in psychotic patients. Archives of General Psychiatry, 58, 305306.CrossRefGoogle ScholarPubMed
Freeman, D. and Garety, P. A. (2000). Cognitive therapy for an individual with a long-standing ersecutory delusions: incorporating emotional processes into a multi-factorial erspective on delusional beliefs. In Morrison, A. P. (Ed.), A Casebook of Cognitive Therapy for Psychosis (pp. 173197). Chichester: Wiley.Google Scholar
Freeman, D., Garety, P. A., Kuipers, E., Fowler, D. and Bebbington, P. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41, 331347.CrossRefGoogle ScholarPubMed
Garety, P. A., Kuipers, E., Fowler, D., Freeman, D. and Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189195.Google Scholar
Gray, N. S., Carman, N. G., Rogers, P., MacCulloch, M. J., Hayward, P. and Snowden, R. J. (2003). Post-traumatic Stress Disorder caused in mentally disordered offenders by the committing of a serious violent or sexual offence. The Journal of Forensic Psychiatry and Psychology, 14, 2743.Google Scholar
Greenfield, S. F., Strakowski, S. M., Tohen, M., Batson, S. C. and Kolbrener, M. L. (1994). Childhood abuse in first-episode psychosis. British Journal of Psychiatry, 164, 831834.Google Scholar
Honig, A., Romme, M. A., Ensink, B. J., Escher, S. D., Pennings, M. H. and DeVries, M. W. (1998). Auditory hallucinations: a comparison between patients and non-patients. Journal of Nervous and Mental Disease, 186, 646651.CrossRefGoogle Scholar
Janssen, I., Krabbendam, L., Bak, M., Hanssen, M., Vollebergh, W., de Graaf, R. and van Os, J. (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica, 109, 3845.Google Scholar
Janoff-Bulman, R. (1979). Characterological versus behavioural self-blame: inquiries into depression and rape. Journal of Personality and Social Psychology, 37, 17981809.Google Scholar
Janoff-Bulman, R. (1992). Shattered Assumptions: towards a new psychology of trauma. New York: New York Free Press.Google Scholar
Jung, K. E. (2001). Posttraumatic spectrum disorder: a radical revision. Psychiatric Times [On-line] 18, 11. Available from: http://www.psychiatrictimes.com/p011158.html [Accessed 2nd January, 2005].Google Scholar
Kennedy, B. L., Dhaliwal, N., Pedley, L., Sahner, C., Greenberg, R. and Manoochehr, M. (2002). Post-traumatic stress disorder in subjects with schizophrenia and bi-polar disorder. Journal of the Kentucky Medical Association, 100, 395399.Google Scholar
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M. and Nelson, C. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 10481060.CrossRefGoogle ScholarPubMed
Kingdon, D. and Turkington, D. (1999). Cognitive-behavioural therapy of schizophrenia. In Wykes, T., Tarrier, N. and Lewis, S. (Eds.), Outcome and Innovation in the Psychological Treatment of Schizophrenia. (pp.5979). London: Wiley.Google Scholar
Kluft, R. P. (1996). Dissociative identity disorder. In Michelson, L. K. and Ray, W. J. (Eds.), Handbook of Dissociation, (pp. 337366). New York: Plenum.Google Scholar
Kruppa, I., Hickey, N. and Hubbard, C. (1995). The prevalence of post traumatic stress disorder in a special hospital population of legal psychopaths. Psychology, Crime and Law, 2, 131141.Google Scholar
Larkin, W., Morrison, A. P. and Frame, L. (2007). The relationship between trauma and dimensions of delusional ideation in a sample of paramedics. Manuscript submitted for publication.Google Scholar
Lothian, J. and Read, J. (2002). Asking about abuse during mental health assessments: clients' views and experiences. New Zealand Journal of Psychology, 31, 98103.Google Scholar
Maher, B. A. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30, 98113.Google Scholar
McFarlane, A. C. (1992). Avoidance and intrusion in posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 180, 439445.Google Scholar
McFarlane, A. C., Bookless, C. and Air, T. (2001). Posttraumatic stress disorder in a general psychiatric inpatient population. Journal of Traumatic Stress, 14, 633645.Google Scholar
McGorry, P. (1991). Negative symptoms and PTSD. Australian and New Zealand Journal of Psychiatry, 25, 913.Google Scholar
McGorry, P., Chanen, A., McCarthy, E., Van Riel, R., McKenzie, D. and Singh, B. S. (1991). Posttraumatic stress disorder following recent-onset psychosis: an unrecognised postpsychotic syndrome. The Journal of Nervous and Mental Disease, 179, 253258.Google Scholar
Mendel, M. P. (1995) The Male Survivor: the impact of sexual abuse. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257276.CrossRefGoogle Scholar
Morrison, A. P., Frame, L. and Larkin, W. (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology, 42, 331353.Google Scholar
Morrison, A. P., Renton, J. C., Dunn, H., Williams, S. and Bentall, R. (2004). Cognitive Therapy for Psychosis: a formulation-based approach. Hove and New York: Brunner-Routledge.Google Scholar
Mueser, K. T., Salyers, M. P., Rosenberg, S. D., Ford, J. D., Fox, L. and Cardy, P. A. (2001). A psychometric evaluation of trauma and PTSD assessments in persons with severe mental illness. Psychological Assessment, 13, 110117.Google Scholar
Mueser, K. T., Trumbetta, S. L., Rosenberg, S. D., Vidaver, R., Goodman, L. B., Osher, F. C. and Auciello, P. (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 66, 493499.CrossRefGoogle ScholarPubMed
Neria, Y., Bromet, E. J., Sievers, S., Lavelle, J. and Fochtmann, L. J. (2002). Trauma exposure and posttraumatic stress disorder in psychosis: findings from a first-admission cohort. Journal of Consulting and Clinical Psychology, 70, 246251.Google Scholar
Papanastassiou, M., Waldron, G., Boyle, J. and Chesterman, L. (2004). Post-traumatic stress disorder in mentally-ill perpetrators of homicide. The Journal of Forensic Psychiatry and Psychology, 15, 6675.Google Scholar
Peters, E. R., Joseph, S. and Garety, P. A. (1999). The assessment of delusions in normal and psychotic populations: introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia Bulletin, 25, 553576.Google Scholar
Pollock, P. H. (1999). When the killer suffers: post-traumatic stress reactions following homicide. Legal and Criminological Psychology, 4, 185202.Google Scholar
Priebe, S., Broker, M. and Gunkel, S. (1998). Involuntary admission and posttraumatic stress disorder symptoms in schizophrenic patients. Comprehensive Psychiatry, 39, 220224.Google Scholar
Proeve, M. and Howells, K. (2002). Shame and guilt in child sexual offenders. International Journal of Offender Therapy and Comparative Criminology, 46, 6, 657667CrossRefGoogle ScholarPubMed
Read, J., Agar, K., Barker-Collo, S., Davies, E. and Moskowitz, A. (2001). Assessing suicidality in adults: integrating childhood trauma as a major risk factor. Professional Psychology: Research and Practice, 32, 367372.Google Scholar
Read, J. and Fraser, A. (1998). Abuse histories of psychiatric inpatients: to ask or not to ask. Psychiatric Services, 49, 355359.Google Scholar
Read, J., Goodman, L., Morrison, A. P., Ross, C. A. and Aderhol, V. (2004). Childhood trauma, loss and stress. In Read, J., Mosher, L. R. and Bentall, R. P. (Eds.), Models of Madness: psychological, social and biological approaches to schizophrenia (pp. 223253). Hove and New York: Brunner-Routledge.CrossRefGoogle Scholar
Read, J., Hammersley, P. and Rudegeair, T. (2006). Why, when, and how to ask about child abuse. Advances in Psychiatric Treatment, 13, 101110.Google Scholar
Read, J., van Os, J., Morrison, A. P. and Ross, C. A. (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112, 330350.Google Scholar
Resnick, S. G., Bond, G. R. and Mueser, K. T. (2003). Trauma and posttraumatic disorder in people with schizophrenia. Journal of Abnormal Psychology, 112, 415423.Google Scholar
Rogers, P., Gray, N. S., Williams, T. and Kitchiner, N. (2000). Behavioural treatment of PTSD in a perpetrator of manslaughter: a single case-study. Journal of Traumatic Stress, 13, 511519.Google Scholar
Romme, M. A. J. and Escher, A. (1989). Hearing voices. Schizophrenia Bulletin, 15, 209216.Google Scholar
Ross, C. A., Anderson, G. and Clark, P. (1994). Childhood abuse and the positive symptoms of schizophrenia. Hospital and Community Psychiatry, 45, 489491.Google Scholar
Shaw, K., McFarlane, A. and Bookless, C. (1997). The phenomenology of traumatic reactions to psychotic illness. The Journal of Nervous and Mental Disease, 185, 434441.Google Scholar
Spitzer, C., Dudeck, M., Liss, H., Orlob, S., Gillner, M. and Freyberger, H. J. (2001). Post-traumatic stress disorder in forensic inpatients. The Journal of Forensic Psychiatry, 12, 163–77.Google Scholar
Spurell, M. T. and McFarlane, A. C. (1995). Life-events and psychiatric symptoms in a general psychiatry clinic: the role of intrusions and avoidance. British Journal of Medical Psychology, 68, 333340.Google Scholar
Steel, C., Fowler, D. and Holmes, E. (2005). Trauma-related intrusions and psychosis: an information processing account. Behavioural and Cognitive Psychotherapy, 33, 139152.CrossRefGoogle Scholar
Symonds, A. (1979). Violence against women: the myth of masochism. American Journal of Psychotherapy, 33, 161173.Google Scholar
Tabachnick, B. G. and Fidell, L. S. (1996). Using Multivariate Statistics (3rd ed.). New York: Harper Collins College Publishers.Google Scholar
Weisaeth, L. (1989). Importance of high response rates in traumatic stress research. Acta Psychiatrica Scandinavica, 355, 131137.Google Scholar
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