Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep 27:7:32095.
doi: 10.3402/ejpt.v7.32095. eCollection 2016.

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

Miriam Fornells-Ambrojo  1 , Alison Gracie  2 , Chris R Brewin  2 , Amy Hardy  3
Affiliations
Review

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

Miriam Fornells-Ambrojo et al. Eur J Psychotraumatol. .

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.

Method: 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.

Keywords: PTSD; Psychosis; assessment; psychosis-related PTSD; trauma.

PubMed Disclaimer

Conflict of interest statement

and funding There is no conflict of interest in the present study for any of the authors.

Figures

Fig. 1
Fig. 1
Selection of studies.
See this image and copyright information in PMC

References

    1. Abdelghaffar W, Ouali U, Jomli R, Zgueb Y, Nacef F. Post-traumatic stress disorder in first episode psychosis: Prevalence and related factors. Clinical Schizophrenia & related psychoses. 2016 doi: http://dx.doi.org/10.3371/csrp.ABOU.123015. - DOI - PubMed
    1. Achim A.M, Maziade M, Raymond É, Olivier D, Mérette C, Roy M.A. How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophrenia Bulletin. 2011;37(4):811–821. doi: http://dx.doi.org/10.1093/schbul/sbp148. - DOI - PMC - PubMed
    1. Allen P, Larøi F, McGuire P.K, Aleman A. The hallucinating brain: A review of structural and functional neuroimaging studies of hallucinations. Neuroscience and Biobehavioral Reviews. 2008;32:175–191. doi: http://dx.doi.org/10.1016/j.neubiorev.2007.07.012. - DOI - PubMed
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: Author; 2013.
    1. Beattie N, Shannon C, Kavanagh M, Mulholland C. Predictors of PTSD symptoms in response to psychosis and psychiatric admission. Journal of Nervous & Mental Disease. 2009;197:56–60. doi: http://dx.doi.org/10.1097/NMD.0b013e31819273a8. - DOI - PubMed