Baseline Reports of Traumatic Experiences as Correlates of Symptom Severity in Naturalistic Psychiatric Treatment for Psychosis

Daphne Ying (1,2), Madison Natarajan (1,2,5), Heather Muir (1,2), Pegah Seif (1,2,3), Ananya Saluja (2), Kelsey Johnson (2), Iqra Imam (2), Nicolas Raymond (1,2,3), Oshin Kushwaha (1,2,3), Yusuf Sendil (1,2,3), Raquelle Mesholam-Gately (1,2),Margaret Guyer (5), Matcheri Keshavan (1,2,5), Paulo Lizano (1,2,3), Sarah Herold (1,2)

1. Advancing Services for Psychosis Integration and Recovery (ASPIRE) Clinic, Beth Israel Deaconess Medical Center
2. Department of Psychiatry, Harvard Medical School
3. Division of Translational Neuroscience, Beth Israel Deaconess Medical Center
4. Center for Early Detection Assessment and Response to Risk(CEDAR) Clinic, Brookline Center for Community Mental Health
5. Massachusetts Department of Mental Health

Abstract

Background: A history of trauma is associated with increased risk for psychosis, and individuals diagnosed with schizophrenia are 2.7 times more likely to have had adverse childhood experiences than healthy controls. Understanding a patient’s trauma history can provide important contextual information in understanding and treating their psychotic symptoms. Thus, it is important to elucidate the associations between trauma and psychosis in the naturalistic treatment of early psychosis patients. The present study aims to examine trauma rates within an early course psychosis clinic, whether traumatic life experiences are associated with baseline symptom severity, whilst considering which types of traumatic events are more strongly associated with psychosis symptoms. We hypothesize that sexual trauma will be most related to symptom severity compared to other types of trauma, as well as racial trauma for ethnic minorities.
Methods: Data was collected from intake assessments used in support of naturalistic early psychosis treatment across multiple MAPNET clinics. Intake assessments include various clinical measures including a self-report checklist of trauma (Life Events Checklist, LEC-5) and a measure of symptom severity (i.e., COMPASS-10, Colorado Symptom Index, and the Global Assessment of Functioning). Patients hold a variety of psychotic spectrum diagnoses, including schizophrenia spectrum disorders, affective psychoses, and substance-induced psychosis.
Results: As data collection is ongoing, analyses will be completed closer to the date of the conference. Means and standard deviations will be presented for both trauma experiences and psychosis symptoms to answer questions regarding descriptives. Additionally, a series of independent t-tests and chi-square analyses will be used to determine differences between trauma experiences as they relate to psychosis symptom severity.
Conclusions: Findings will help clarify the associations between trauma and psychosis symptom severity in naturalistic treatment for early psychosis. Incorporating trauma-informed psychosis interventions is one way in which clinics can foster a bio-psycho-social conceptualization of psychosis.