Tag Archives: Signs Of Psychosis

Childhood Trauma And Psychosis

Although there is now a vast amount of research that has been conducted on the link between childhood trauma and the later development of non-psychotic disorders, the amount of research that has been conducted on the link between childhood trauma and the later development of psychotic conditions has been rather less plentiful ; however, increasingly, researchers are focusing on this, so far, less studied link and in this article I will review some of what is currently known or theorized about the association.

 

Childhood Trauma And Psychosis :

‘The psychiatric profession is about to experience an earthquake that will shake its intellectual foundations…there is tectonic, plate-shifting evidence'[for the environmental basis of psychosis]’

-Oliver James (leading UK psychologist). Comment in relation to the now overwhelming evidence that psychosis is strongly related to childhood trauma and the need to stop over-focusing on biological causes.

There is now extremely strong research evidence showing the link between childhood trauma and the affected individual’s likelihood of developing PSYCHOTIC ILLNESS in later life.

It is, of course, already well-established that there is a powerful link between childhood trauma and psychiatric conditions which include depression, anxiety, substance abuse, eating disorders, post traumatic stress disorder, sexual dysfunction, personality disorder, dissociation and suicidal ideation. Now, however, it is becoming increasingly apparent that there is also a strong link with psychotic conditions such as BIPOLAR DEPRESSION and SCHIZOPHRENIA.

An ever-increasing body of  evidence is now demonstrating the very high prevalence of experiences of severe childhood trauma in psychiatric patients who are suffering from psychotic illnesses

Indeed, many leading psychologists are arguing that researchers have neglected the importance of childhood experiences in relation to psychotic illness in the past. Here, then, I present some recent research which helps to redress the balance:

Studies About Childhood Trauma And Psychosis :

– Read et al reviewed 51 previous studies on causes of psychotic illness and found that 69% of female psychotic patients and 59% of male psychotic patients had suffered severe childhood trauma. It was also pointed out by the researchers that these figures, although already extremely high, may be UNDERESTIMATES due to the fact that experiences of child abuse are well known to be under-reported.

– Bebbington et al : these researchers, examining data generated from 8500 individuals, found that those suffering from psychosis were approx. 15 times more likely than the mentally well to have suffered severe childhood trauma.

– A Dutch study of 4000 patients found that those who had suffered severe childhood trauma were approx. 11 times more likely to have developed psychotic conditions in later life.

– A Californian study found that those who had suffered severe childhood trauma were 5 times more likely to have gone on to experience HALLUCINATIONS in later life.

HOW IS CHILDHOOD TRAUMA THOUGHT TO LEAD TO PSYCHOSIS?

– COGNITIVE THEORY: Due to adverse childhood experiences, the individual develops what is called a NEGATIVE COGNITIVE TRIAD of beliefs; these are:

a negative view of self
– a negative view of others
– a negative view of the world in general

More specifically, beliefs such as the following are likely to develop:
– I am vulnerable
others cannot be trusted
– the world is dangerous

Such beliefs can become so ingrained and severe that they eventually manifest themselves in the guise of psychotic symptoms e.g PARANOIA.

– AFFECT OF CHILDHOOD TRAUMA ON THE BRAIN: Research is showing that extreme stress in childhood can adversely affect the physical development of vital brain regions responsible for emotional control (e.g the AMYGDALA) which can lead to extreme emotional dysregulation (INABILITY TO CONTROL STRONG EMOTIONS) and concomitant over-sensitivity and emotional over-reactivity. If the problem becomes sufficiently intense psychotic conditions may result.

IMPLICATIONS:

It is thought a new, over-arching theory of the causes of psychosis (known in scientific circles as a PARADIGM SHIFT) is likely take root in the field of psychiatric research – namely one that emphasizes the enormous importance of adverse childhood experiences.

It is argued that patients who present with psychotic symptoms should ROUTINELY undergo DETAILED ASSESSMENTS relating to their childhood experiences and that there should be a much greater emphasis upon the importance of psychological therapy (as opposed to drug therapy- so popular up until now- based upon theories of the biological origins of psychotic conditions).

 

Early Signs Of Psychosis :

 

Usually a person does not suddenly become psychotic. Instead, the onset of psychosis is often a gradual process and sometimes individuals may start to show possible signs of incipient psychosis in their teens.

So what are the early warning signs? I provide a list based on the most current research in this area below. However, it is important to realize these symptoms are NOT specific to psychosis, they may also be due to numerous other conditions or set of personal psychosis. Anyone worried they or someone else may be psychotic or may be developing psychosis should seek an expert opinion and NOT attempt an amateur diagnosis based on the symptoms that follow.

 

Possible Early Signs That A Person May Be Becoming Psychotic:

These signs may be split into six categories as follows:

1) Cognitive symptoms

2) Neurotic symptoms

3) Changes in mood

4) Changes in volition

5) Behavioral symptoms

6) Physical symptoms

Let’s look at each of these six categories below:

Cognitive Symptoms:

– problems with concentration/attention/mental focus

– frequent daydreaming/ retreating into fantasy worlds

– thought blocking (a sudden lapse into silence during conversation due to the mind ‘going blank’. This most frequently occurs when the individual is asked about something that is, consciously or unconsciously, psychologically disturbing to him/her. It is a psychological defense mechanism and form of repression.)

– reduced ability to think in abstract terms

Neurotic Symptoms:

– restlessness/agitation

anger

– irritability

Changes in Mood:

guilt

– suicidal ideation

– depression

– mood swings

anhedonia (an inability to derive pleasure from people, events or circumstances – a feeling of emptiness, flatness and numbness)

Change in Volition:

– loss of drive

loss of interest in events, activities and people that used to interest one

– feelings of apathy and fatigue and a general lack of energy

Behavioural Symptoms:

– social withdrawal

– drop in standard of school/college work

– increase in impulsivity

– increasingly odd/strange behaviour

– aggression

– destructiveness

Physical Symptoms:

– weight loss

– poor appetite

sleep problems

 

The Main Types Of Psychotic Delusions :

 

Psychotic delusions can occur in two conditions linked to childhood trauma : 

A) DEPRESSION WITH PSYCHOTIC FEATURES (click here to read my article about the link between childhood trauma and depression) 

B) SCHIZOPHRENIA (click here to read my article about the link between childhood trauma and SCHIZOPHRENIA) may involve the sufferer developing psychotic delusions.

 

What Is Meant By The Term ‘PSYCHOTIC DELUSION?’

A PSYCHOTIC DELUSION results from a THOUGHT DISORDER that gives rise to BLATANTLY FALSE BELIEFS. Whilst the belief is clearly and obviously false, the person who holds it has an UNSHAKEABLE BELIEF that the belief is true, even in the face of utterly overwhelming evidence to the contrary.

Classification of delusions:

Delusions can be classified as follows:

They can be:

A) Bizarre or non-bizarre

and:

B) Mood-congruent or mood- incongruent

I define these classifications below:

BIZARRE – extremely strange and odd beliefs that are CLEARLY IMPOSSIBLE. For example, a belief that the birds’ singing is really Morse code and they are communicating with each other in such code in order to form a plot to take over the world.

NON- BIZARRE – the belief held is still clearly wrong but, theoretically, not totally impossible. For example, a belief that the government has placed listening devices in every room of one’s house.

MOOD – CONGRUENT – the delusion is in line with the mood the person manifests as a result of his/her condition. For example, a depressed individual who believes that aliens have removed the part of his/her brain the used to give rise to the experience of pleasure. Or, a person who is manic may believe s/he has supernatural powers

MOOD – INCONGRUENT – the delusion is not obviously in line with the individual’s prevailing mood  (eg. a newsreader on the TV is talking about him/her. These are sometimes referred to as ‘mood-neutral’ delusions

Within these classification groups, delusions can also be of a specific type. I list these types below:

   – Delusions of jealousy : an all-consuming obsession that one’s partner is being unfaithful when there is no evidence this is the case and there is no objective reason for suspicion.

   – Delusions of nihilism : the belief that oneself, other people or the world do not really exist

   – Delusions of grandeur ,: a belief one is a person of massive importance such as Jesus, Emperor of the World etc. Or the belief one has made a great achievement (that the world refuses to recognise) such as a belief one has written plays vastly superior to those of Shakespeare when, in reality, they are barely literate.

– Delusions of control : a belief that one is having one’s thoughts and behaviour controlled by an external force e.g. by aliens

– Delusions of reference : a clearly false belief that people are talking about one or making reference to one when they are not e.g. a belief that the newsreader on the radio is always referring to one in a or a coded or indirect manner

– Delusions of guilt : a false belief one is responsible for some terrible event (such as a belief one is personally responsible for all the starving people in the world

Erotomania : the belief a famous person or person of high status (normally a person the sufferer of the delusion has never met) is deeply and passionately in love with one ( click here to read my article on this)

– Delusions of mind-reading : the belief that others are reading one’s mind

– Delusions of persecution : the belief that others are conspiring against one ( e.g trying to poison or drug one)

– Religious delusions: Delusions with a religious theme e.g .that one is a human incarnation of God

– Somatic delusions : these are delusions about one’s body ( e.g. that ants are crawling under one’s skin)

ALL OTHER ARTICLES ABOUT PSYCHOSIS :

 

David Hosier BSc Hons; MSc; PGDE (FAHE).

 

 

 

Psychotic Symptoms In Adolescence Linked To Childhood Trauma

 adolescent psychotic symptoms

A recent study (Upthegrove et al) has shown that individuals who have experienced significant childhood trauma are far more likely to experience early (ie during adolescence) symptoms of psychosis than those fortunate enough to have experienced a relatively stable childhood.

The study involved over 200 young people and focused upon the effects on these individuals’ mental health of the following categories of childhood trauma:

1) Physical abuse

2) Sexual abuse

3) The witnessing of domestic violence

4) Bullying

In order to find out if there was a relationship between these kinds of childhood trauma and the early development of psychotic symptoms, interviews were conducted with each of the participants in the study.

Let’s look at the effects on mental health of each of these four types of abuse:

1) Effects of physical abuse: those who had been physically abused were found to be at much greater risk of developing early signs of psychosis than those who had not had traumatic childhoods

2) Effects of sexual abuse: those who had been sexually abused were not found to be of significantly higher risk of developing early signs of psychosis than those who had not had a traumatic childhood. However, this finding might have been due to methodological shortcomings of the study

3) The witnessing of domestic violence: those who had been exposed and subjected to the witnessing of domestic violence within their household were found to be of much greater risk of developing early signs of psychosis than those who had not had traumatic childhoods

4) Effects of being bullied: those who had been significantly bullied were not found to be at increased risk of developing early signs of psychosis.

However, these individuals were found to be significantly more likely than those who had had a more settled childhood of to become bullies themselves.

This finding could be due to:

a) modelling their behaviour on the behaviour of the person who was physically abusing them.

b) modelling their behaviour on that of the perpetrator of the domestic violence they were exposed to witnessing in the home

c) genetic reasons – for example, if they had a violent father who physically abusef them they may have inherited a set of genes that predisposed them to behaving aggressively/violently

d) a need to express control/power – if these individuals felt powerless at home due to being physically abused, they may have developed the need to express power over others in order to ‘psychologically compensate’ themselves/feel less powerless/gain the control they lacked at home

PSYCHOTIC SYMPTOMS:

In all, 6.6% of the original 200+ studied had psychotic symptoms, mainly visual and auditory hallucinations (seeing and hearing things in the absence of corresponding external stimuli – ie things that weren’t there).

Compared to those who had had relatively stable childhoods:

– those who had been physically abused were 6x more likely to have experienced early psychotic symptoms

– those who had witnessed domestic violence were 10x more likely to have experienced early psychotic symptoms

F1.small

Above: Graph displaying the results of the study.

Comorbid conditions:

Those who had developed early psychotic symptoms due to childhood trauma were also more likely to have other mental health problems alongside these (psychologists often refer to these as comorbid conditions). These included:

– depression

– conduct disorder

– phobias

– ADHD

– PTSD

– nervous tic

– over anxiousness

– oppositional defiance disorder

– separation and anxiety order

Males were more at risk of developing early psychotic symptoms than females.

How Does Childhood Trauma Make A Young Person More At Risk Of Developing Early Signs And Symptoms Of Psychosis?

Experts now believe the experience of significant childhood trauma can adversely affect the biological development of the brain.

Specifically, prolonged exposure to significant stress in childhood can adversely affect the brain’s:

– structure

– biology/chemistry

– and, as a result, its functionality

For example, prolonged stress can affect the production in the brain of the hormones known as adrenalin and catecholamine (involved in the body’s stress/threat response; often referred to as the fight/flight response) and interfere with the physical development of a structure in the brain known as the amygdala (also involved in regulating how the individual responds to stress/perceived threat).

Conclusion:

This study supports an already vast quantity of research that shows a link between childhood trauma and the development of mental illness (in this case, psychosis).

Table Below: Some of the lesser known manifestations of psychosis:

psychosis_syndromes_delusions_hallucinations

Resources:

My eBook on how childhood trauma can adversely affect brain development is available from Amazon. For more details, click on image below:

child_trauma_and_NEUROPLASTICITY, functional_and_structural_ neuroplasticity  Click image for more information.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

Top