Stressful events provide clues to psychosis delusion content

[David Baxter PhD]

Stressful events provide clues to psychosis delusion content

Researchers have found links between the stressful events experienced by patients prior to their first episode of psychosis and the types of delusions and auditory hallucinations they suffer due to their condition.

"If life-event characteristics are related to the content of subsequent delusions and auditory hallucinations, this goes some way to refute the idea that symptoms of psychosis are without meaning and certainly has clinical implications," say David Raune (West London Mental Health Trust, London, UK) and colleagues.

The researchers assessed the stressful life events occurring in the year before psychosis onset in 41 people, along with the themes - persecutory, depressive, and grandiose - associated with their delusions and auditory hallucinations.

Analysis revealed that intrusive events, such as physical assault, being threatened with a knife, rape, and sexual disease infection, were associated with persecutory delusions and voices.

The researchers suggest in the journal Psychological Medicine, that this may be because intrusive stressful events can skew individual's ideas about the world, inducing suspicions about other people's intentions and a self-perception of vulnerability.

In contrast, depressive delusions were linked to danger events, while depressive auditory hallucinations were associated with intrusive events, which may be due to overlap with persecutory voice content.

However, there was no indication that loss events, including loss, self-esteem, and humiliation events, were associated with the development of depressive psychotic themes.

Grandiose themes were primarily associated with an absence of loss events, with grandiose delusions being a potential way of improving and maintaining self-esteem, regardless of whether it was initially low.

The researchers say that "incorporating recent stressful events into the assessment and psychological formulation of core psychotic themes may assist with patient engagement, normalization, and insight."

They explain: "Helping an individual to 'make sense' of how previous events relate to current symptoms should reduce anxiety, depression, and feelings of powerlessness, all of which seem to be associated with psychological appraisal."
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Psychol Med 2006; 36: 221-230

 

[g-scared]

Ah.. this is most helpful. I know I don't post that often, but I would like to thank you for having this space. Just reading what you and others have to say has been helped me approach my boyfriend. I think that a lot of things happen for a reason, and am beginning to get a clearer picture as to what might have triggered my boyfriend's psychotic episode.

The events prior to his psychotic break included being mugged at gunpoint, told that he had an Internet stalker, and the fear of having HIV. He also has a disturbing family history, and I've had some insightful conversations with him and his father about this.

His aunt called the yesterday, asking that he drive to another state to rescue a cousin of his. What disturbed me most where the details. She claimed that the cousin was starving and staying on a street called Homo-assassin Lane. This was most upsetting to him as his mother has always suspected him of being gay, even though he isn't. Frankly, the story itself seems far-fetched and weird, and I cannot understand why they would ask someone who was in a fragile mental state to help with it. I don't think there is much truth to it, and I have suspicions of underlying motives. I also cannot help to wonder why they would not just wire his cousin money and help him find a taxi or bus ticket. It is after all the 21st century and there are easier ways to handle situations remotely, rather than have a disturbed youth go out of his way to take care of a stressful situation. He is not in any state to take on great responsibilities or make a trip like that.

His aunt has, according to his father been involved with prostitution, extortion, drug trafficking, and many other illegal activities in the past. She has also been a major influence in his mother's life growing up. I am almost afraid to think of what more I will find out, as my boyfriend himself has spoken to me very little about these kind of details of his family story. I do think that it will be very helpful for him to speak to someone about them though, and could be a relief for him to understand the relationship between his mental illness and his past.

I'm going to make an appointment with a psychologist for him and myself. He referred to it as couple's counseling, which in a way can be valid, as his problems affect my own wellbeing, and I think it would be a good segue into full counseling for the two of us. He has agreed to come with.

 

[ThatLady]

The couples counselling sounds like a wonderful idea that will benefit both of you, hon! Good luck!

 

[foghlaim]

G-scared: i can only echo what TL has said.. brill idea.. as they say "go for it". *s* and well done!

 

[g-scared]

oh thanks.? i hope it will all stop there.? i told his dad the same story, and he wrote me a most disturbing and urgent email in response.? i am starting to feel like i am in a stephen king movie.? his take on the homo-assassin referrence is that my b/f's mom and aunt were not only trying to mess with him mentally, but might want to have him killed.? i know it sounds unreal, and fortunately she lives on the other side of the country. however, it is most unnerving.? i think i will get a restraining order on her tomorrow.

i hope i'm overreacting, but he was sincerely distressed when i told him the story.?

 

[David Baxter PhD]

Yikes! Any chance you can get the whole family into that appointment?

 

[g-scared]

yeah, i know what you mean. it gets really confusing sometimes.