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  • 标题:Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review
  • 作者:Miriam Fornells-Ambrojo ; Alison Gracie ; Chris R. Brewin
  • 期刊名称:European Journal of Psychotraumatology
  • 印刷版ISSN:2000-8198
  • 电子版ISSN:2000-8066
  • 出版年度:2016
  • 卷号:7
  • 期号:1
  • 页码:32095
  • DOI:10.3402/ejpt.v7.32095
  • 语种:English
  • 出版社:Taylor & Francis Group
  • 摘要: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. Highlights of the article “Overall, robust measures of PTSD were employed but psychosis-related trauma was not specifically defined and time since trauma was not consistently recorded Given the above methodological limitations in the assessment of PR-PTSD, a revised prevalence rate is not provided A new conceptualisation of PR-PTSD in relation to the type of stressor is proposed in the context of current diagnostic systems
  • 关键词:Psychosis ; trauma ; PTSD ; psychosis-related PTSD ; assessment
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