Abstract
The risk of the appearance of psychosis may reflect the existence of an underlying vulnerability, which may be influenced by environmental factors such as early traumatic experiences. This means that in clinical practice, the assessment of and approach to previous traumatic events is important in persons with psychotic disorders. The psychometric assessment of trauma has advanced considerably in recent years; however, there is no instrument that has been constructed and validated specifically for the evaluation of early traumatic experiences in the clinical population with psychosis. The main goal of this study was to present the construction and validation process of the Screening of Early Traumatic Experiences in Patients with Severe Mental Illness (ExpTra-S). The sample consisted of 114 patients who had experienced at least one psychotic episode (M = 35.5 years of age; SD = 9.26) and a comparison group of 153 young adults (M = 20.8 years of age; SD = 1.8). The factor analysis revealed an essentially one-dimensional structure. The ExpTra-S was associated with the positive dimension of the psychosis phenotype but not with the negative or affective dimensions, or subjective experiences. No items displayed differential functioning for sex and age. The ordinal alpha for the total score was 0.96. The patients with psychosis had a higher score for early traumatic experiences in comparison with the non-clinical group. The results obtained showed that the measuring instrument developed, the ExpTra-S, is a brief, simple, and useful measuring instrument for assessing the presence of early traumatic experiences in patients with severe mental illness.
Highlights
Different research shows that people who have suffered abuse have worse overall mental health, with a greater presence of psychiatric symptoms and disorders (Sweeney et al, 2015; Park et al, 2016; Sonu et al, 2019)
Among the entire population served in the centers, patients who were at that time in treatment for a schizophrenia spectrum disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association [APA], 2013) were selected; 71 (62.3%) patients had a diagnosis of schizophrenia, 19 (16.7%) of brief psychotic disorder, 7 (6.1%) of schizoaffective disorder, 7 (6.1%) of bipolar disorder with psychotic symptoms, 5 (4.4%) of delusional disorder, 3 (2.6%) of schizophreniform disorder, and 2 (1.8%) of schizotypal disorder
The percentage of patients with psychosis who responded affirmatively [categories "sometimes" (1), "often" (2), or "almost always" (3)], to any of the items on the frequency scale ranged between 10.5% and 52.6%
Summary
Different research shows that people who have suffered abuse have worse overall mental health, with a greater presence of psychiatric symptoms and disorders (Sweeney et al, 2015; Park et al, 2016; Sonu et al, 2019). Patients with mental health problems have a 34–53% history of physical and sexual abuse in childhood (Alarcón et al, 2010). There is a great deal of research showing childhood trauma—physical, sexual, and emotional abuse and neglect—as a risk factor for psychotic disorder (De Loore et al, 2007; Trauelsen et al, 2015). In this regard, various studies have found that traumatic experiences can play a causal role in the development of psychotic disorders (Read et al, 2005; Thompson et al, 2014). A meta-analysis by Varese et al (2012) estimated a 3-fold increase in risk for psychosis after exposure to childhood traumatic events
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