Exploring Complex PTSD and Psychosis

Scientific research on cptsd

Interesting stuff coming out of the UK about Complex PTSD.

The North West United Kingdom mental health services conducted a unique study looking into the relationship of trauma, particularly complex trauma, with psychosis. They published their findings in March 2022 with Frontiers in Psychology.

In short, they had 144 people who suffer from psychosis answer questions. The questions were designed to help assess the trauma the person suffered, the prevalence of PTSD and Complex-PTSD symptoms, as well as their symptoms of psychosis.

What the researchers found was –
10% of the study participants suffered from PTSD, but 40% of the sample suffered from cPTSD.

That in itself is a remarkable finding, but wait, there’s more.

The following sentence from the summary carries more meaning than you might initialy attatch to it.

PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership.

Let’s start with the definition of ‘positive symptoms’ –
In psychology ‘positive symptoms’ are defined as : highly exaggerated ideas, perceptions, or actions that show the person can’t tell what’s real from what isn’t. Here the word “positive” means the presence of symptoms. Which, in itself is not a positive thing. (Sorry, couldn’t resist the word play.)

The second term to parse out is DSOs. This is short hand for ‘disturbances in self-organization’ (DSOs) – which is a recognized attribute of Complex-PTSD in the International Classification of Diseases-11th Edition. Thank you Europe. You are so far ahead of the DSM.

Putting those terms together the sentence is telling us that PTSD and DSOs (aka cPTSD) were present in people who had suffered trauma and were now suffering psychosis. In addition there was also a relationship to exist between cPTSD and affective disorders (illnesses that affect the way a person thinks and feels).  

However, the relationship did not carry over to explain significant differences in the presence of negative sypmtoms. Remember, a ‘negative symptom’ doesn’t mean that there isn’t a problem. In psychology, a negative symptom denotes a loss of something. Negative symptoms include the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.

The summary of the article includes two important sentences:
1. Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response.
2. The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored.

So, what I’m reading here is that trauma that results in cPTSD does have some linkage to some symptoms of psychosis. BUT, we don’t know what that particular mechanism is yet.

They end the study summary with this line: “These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.”

In other words – people who suffer from psychosis might also benefit from therapies for cPTSD — as long as a future study doesn’t toss all this in the proverbial bin.

The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis [https://www.frontiersin.org/articles/10.3389/fpsyg.2022.791996/full]

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