Comprehensive Textbook of Psychiatry.

Objective: To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications.

Method:  Relevant studies and previous review papers were identified via computer literature searches.

Results:  Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect.

Conclusion:  Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified.

/pdf/childhood-trauma-psychosis-and-schizophrenia-a-literature-1crq7wo3qp.pdf

Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

Purpose A new strain of H1N1 influenza, also known as swine flu was confirmed in the UK in May 2009 and has spread to over 100 countries around the world causing the World Health Organization to declare a global flu pandemic. The primary objectives of this review are to identify the key demographic and attitudinal determinants of three types of protective behaviour during a pandemic: preventive, avoidant, and management of illness behaviours, in order to describe conceptual frameworks in which to better understand these behaviours and to inform future communications and interventions in the current outbreak of swine flu and subsequent influenza pandemics. Methods Web of Science and PubMed databases were searched for references to papers on severe acute respiratory syndrome, avian influenza/flu, H5N1, swine influenza/flu, H1N1, and pandemics. Forward searching of the identified references was also carried out. In addition, references were gleaned from an expert panel of the Behaviour and Communications sub-group of the UK Scientific Pandemic Influenza Advisory Group. Papers were included if they reported associations between demographic factors, attitudes, and a behavioural measure (reported, intended, or actual behaviour). Results Twenty-six papers were identified that met the study inclusion criteria. The studies were of variable quality and most lacked an explicit theoretical framework. Most were cross-sectional in design and therefore not predictive over time. The research shows that there are demographic differences in behaviour: being older, female and more educated, or non-White, is associated with a higher chance of adopting the behaviours. There is evidence that greater levels of perceived susceptibility to and perceived severity of the diseases and greater belief in the effectiveness of recommended behaviours to protect against the disease are important predictors of behaviour. There is also evidence that greater levels of state anxiety and greater trust in authorities are associated with behaviour. Conclusions The findings from this review can be broadly explained by theories of health behaviour. However, theoretically driven prospective studies are required to further clarify the relationship between demographic factors, attitudes, and behaviour. The findings suggest that intervention studies and communication strategies should focus on particular demographic groups and on raising levels of perceived threat of the pandemic disease and belief in the effectiveness of measures designed to protect against it.

/pdf/demographic-and-attitudinal-determinants-of-protective-3hta66e9xw.pdf

Demographic and attitudinal determinants of protective behaviours during a pandemic: A review

http://www.antoniocasella.eu/archipsy/Johns_2001.pdf

The continuity of psychotic experiences in the general population

Strauss (1969) revisited: a psychosis continuum in the general population?

The form and the content of chronic auditory hallucinations were compared in three cohorts, namely patients with schizophrenia, patients with a dissociative disorder, and nonpatient voice-hearers. The form of the hallucinatory experiences was not significantly different between the three groups. The subjects in the nonpatient group, unlike those in the patient groups, perceived their voices as predominantly positive: they were not alarmed or upset by their voices and felt in control of the experience. In most patients, the onset of auditory hallucinations was preceded by either a traumatic event or an event that activated the memory of earlier trauma. The significance of this study is that it presents evidence that the form of the hallucinations experienced by both patient and nonpatient groups is similar, irrespective of diagnosis. Differences between groups were predominantly related to the content, emotional quality, and locus of control of the voices. In this study the disability incurred by hearing voices is associated with (the reactivation of) previous trauma and abuse.

Auditory hallucinations: a comparison between patients and nonpatients.

A questionnaire comprising 30 open-ended questions was sent to 450 people with chronic hallucinations of hearing voices who had responded to a request on television. Of the 254 replies, 186 could be used for analysis. It was doubtful whether 13 of these respondents were experiencing true hallucinations. Of the remaining 173 subjects, 115 reported an inability to cope with the voices. Ninety-seven respondents were in psychiatric care, and copers were significantly less often in psychiatric care (24%) than non-copers (49%). Four coping strategies were apparent: distraction, ignoring the voices, selective listening to them, and setting limits on their influence.

Coping with hearing voices: an emancipatory approach.

In Maastricht, the Netherlands, over the past 20 years psychiatrist Marius Romme and researcher Sandra Escher have developed a new approach to hearing voices, which we will call the ‘Maastricht’ approach, that emphasizes accepting and making sense of voices.1 This approach has become progressively more influential, in Europe, Australia, New Zealand and elsewhere, and has led to voice hearers organizing themselves into networks, empowering themselves and working towards recovery in their own ways. This approach contends that people hearing voices (hereafter referred to as ‘VH’ for ‘voice hearers’) can learn to cope with their voices and benefit from psychological and social interventions. It is based on three central tenets, that the phenomena of hearing voices is: (a) more prevalent in the general population than was previously believed, (b) a personal reaction to life stresses, whose meaning or purpose can be deciphered, and (c) best considered a dissociative experience and not a psychotic symptom (though it can sometimes occur in the context of psychotic symptoms, such as delusions; Moskowitz and Corstens, 2007). In addition to emphasizing understanding the purpose or meaning of the voices, a specific treatment model for working directly with a person’s voices – emphasizing their dissociative nature – has been developed by adapting the voice dialogue method (Stone and Stone, 1989) for working with VH.

Accepting and Working with Voices: The Maastricht Approach

Chavez, Foreword. Romme, Escher, Psychosis as a Personal Crisis: Introduction. Part I: Changes in Attitude. Martindale, Psychiatry at the Cross Roads. Hoffman, Changing Attitudes in a Clinical Setting. Johnstone, Voice Hearers Are People with Problems Not Patients with Illness. Coleman, Taylor, The Process of Recovery and the Implications for Working in Psychosis. Escher, Useful Instruments for Exploring Hearing Voices and Paranoia. Part II: Relationship with Trauma or Other Live Experiences. Larkin, Read, Childhood Trauma and Psychosis: Revisiting the Evidence. Bullimore, The Relation Between Trauma and Paranoia. Romme, Personal Links Between Trauma, Distorted Emotions and Hearing Voices. Part III: Recovery Oriented Approaches. Escher, Hearing Voices in Children: The Message of the Voices. Seikkula, Alakare, Open Dialogue with Psychotic Patients and Their Families. Dillon, Longden, Hearing Voices Groups: Creating Safe Spaces to Share Taboo Experiences. May, Relating to Alternative Realities. Romme, Escher, Accepting and Making Sense of Hearing Voices. Corstens, May, Longden, Talking Directly with Voices. Kingdom, Cognitive Psychological Intervention: Understanding Psychosis and Cognitive Therapy. Garfield, Iagura, A Psychoanalytic Framework for Psychotic Experiences. Watkins, Using Medication Wisely in Treating Psychosis.

Psychosis as a Personal Crisis : An Experience-Based Approach

(2003). Hearing voices: A common human experience. Nordic Journal of Psychiatry: Vol. 57, No. 2, pp. 157-159.

Hearing Voices: A Common Human Experience

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