Trauma in relation to psychosis and hospital experiences: The role of past trauma and attachment.

OBJECTIVES: We investigated rates of psychosis-related and hospital-related post-traumatic stress disorder (PTSD) in people with psychosis in secure settings. We also investigated relationships between PTSD symptoms and previous experiences of trauma and adult attachment. METHOD: Using a cross-sectional design, 50 participants from medium-secure and low-secure settings were interviewed to identify distressing experiences related to psychosis and hospitalization. PTSD symptoms related to those experiences, past trauma and attachment were assessed using self-report measures. RESULTS: The combined rate of psychosis-related and hospital-related PTSD was 30%. Twenty-four percent and 18% met criteria for psychosis-related and hospital-related PTSD, respectively. Severity of psychosis was associated with both psychosis-related and hospital-related PTSD symptoms. The prevalence of previous trauma was high, but previous trauma was not significantly correlated with psychosis-related or hospital-related PTSD symptoms. Anxiety in attachment relationships was significantly associated with both psychosis-related PTSD symptoms and hospital-related PTSD symptoms. CONCLUSIONS: This study adds to the growing body of research highlighting the distressing nature of psychosis and the iatrogenic effects of treatments. It also highlights the potentially important role of attachment styles in PTSD in psychosis. PRACTITIONER POINTS: 30% of patients met criteria for psychosis- or hospital-related PTSD. Severity of psychosis was associated with PTSD symptoms. Anxiety in attachment relationships was positively correlated with PTSD symptoms.