The subjective effect of antipsychotic medication on trauma-related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis.
antipsychotic medication
childhood trauma
psychosis
qualitative research
Journal
Psychology and psychotherapy
ISSN: 2044-8341
Titre abrégé: Psychol Psychother
Pays: England
ID NLM: 101135751
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
06
09
2021
received:
18
02
2021
pubmed:
8
10
2021
medline:
24
3
2022
entrez:
7
10
2021
Statut:
ppublish
Résumé
Among people with psychosis, those with a history of childhood trauma are likely to experience trauma-related symptoms, such as trauma memory intrusions. Irrespective of whether these individuals continue to remember and re-experience trauma, their treatment very often includes alleviating psychotic symptoms through the use of antipsychotic medication. Antipsychotics, while primarily used to treat psychotic symptoms, can influence non-psychotic symptoms and alter how people think and feel. We thus aimed to explore how people with childhood trauma and psychosis experience the effects that antipsychotics have on their (1) thoughts, images, and memories, (2) emotions, and (3) physical responses, related to their childhood trauma. A qualitative phenomenological research design using semi-structured interviews was implemented. Data were analysed using interpretative phenomenological analysis. Nineteen participants were interviewed. Two super-ordinate themes were conceptualized. Many participants spoke about the impact of antipsychotics on trauma-related experiences (Theme 1). Some indicated that antipsychotics alleviated the intensity and frequency of trauma-related thoughts, emotions, and physical symptoms. A few others reported that their trauma-related flashbacks, thoughts, and physical symptoms intensified while taking antipsychotics. Participants spoke about the role of antipsychotics in confronting and processing trauma (Theme 2). A few participants reported that by suppressing trauma-related thoughts and emotions antipsychotics prevented them from confronting their trauma. The effects of antipsychotics can be subjectively experienced as beneficial or detrimental depending on how they influence trauma-related thoughts, emotions, and physical responses. Intervention studies are needed to determine how people with childhood trauma and psychosis respond to antipsychotic drugs. Antipsychotics may alter the way in which people with childhood trauma and psychosis remember and re-experience trauma. These alterations can be beneficial or detrimental, and thus play a role in whether people consider their medication helpful. By suppressing trauma-related thoughts and emotions, antipsychotics can prevent people from confronting their trauma. This may be considered beneficial to some, but other people may need or want to confront their trauma to heal. The effectiveness of trauma-focused psychological therapies may be influenced by the emotional, cognitive, and physiological effects of antipsychotic medications. The ability of antipsychotics to suppress people's trauma memories may contribute to post-traumatic avoidance. People with post-traumatic stress symptoms and psychosis should be provided with psycho-education about post-traumatic avoidance and its role in the maintenance of post-traumatic stress disorder.
Substances chimiques
Antipsychotic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
256-276Informations de copyright
© 2021 British Psychological Society.
Références
Bal, S., Van Oost, P., De Bourdeaudhuij, I., & Crombez, G. (2003). Avoidant coping as a mediator between self-reported sexual abuse and stress-related symptoms in adolescents. Child Abuse & Neglect, 27, 883-897. https://doi.org/10.1016/s0145-2134(03)00137-6
Barrantes-Vidal, N. (2014). Trauma and psychosis: It is easier to study quarks than subjective meaning. Acta Psychiatrica Scandanavica, 129, 478-479. https://doi.org/10.1111/acps.12218
Bendall, S., Hulbert, C.A., Alvarez-Jimenez, M., Allott, K., McGorry, P.D., & Jackson, H.J. (2013). Testing a model of the relationship between childhood sexual abuse and psychosis in a first-episode psychosis group: The role of hallucinations and delusions, posttraumatic intrusions, and selective attention. The Journal of Nervous and Mental Disease, 201, 941-947. https://doi.org/10.1097/NMD.0000000000000033
Bernstein, D.P., & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report manual. San Antonio, TX: The Psychological Corporation.
Bernstein, D.P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., … Ruggiero, J. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American Journal of Psychiatry, 151, 1132-1136. https://doi.org/10.1176/ajp.151.8.1132
Bonoldi, I., Simeone, E., Rocchetti, M., Codjoe, L., Rossi, G., Gambi, F., … Fusar-Poli, P. (2013). Prevalence of self-reported childhood abuse in psychosis: A meta-analysis of retrospective studies. Psychiatry Research, 210(1), 8-15. https://doi.org/10.1016/j.psychres.2013.05.003
Brand, R.M., Bendall, S., Hardy, A., Rossell, S.L., Meyer, D., & Thomas, N. (2020). Moment-to-moment associations between posttraumatic stress symptoms and auditory hallucinations in the flow of daily life. Psychiatry Research, 285, 112838. https://doi.org/10.1016/j.psychres.2020.112838
Brand, R.M., Bendall, S., Hardy, A., Rossell, S.L., & Thomas, N. (2021). Trauma-focused imaginal exposure for auditory hallucinations: A case series. Psychology and Psychotherapy: Theory, Research and Practice, 94(S2), 408-425. https://doi.org/10.1111/papt.12284
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. https://doi.org/10.1191/1478088706qp063oa
Brocki, J.M., & Wearden, A.J. (2006). A critical evaluation of the use of interpretive phenomenological analysis (IPA) in health psychology. Psychology & Health, 21(1), 87-108. https://doi.org/10.1080/14768320500230185
Calhoun, P.S., Stechuchak, K.M., Strauss, J., Bosworth, H.B., Marx, C.E., & Butterfield, M.I. (2007). Interpersonal trauma, war zone exposure, and posttraumatic stress disorder among veterans with schizophrenia. Schizophrenia Research, 91, 210-216. https://doi.org/10.1016/j.schres.2006.12.011
Creswell, J.W. (2007). Qualitative inquiry and research design: Choosing among five traditions (2nd ed.). Thousand Oaks, CA: Sage Publications.
de Bont, P.A.J.M., van den Berg, D.P.G., van der Vleugel, B.M., de Roos, C., de Jongh, A., van der Gaag, M., & van Minnen, A.M. (2016). Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: Effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders. Psychological Medicine, 46, 2411-2421. https://doi.org/10.1017/S0033291716001094
Dey, I. (1993). Qualitative data analysis: A user-friendly guide for social scientists. London, UK: Routledge.
Ehlers, A., Bisson, J., Clark, D.M., Creamer, M., Pilling, S., Richards, D., … Yule, W. (2010). Do all psychological treatments really work the same in posttraumatic stress disorder? Clinical Psychology Review, 30, 269-276. https://doi.org/10.1016/j.cpr.2009.12.001
Ehlers, A., & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345. https://doi.org/10.1016/s0005-7967(99)00123-0
First, M.B., Williams, J.B.W., Karg, R.S., & Spitzer, R.L. (2015). Structured clinical interview for DSM-5 - Research version (SCID-5-RV, Version 1.0.0). Arlington, VA: American Psychiatric Association.
Fleurkens, P., Rinck, M., & van Minnen, A. (2014). Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: A pilot study. European Journal of Psychotraumatology, 5(1), 21359. https://doi.org/10.3402/ejpt.v5.21359
Foa, E.B., Zoellner, L.A., Feeny, N.C., Hembree, E.A., & Alvarez-Conrad, J. (2002). Does imaginal exposure exacerbate PTSD symptoms? Journal of Consulting and Clinical Psychology, 70, 1022-1028. https://doi.org/10.1037//0022-006X.70.4.1022
Gray, M.J., Litz, B.T., Hsu, J.L., & Lombardo, T.W. (2004). Psychometric properties of the life events checklist. Assessment, 11, 330-341. https://doi.org/10.1177//1073191104269954
Harper, D. (2012). Choosing a qualitative research method. In D. Harper & A.R. Thomson (Eds.), Qualitative research methods in mental health and psychotherapy: A guide for students and practitioners (pp. 83-97). Chichester, UK: Wiley-Blackwell.
Hershenberg, R., Gros, D.F., & Brawman-Mintzer, O. (2014). Role of atypical antipsychotics in the treatment of generalized anxiety disorder. CNS Drugs, 28, 519-533. https://doi.org/10.1007/s40263-014-0162-6
Johnson, D.M., Sheahan, T.C., & Chard, K.M. (2003). Personality disorders, coping strategies, and posttraumatic stress disorder in women with histories of childhood sexual abuse. Journal of Child Sexual Abuse, 12, 19-39. https://doi.org/10.1300/J070v12n02_02
Kezelman, C., & Stavropoulos, P. (2012). ‘The last frontier’: Practice guidelines for treatment of complex trauma and trauma informed care and service delivery. Sydney, Australia: Adults Surviving Child Abuse.
Larkin, M., & Thomson, A.R. (2012). Interpersonal phenomenological analysis in mental health and psychotherapy research. In D. Harper & A.R. Thomson (Eds.), Qualitative research methods in mental health and psychotherapy: A guide for students and practitioners (pp. 101-116). Chichester, UK: Wiley-Blackwell.
Larsen-Bar, M., Seymour, F., Read, J., & Gibson, K. (2018). Attempting to stop antipsychotic medication: Success, supports, and efforts to cope. Social Psychiatry and Psychiatric Epidemiology, 53, 745-756. https://doi.org/10.1007/s00127-018-1518-x
Leucht, S., Cipriani, A., Spineli, L., Mavridis, D., Örey, D., Richter, F., … Davis, J.M. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple treatments meta-analysis. The Lancet, 382(9896), 951-962. https://doi.org/10.1016/S0140-6736(13)60733-3
McMillen, J.C., North, C.S., & Smith, E.M. (2000). What parts of PTSD are normal: Intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake. Journal of Traumatic Stress, 13(1), 57-75. https://doi.org/10.1023/A:1007768830246
Moritz, S., Andreou, C., Kingberg, S., Thoering, T., & Peters, M.J.V. (2013). Assessment of subjective cognitive and emotional effects of antipsychotic drugs. Effect by defect? Neuropharmacology, 72, 179-186. https://doi.org/10.1016/j.neuropharm.2013.04.039
Moser, A., & Korstjens, I. (2017). Series: Practical guidance to qualitative research. Part 1: Introduction. European Journal of General Practice, 23(1), 271-273. https://doi.org/10.1080/13814788.2017.1375093
Padilla-Diaz, M. (2015). Phenomenology in educational qualitative research: Philosophy as science or philosophical science? International Journal of Educational Excellence, 1, 101-110. https://doi.org/10.18562/IJEE.2015.0009
Peach, N., Alvarez-Jimenez, M., Cropper, S.J., Sun, P., & Bendall, S. (2019). Testing models of post-traumatic intrusions, trauma-related beliefs, hallucinations, and delusions in a first episode psychosis sample. British Journal of Clinical Psychology, 58, 154-172. https://doi.org/10.1111/bjc.12206
Peach, N., Alvarez-Jimenez, M., Cropper, S.J., Sun, P., Halpin, E., O’Connell, J., & Bendall, S. (2021). Trauma and the content of hallucinations and post-traumatic intrusions in first-episode psychosis. Psychology and Psychotherapy: Theory, Research and Practice, 94(S2), 223-241. https://doi.org/10.1111/papt.12273
Perrin, S. (2013). Prolonged exposure therapy for PTSD in sexually abused adolescents. JAMA, 310, 2619-2620. https://doi.org/10.1177/1529100612468841
Phanichrat, T., & Townshend, J.M. (2010). Coping strategies used by survivors of childhood sexual abuse on the journey to recovery. Journal of Child Sexual Abuse, 19(1), 62-78. https://doi.org/10.1080/10538710903485617
Reddy, M.K., Pickett, S.M., & Orcutt, H.K. (2006). Experiential avoidance as a mediator in the relationship between childhood psychological abuse and current mental health symptoms in college students. Journal of Emotional Abuse, 6(1), 67-85. https://doi.org/10.1300/J135v06n01_04
Runyon, M.K., Faust, J., & Orvaschel, H. (2002). Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression. Child Abuse & Neglect, 26(1), 39-53. https://doi.org/10.1016/s0145-2134(01)00305-2
Sandelowski, M. (2001). Real qualitative researchers do not count: The use of numbers in qualitative research. Research in Nursing & Health, 24, 230-240. https://doi.org/10.1002/nur.1025
Schneeberger, A.R., Muenzenmaier, K., Castille, D., Bataglia, J., & Link, B. (2014). Use of psychotropic medication groups in people with severe mental illness and stressful childhood experiences. Journal of Trauma and Dissociation, 15, 494-511. https://doi.org/10.1080/15299732.2014.903550
Smith, J.A., Flowers, P., & Larkin, M. (2009). Interpretive phenomenological analysis: Theory, method and research. London, UK: Sage Publications.
Smith, J.A., & Osborn, M. (2008). Interpretative phenomenological analysis. In J.A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 53-80). London, UK: Sage Publications.
Starks, H., & Trinidad, S.B. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research, 17, 1372-1380. https://doi.org/10.1177/1049732307307031
Thompson, J., Stansfeld, J.L., Cooper, R.E., Morant, N., Crellin, N.E., & Moncrieff, J. (2020). Experiences of taking neuroleptic medication and impacts on symptoms, sense of self and agency: A systematic review and thematic synthesis of qualitative data. Social Psychiatry and Psychiatric Epidemiology, 55, 151-164. https://doi.org/10.1007/s00127-019-01819-2
Tohen, M., Kryzhanovskaya, L., Carlson, G., DelBello, M., Wozniak, J., Kowatch, R., … Biederman, J. (2007). Olanzapine versus placebo in the treatment of adolescents with bipolar mania. American Journal of Psychiatry, 164, 1547-1556. https://doi.org/10.1176/appi.ajp.2007.06111932
Tong, J., Simpson, K., Alvarez-Jimenez, M., & Bendall, S. (2019). Talking about trauma in therapy: Perspectives from young people with post-traumatic stress symptoms and first episode psychosis. Early Intervention in Psychiatry, 13, 1236-1244. https://doi.org/10.1111/eip.12761
van den Berg, D., de Bont, P.A.J.M., van der Vleugel, B.M., de Roos, C., de Jongh, A.D., van Minnen, A., & van der Gaag, M. (2018). Long-term outcomes of trauma-focused treatment in psychosis. The British Journal of Psychiatry, 212, 180-182. https://doi.org/10.1192/bjp.2017.30
Vita, A., De Peri, L., & Sacchetti, E. (2011). Antipsychotics, antidepressants, anticonvulsants, and placebo on the symptom dimensions of borderline personality disorder: A meta-analysis of randomized controlled and open-label trials. Journal of Clinical Psychopharmacology, 31, 613-624. https://doi.org/10.1097/JCP.0b013e31822c1636
Waterreus, A., Morgan, V.A., Castle, D., Galletly, C., Jablensky, A., Di Prinzio, P., & Shah, S. (2012). Medication for psychosis - Consumption and consequences: The second Australian national survey of psychosis. Australian & New Zealand Journal of Psychiatry, 46, 762-773. https://doi.org/10.1177/0004867412450471