Childhood trauma and psychosis

Great academic article from 2008 that very credibly disputes the biomedical model of psychiatry. This is just a small excerpt:

From Journal of Post Graduate Medicine:

trauma_indo_287142tA recent review of the North American psychiatric literature over the past 40 years concluded that potential social causes of psychosis, including schizophrenia, have been neglected in favor of the advancement of genetic and biological etiologies. [30] However, Kraeplinian conceptualizations of psychotic experiences as merely the symptoms of a disordered brain have been challenged by prominent academicians such as Richard Bentall and others who question the validity and utility of schizophrenia as a conceptual and diagnostic entity, and argue that psychotic experiences lie on a continuum with “normal” functioning and suggest that contemporary conceptualizations of “schizophrenia,” “bipolar disorder,” and associated complaints should take into account the role of adverse environmental factors. [31] Furthermore, in the last ten years there has been renewed interest and a growing body of literature examining the role of social and environmental factors in the etiology of psychosis and schizophrenia. Much of this research has specifically focused on the relationship between childhood trauma, psychosis, and schizophrenia.

A number of significant reviews of the literature examining the relationship between childhood trauma, psychosis and schizophrenia have been published in the last few years. [18],[32],[33],[34] A review by Read et al . [6] summarized research studies and examined other review papers addressing the relationship between childhood trauma, psychosis and schizophrenia. This review examined studies of psychiatric inpatients and outpatients where at least 50% were diagnosed with a psychotic condition. Studies that were included were required to have used interview protocols or questionnaire measures that specified examples of abusive acts to determine abuse, therefore chart reviews were excluded. The review produced weighted averages from 51 studies and reported that the majority of female patients (69%) reported either childhood sexual abuse (CSA) (48%) or childhood physical abuse (CPA) (48%). The majority of male patients (59%) reported either CSA (28%) or CPA (50%). The authors of this review point out that these rates are likely to be underestimates as child abuse is generally under-reported [35] especially by people who are inpatients [36],[37] and men in particular. [38] The bulk of the evidence considered in this review, however, was from studies using cross-sectional designs or uncontrolled group comparisons, which the authors concede can give us useful estimates of the prevalence of childhood trauma in clinical populations, but tell us little about whether the relationship between childhood trauma and psychosis is causal. Consequently, Read and colleagues also examined data from four large-scale studies with more sophisticated methodologies which represent a more robust test of the hypothesis that childhood trauma plays a causal role in psychosis. (read much more here)

Definitely an article to keep handy for those who want academic studies that support an alternative view to the biomedical model.

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters

12 Responses

  1. From the article: “Oliver James, a respected British clinical psychologist and writer suggested on the eve of the publication of this review that, “The psychiatric establishment is about to experience an earthquake that will shake its intellectual foundations.” He went on in that article for the Guardian newspaper to describe the review as presenting “tectonic plate-shifting evidence.” [45] Critics have, however, questioned the validity of these claims and have pointed to the modest number of large-scale studies and to methodological limitations which they suggest limit the conclusions that can be drawn from this data. [34] ”

    Oh right. And there are large-scale studies proving chemical imbalances and damaged brains??? Show me one. I dare you.

  2. The bottom line, for me, is that biopsychiatry is not helping when you look at patients’ actual lives. And the push for a gene is for what reason, exactly? How much did Cystic Fibrosis patients’ and Sickle-Cell Anemia patients’ lives and/or treatment improve when they found those genes?

    Whereas, it’s been shown that when people believe that a gene is the cause of their ailment, they are less likely to believe they have any control over their condition, and more likely to be dependent on meds. THAT’S the real agenda.

  3. Darby Penney

    Studies showing the connection between serious psychiatric diagnoses and childhood sexual and/or physical abuse and other trauma have been published in professional journals for more than 20 years. Uunfortunately, this information seems to have had no impact on the practice of psychiatry, which has only grown more pharmaceutically oriented during that time. What will it take to have this information make an impact?

  4. “Why don’t you believe in what we tell about the negative consequences we suffered from being incarcerated and forcibly drugged in the system of psychiatric coercion?!!” was the title of a recent post by Jan Olaf. In another post title he asked: “Does the mental health system realize that it commits wrongful acts of coercion?”

    I think, it’s about more and other things than money. Not only are people more likely to be dependent on the drugs when they believe in the gene/chemical imbalance bs. They’re also much more likely to be and stay dependent on their “care”givers. To a self-annihilating point.

    In spite of all efforts to make the system adopt “empowerment” and “recovery”, as long as defective brain functioning is made responsible for “mental illness”, it’ll always be the “care”givers, who will have the final say, who hold the power. The word of someone whose brain functioning is defined as defective can always be declared invalid. No matter how much “empowerment” or “recovery”. Every narcissists dream: someone, who is 100 per cent dependent on them, whom they can define, manipulate and control without limitations. God-like. Psychiatry offers the ultimate opportunity to live that dream. They’ll do whatever it takes to keep that opportunity alive. Just look at, what psychiatry does: they even deny trauma to be just as much as a possible cause of other than maybe PTSD. In spite of the fact, that there never has been and still isn’t any evidence for the gene/chemical imbalance bs to be valid, and in spite of that there has been and is a load of – at least circumstantial – evidence in favor of trauma to be the root cause of people’s problems.

    We’ve been there before. Laing, Bateson, etc. They’ll come up with something. They already have tried: childhood trauma causes brain changes – permanent ones. Remember?

    So, I guess, it’ll take for the narcissists to become conscious of their narcissism for this information to make an impact. Rather unlikely to happen in our ego-worshipping culture.

  5. Holly

    A ray of hope out there, perhaps. At a conference today in New York City, the deputy commissioner of the state Office of Mental Health was talking about the ACE study mentioned in this article. That study shows that not only are adverse childhood events (ie. abuse and trauma) predictors of mental disorders, but of poor health outcomes later in life. Okay, this is not good news in itself, but the fact that this state official is talking about it is a good thing. He and another speaker talked about the need for interventions early on with abused children, to improve their future mental and physical health picture, and to avoid the “need” for psychotropic medications. This is perhaps a small step, but at least they are starting to think, “How can we prevent mental illness?” This was at a conference on Medicaid, which in NYS is spending a bundle on people with serious mental illness.

  6. I’ve just set up a project in the UK to pilot self help groups for adolescents who hear voices, see visions or have other unusual sensory perceptions – I’m really hoping that it’ll help young people from becoming so distressed that they end up in the mental health system. I’m becoming increasingly convinced that if I had someone to talk to back when I was 14 and starting to beleive I had an alien inside me, that I would have been able to make sense of it and get help with the terrible things that had happened to me – rather than squishing it all down until I officially broke down a few years later.

    For me, and many like me, trauma (or rather the impact of the trauma and what you take from it … the guilt, the secrecy, the powerlessness etc) is at the root of the psychosis. Seeing it as schizoaffective disorder/schizophrenia just compounded all this.

    Above and beyond this, though, it would be really interesting to look at the traumatic effects of the psychiatric system (especially hospitalisation) and it’s role in psychosis. If psychosis can be seen as post-traumatic, then surely the system itself could have a major role in perpetuating/causing it?

    x

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