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Trauma and psychosis : the complex interaction between demographic, behavioural, and social correlates

The modern conceptualization of schizophrenia is flawed. An accumulating body of research has challenged psychiatry's perspective on psychosis. It is no longer accepted that schizophrenia and spectrum disorders are a categorical phenomenon whereby the presence of psychotic symptoms are indicative of psychopathology that lead to poor outcomes (Ahmed, Buckley, & Mabe, 2012). Evidence from a litany of studies indicates that psychosis is better conceptualized dimensionally than categorically. Evidence shows that psychotic symptoms manifest along a continuum of severity long before the development of a diagnosable illness (Dominguez, Wichers, Lieb, Wittchen, & van Os, 2011a). Therefore, the psychosis continuum is maybe better thought of a 'risk pathway' where individuals may transiently move between infrequent but non distressing psychotic-like symptoms (PLEs) to persistent distressing psychotic-like symptoms (PLSs) and finally to functional impairment due to the persistent of distressing symptoms. Moving between these states may be contingent on biological, psychological, and social factors and the influence of the social environment including individual resilience to stress (Tamminga, 2010) . This thesis tests the psychosis continuum by modelling the latent structure of psychosis in a non-clinical sample using confirmatory factor analysis. The findings from chapter 2 suggest that the latent structure of psychosis is best represented by a five factor strucuture. Chapters 3, 4, and 5 examine how various demographic, behavioural, and social correlates can influence the expression of these experiences. The findings suggest that risk factors which are typically associated with clinical samples have the same capacity to influence psychopathology, and sub-clinical psychotic symptoms, thus lending weight to the proposition that a 'risk pathway' may well indeed exist. Chapters 5 and 6 then examine the relationship between different forms of adversity, psychotic-like experiences, and proposed intermediary mechanisms (i.e. perception of threat, salience, top-down, and bottom-up processing); factors which may help influence the expression of such symptoms. In closing, this thesis advances traditional perspectives on trauma and psychosis and demonstrates that from a social and behavioural perspective, subclinical psychosis can also manifest from lesser forms of adversity and not just severe trauma such as physical and sexual abuse.
Date January 2014
CreatorsBoyda, David
PublisherUlster University
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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