Predictors of post-traumatic stress after first episode psychosis
Research type
Research Study
Full title
Cognitive appraisals and self-compassion as predictors of post-traumatic stress symptoms after first episode psychosis
IRAS ID
304971
Contact name
Eimear Galvin
Contact email
Sponsor organisation
Oxford Health NHS Foundation Trust
Clinicaltrials.gov Identifier
0000, 00000
Duration of Study in the UK
1 years, 4 months, 27 days
Research summary
Research shows that for some people, the distressing experience of first episode psychosis (FEP) can lead to symptoms of post-traumatic stress disorder (PTSD). People who experience post-traumatic stress symptoms after FEP are more likely to feel depressed and anxious and to have difficulties managing in their day-to-day lives. Although around one in every two people with FEP will develop post-traumatic stress symptoms, the factors which predict these symptoms are not yet fully understood. Although studies shows that people who have negative cognitive appraisals of a traumatic event are more likely to develop post-traumatic stress symptoms, there is very little research exploring appraisals after a psychotic episode, and none looking specifically about people’s negative thoughts about themselves and the world. This study will explore whether people who have negative thoughts about themselves and the world, or thoughts of self-blame regarding the psychosis, are more likely to develop persistent post-traumatic stress symptoms. The second question in the study looks at self-compassion. Previous studies have shown that when people are self-compassionate, they are less likely to develop PTSD-symptoms after a traumatic event. Research has yet to examine whether people who demonstrate self-compassion after FEP are less likely to develop post-traumatic stress symptoms. Participants in this study will be under the care of an Early Intervention Service (EIS). Following their acceptance to the EIS, participants will be asked to complete 6 questionnaires, looking at their cognitive appraisals, PTSD symptoms, mood, psychotic symptoms, self-compassion, and their trauma history. They will again be asked to complete measures of mood and PTSD symptoms 3 months later. We predict that those with negative appraisals about themselves, the world and self-blame will have significantly more PTSD symptoms, but if they have high levels of self-compassion, they will be less likely to develop PTSD symptoms.
Summary of Results
This study showed that about 35% of participants experienced significant post-traumatic stress symptoms, although most participants experienced at least a few symptoms. The study showed that people who have self-blame thoughts (e.g. ‘someone else would not have gotten into this situation’) are likely experience more persistent post-traumatic stress symptoms. Additionally, this study found that people who had lower mood were more likely to experience persistent post-traumatic stress symptoms. Having negative thoughts about yourself (e.g. ‘I am a weak person’), or negative thoughts about the world (e.g. ‘The world is a dangerous place' is not associated with persistent post-traumatic stress symptoms. The study also showed that self-compassion did not seem to alter post-traumatic cognitions, and did not have a direct effect on post-traumatic stress symptoms.
These findings are important, in that they show that many people experience post-traumatic stress symptoms after their first episode of psychosis, and NHS Early Intervention in Psychosis teams should therefore assess people in their care for post-traumatic stress symptoms. In many cases, individuals’ post-traumatic stress symptoms will reduce on their own in time, but some might need a little extra support to address these symptoms. When people experience self-blame, it is a little more likely that their post-traumatic stress symptoms may not reduce as much without some support. For people who have post-traumatic stress symptoms, it is important for clinicians to ask about self-blame, and to support people to change some of these cognitions, to blame themselves less. It is also important that people receive support for low mood. It is likely that changing these cognitions, and improving mood, will help to reduce post-traumatic stress symptoms.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
22/WM/0108
Date of REC Opinion
1 Jun 2022
REC opinion
Further Information Favourable Opinion