Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: A critical review

Author(s)Grubaugh, Anouk L., Heidi M. Zinzow, Lisa Paul, Leonard E. Egede, and B. Christopher Frueh
Title Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: A critical review
Source Clinical Psychology Review,2011, Vol. 31, Issue 6, pp883-899
Date 2011
Document type Journal article
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148295
Summary This article reviews the literature on trauma exposure and PTSD within the context of severe mental illness (SMI). The authors explore underlying theory, such as the model of the interplay between PTSD and SMI that hypothesises that PTSD is a comorbid disorder that mediates the relationship between trauma, increased symptom severity, and the increased use of acute care services. Another theory discussed is that psychotic episodes may in themselves be traumatic events that lead to the development of PTSD in individuals with SMI. The difficulties in accurately assessing PTSD in patients with SMI are examined, including reference to studies that suggest that individuals with SMI are more likely to not disclose trauma and abuse rather than over-report. The evidence suggests that rates of trauma exposure and PTSD are higher among individuals with SMI than in the general population and a significant number of individuals with SMI report multiple traumas. However, it is also noted that PTSD is rarely assessed in public mental health settings. Treatment options are explored, including cognitive restructuring and exposure therapy. The authors conclude by examining limitations in the relevant literature and suggest future directions for research, practice and policy in this area.
Keywords PTSD; trauma: severe mental illness; SMI; psychotic
Topic Psychological effects and treatment