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Trauma and psychosis: synthesising evidence, network modelling and expanding into an interventionist-causal paradigm to investigate mediating mechanisms

Woodrow, Amanda

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Abstract

The link between childhood trauma and the development of psychosis in adulthood is already well established, but factors which explain this relationship are currently less well understood. This thesis firstly aims to review the current state of evidence, then contribute novel empirical findings to help expand the understanding of how early traumatic experience leads to the development of psychosis. Information about causal factors is essential to the future development of effective therapeutic interventions for psychosis.

Firstly an extensive systematic review of studies which examines potential mediating mechanisms between trauma and psychosis is undertaken. Data from 37 studies were used to analyse 232 mediation models, taking into account the magnitude and significance of effects, along with study quality. Judgements are offered on the strongest areas of evidence, and implications for future research are discussed.

The first empirical study uses network analysis to generate a data-driven model of trauma, sub-clinical psychotic experiences and other relevant factors using data gathered from an online survey in a general population sample. Exploratory analyses were undertaken to derive a hypothetical model, which was then analysed statistically using structural equation modelling. The model hypothesis was pre-registered then prospectively tested in a second sample of data. Results and implications are discussed in the context of psychological models of psychosis.

The second empirical study uses an interventionist-causal paradigm to conduct a randomised controlled trial in a clinical psychosis population with experience of paranoia. An emotion regulation skills intervention was tested against an active control condition, with participants providing pre- and post- data, along with experience sampling data collected using mobile phones for analysis of individual and group change. Although limited by small sample size, findings are discussed in terms of acceptability, feasibility and implications for research and practice.

Thesis Type Thesis
Deposit Date Mar 8, 2022
Publicly Available Date Mar 8, 2022
DOI https://doi.org/10.17869/enu.2022.2851957
Public URL http://researchrepository.napier.ac.uk/Output/2851957
Award Date Jul 31, 2021

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