Psychological Trauma and Mental Disorders
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Questions and Answers

What is the recommended duration for trauma-focused psychological treatment for PTSD resulting from a single event?

  • 12-16 sessions
  • 4-6 sessions
  • 8-12 sessions (correct)
  • 6-8 sessions

    • What is a key focus of Phase Two in Trauma-Focused CBT?

  • Developing safety and stability in personal circumstances
  • Memory work to contextualize and elaborate memories (correct)
  • Assessing emotional responses
  • Setting therapeutic goals

    • Which of the following statements is true regarding trauma-informed care?

  • Every interaction with a trauma survivor has the potential to activate a trauma response. (correct)
  • Trauma-informed organizations require all staff to have trauma-specific training.
  • Trauma-informed care can be provided without specific trauma-related training.
  • Trauma-informed care does not need to consider the survivor's safety.

    • What factor is particularly important when addressing PTSD with complex needs?

    <p>Building time to develop trust</p> Signup and view all the answers

    What signifies a trauma-informed organization?

    <p>A design that realizes, recognizes, and responds to trauma while resisting retraumatization</p> Signup and view all the answers

    What is the focus of Trauma Informed Care (TIC)?

    <p>To ensure trauma-related needs are addressed within an organization</p> Signup and view all the answers

    Which of the following is NOT one of the components of the 3 E's of trauma?

    <p>Effectiveness</p> Signup and view all the answers

    According to the bio-psycho-social model, what influences vulnerability to trauma?

    <p>Both risk and resilient factors influence vulnerability</p> Signup and view all the answers

    What does the principle of 'Resist' in TIC aim to achieve?

    <p>To prevent service practices that may cause additional trauma</p> Signup and view all the answers

    What should organizations recognize according to TIC principles?

    <p>The widespread impact of trauma on individuals</p> Signup and view all the answers

    What is one of the recommended practices in the NHS Trauma-Informed Mental Health Policies?

    <p>Assess for PTSD and trauma reactions in individuals with psychosis</p> Signup and view all the answers

    How can trauma be experienced in relation to psychosis?

    <p>Trauma may occur alongside or result from psychosis</p> Signup and view all the answers

    What is one way organizations can make relationships safer within TIC?

    <p>By viewing relationships as healing rather than traumatic</p> Signup and view all the answers

    What was a primary reason for creating the Trauma & Life Events Checklist?

    <p>To simplify the assessment process</p> Signup and view all the answers

    What conclusion was drawn from the meta-analysis regarding trauma-focused therapy for PTSD in psychosis?

    <p>Memory work is essential in treatment</p> Signup and view all the answers

    What was the outcome of the meta-analysis on trauma-focused therapy's effect on delusions?

    <p>Only reached significance at follow-up</p> Signup and view all the answers

    Which technique was found to be beneficial for individuals with voices linked to trauma?

    <p>Imagery rescripting</p> Signup and view all the answers

    How many sessions does the Integrated tf-CBTp trial proposed by STAR involve?

    <p>26 sessions</p> Signup and view all the answers

    What is the main focus of the trauma-focused therapies mentioned for psychosis?

    <p>PTSD symptoms</p> Signup and view all the answers

    What is one of the trials underway for Trauma-Focused Therapy for Psychosis?

    <p>EMDR for trauma in early intervention</p> Signup and view all the answers

    What effect did trauma memory techniques have on voices according to recent findings?

    <p>Beneficial impact for people with linked trauma</p> Signup and view all the answers

    What is a significant barrier to conducting routine trauma assessments according to the content?

    <p>Fear of retraumatisation due to inappropriate questioning</p> Signup and view all the answers

    What percentage of service users was recorded as having been asked about trauma in the audit of the REVA policy implementation?

    <p>17%</p> Signup and view all the answers

    Which of the following is NOT highlighted as a requirement for trauma assessments in the content?

    <p>Conducting assessments without informed consent</p> Signup and view all the answers

    What was the main focus of inpatients regarding trauma inquiry in the content?

    <p>Desire for routine enquiry and support information</p> Signup and view all the answers

    What issue arises from the current enquiry prompt regarding trauma assessments?

    <p>It may not be specific enough for all types of trauma</p> Signup and view all the answers

    What is a significant risk factor associated with childhood psychological trauma?

    <p>Psychosis with an odds increase of 3x</p> Signup and view all the answers

    Which of the following is NOT a term related to childhood psychological trauma?

    <p>Acute stress reaction</p> Signup and view all the answers

    According to the Bradford Hill Criteria, which statement is TRUE about trauma and psychosis?

    <p>Alterations in brain regions involved in emotion regulation are plausible mechanisms</p> Signup and view all the answers

    What might be a potential outcome if psychological trauma could be eradicated?

    <p>Reduction in psychosis prevalence by 30%</p> Signup and view all the answers

    What type of response might individuals with a history of childhood trauma exhibit?

    <p>Blunted cortisol responses</p> Signup and view all the answers

    Which factor does NOT contribute to the Bradford Hill Criteria for assessing trauma's impact on mental health?

    <p>Financial impact on healthcare systems</p> Signup and view all the answers

    What neurological alteration is suggested for individuals exposed to childhood trauma?

    <p>Alterations in grey matter volume</p> Signup and view all the answers

    Which of the following mental disorders has been linked to childhood psychological trauma?

    <p>Psychosis</p> Signup and view all the answers

    What is an essential consideration when addressing PTSD with complex needs?

    <p>Building trust and ensuring personal safety</p> Signup and view all the answers

    Which phase of Trauma-Focused CBT involves memory work to contextualise and elaborate memories?

    <p>Phase Two</p> Signup and view all the answers

    In trauma-informed care, what assumption can be made about interactions with trauma survivors?

    <p>Every interaction can trigger a trauma response</p> Signup and view all the answers

    How do trauma-focused treatments differ from general interventions?

    <p>They address specific trauma-related issues</p> Signup and view all the answers

    What is a unique aspect of trauma-focused therapy compared to other forms of therapy?

    <p>It includes a focus on contextualizing trauma memories</p> Signup and view all the answers

    What are the two main factors that influence the development of trauma according to the theory of latent vulnerability?

    <p>Risk and resilient factors</p> Signup and view all the answers

    What is a primary goal of Trauma Informed Care (TIC)?

    <p>To address trauma-related needs and reduce incidents of trauma</p> Signup and view all the answers

    Which of the following best describes the 'Events' component of the 3 E's of trauma?

    <p>Any event that is psychologically or physically threatening</p> Signup and view all the answers

    How does the 'Relation' focus in TIC approach relationships within therapeutic settings?

    <p>Creating safe, trustworthy, collaborative, and empowering relationships</p> Signup and view all the answers

    What is one of the key recommendations for trauma-informed care in managing psychosis?

    <p>Assessing for PTSD and other trauma reactions</p> Signup and view all the answers

    In the context of TIC, what does the term 'Resist' refer to?

    <p>Minimizing the possibility of service-induced trauma</p> Signup and view all the answers

    What is considered a systemic approach within Trauma Informed Care (TIC)?

    <p>Organizational practices that address trauma-related needs</p> Signup and view all the answers

    Which of the following describes the 'Experience' component of the 3 E's of trauma?

    <p>It refers to the immediate reactions to a traumatic event.</p> Signup and view all the answers

    What was a key reason for developing the shortened version of the Trauma & Life Events Checklist?

    <p>To make it less time-consuming for routine use</p> Signup and view all the answers

    What have meta-analyses concluded about the effectiveness of trauma-focused therapy for PTSD in individuals with psychosis?

    <p>Memory work should be included in treatment</p> Signup and view all the answers

    What outcome was reported regarding trauma memory techniques for voices linked to trauma?

    <p>They are supportive when addressing linked traumatic memories</p> Signup and view all the answers

    What does the upcoming trial 'EASE' focus on in the context of trauma-focused therapy for psychosis?

    <p>EMDR for trauma in early intervention</p> Signup and view all the answers

    What effects did the meta-analysis of 12 studies find regarding trauma-focused therapy's impact on delusions?

    <p>Effects on delusions were small but significant at follow-up</p> Signup and view all the answers

    What is a common barrier to routine inquiry about trauma assessments?

    <p>Potential for retraumatisation</p> Signup and view all the answers

    Which of the following statements is true according to the emerging evidence about treatment approaches for psychosis?

    <p>Trauma techniques can specifically address voices linked to trauma</p> Signup and view all the answers

    Why is there an increasing interest in trauma-informed care (TIC) for psychosis both nationally and internationally?

    <p>To effectively integrate trauma-focused therapies into psychosis treatment</p> Signup and view all the answers

    What percentage of service users were recorded as having been asked about trauma during the implementation audit?

    <p>17%</p> Signup and view all the answers

    What is the primary goal of the trials underway for Trauma-Focused Therapy for Psychosis?

    <p>To evaluate varying trauma-focused interventions</p> Signup and view all the answers

    Which of the following is emphasized as a necessity before conducting a trauma assessment?

    <p>Obtaining informed consent</p> Signup and view all the answers

    What outcome did inpatient service users want from routine trauma inquiry?

    <p>More support and information</p> Signup and view all the answers

    What is a noted issue with the enquiry prompt used in trauma assessments?

    <p>It lacks proper specificity for the abuse types</p> Signup and view all the answers

    What is the risk factor associated with childhood psychological trauma in relation to psychosis?

    <p>Increases the odds of experiencing psychosis by 3x</p> Signup and view all the answers

    Which statement about the Bradford Hill Criteria is correct?

    <p>It includes a measure of association strength</p> Signup and view all the answers

    What could be a potential outcome of eradicating psychological trauma according to the content?

    <p>A 30% reduction in prevalence of psychosis</p> Signup and view all the answers

    What neurological alterations are associated with childhood trauma?

    <p>Alterations in the hypothalamic-pituitary-adrenal axis</p> Signup and view all the answers

    What does the term 'childhood maltreatment' refer to?

    <p>Neglect and various forms of abuse experienced in childhood</p> Signup and view all the answers

    Which is NOT considered a potential outcome of childhood psychological trauma?

    <p>Physical health improvement</p> Signup and view all the answers

    What did Freud contribute to the understanding of psychological trauma?

    <p>A link between childhood events and later mental disorders</p> Signup and view all the answers

    How does childhood trauma potentially influence cortisol responses?

    <p>It can lead to either heightened or blunted cortisol responses</p> Signup and view all the answers

    What is a key component of Phase One in Trauma-Focused CBT?

    <p>Assessment and goal setting</p> Signup and view all the answers

    When should the duration of trauma-focused psychological treatment be extended?

    <p>When multiple traumatic events have occurred</p> Signup and view all the answers

    What assumption is made about trauma-informed care interactions with survivors?

    <p>Every interaction has the potential to activate a trauma response</p> Signup and view all the answers

    Which statement is false regarding trauma-specific treatments?

    <p>They are necessary for care to be trauma-informed</p> Signup and view all the answers

    What does the term 'Effects' refer to in the 3 E's of trauma?

    <p>The cognitive and emotional outcomes of trauma</p> Signup and view all the answers

    Which of the following is a principle of Trauma Informed Care (TIC)?

    <p>Recognize the prevalence of trauma and its impacts</p> Signup and view all the answers

    How should organizations approach the issue of retraumatization in TIC?

    <p>By adapting practices to minimize additional trauma</p> Signup and view all the answers

    What role does the concept of 'Resist' play within Trauma Informed Care?

    <p>It focuses on preventing secondary trauma in service delivery</p> Signup and view all the answers

    Which statement correctly describes the bio-psycho-social model in relation to trauma?

    <p>It integrates biological, psychological, and social aspects of trauma.</p> Signup and view all the answers

    What is a recommendation for organizations implementing TIC principles?

    <p>To develop trauma-specific therapies and training for staff</p> Signup and view all the answers

    What is a primary focus of NHS Trauma-Informed Mental Health Policies?

    <p>To assess for PTSD and related trauma experiences in individuals with psychosis</p> Signup and view all the answers

    In the context of TIC, how should relationships be approached?

    <p>As collaborative, trustworthy, and empowering</p> Signup and view all the answers

    What is a significant limitation of the longer version of the Trauma & Life Events Checklist?

    <p>It is cumbersome and not suitable for routine use.</p> Signup and view all the answers

    What approach is suggested for trauma memory techniques related to voices in psychosis?

    <p>Reciting memories of traumatic events.</p> Signup and view all the answers

    What was a conclusion regarding trauma-focused therapy from the meta-analysis on PTSD in psychosis?

    <p>Memory work should be included in treatment.</p> Signup and view all the answers

    What does the mini-TALE include that distinguishes it from the longer version?

    <p>Inclusion of experiences of discrimination.</p> Signup and view all the answers

    Which factor was observed to affect the results of trauma-focused therapy on hallucinations and negative symptoms?

    <p>Complexity of trauma history.</p> Signup and view all the answers

    What was found regarding the effectiveness of trauma-focused therapies on delusions during follow-up assessments?

    <p>Only small effects reached significance at follow-up.</p> Signup and view all the answers

    What type of trauma-focused therapy trial is associated with the EASE study?

    <p>16 sessions of EMDR for trauma in early intervention.</p> Signup and view all the answers

    What can be inferred about the future of trauma-informed care (TiC) for psychosis from the content?

    <p>Trials for trauma-focused therapies are being developed.</p> Signup and view all the answers

    What is a significant barrier to conducting routine trauma assessments?

    <p>Concern about potential retraumatisation</p> Signup and view all the answers

    What does the current enquiry prompt regarding trauma assessments fail to align with?

    <p>Best practice guidance for trauma assessments</p> Signup and view all the answers

    What is a proposed recommendation for improving trauma inquiries in mental health settings?

    <p>Offer mandatory training for healthcare professionals</p> Signup and view all the answers

    How should questions about trauma be framed to ensure they are effective?

    <p>Specific and direct to target particular experiences</p> Signup and view all the answers

    What is the relationship between childhood psychological trauma and the development of psychosis?

    <p>Childhood trauma can increase the risk of developing psychosis.</p> Signup and view all the answers

    According to the Bradford Hill Criteria, which criterion involves exposure to trauma predicting future mental health outcomes?

    <p>Temporality</p> Signup and view all the answers

    What percentage of psychosis prevalence could potentially be reduced by eradicating psychological trauma?

    <p>30%</p> Signup and view all the answers

    Which of the following does NOT describe childhood psychological trauma?

    <p>Severe academic pressure</p> Signup and view all the answers

    What type of brain alterations have been suggested to occur in individuals exposed to childhood trauma?

    <p>Alterations in limbic regions</p> Signup and view all the answers

    Which common misconception regarding trauma and psychosis does the content address?

    <p>Psychosis is only caused by genetic factors.</p> Signup and view all the answers

    What physiological response might individuals with a history of childhood trauma exhibit?

    <p>Altered cortisol responses</p> Signup and view all the answers

    Which of the following statements best reflects the impact of childhood trauma on treatment response?

    <p>Trauma is linked to more severe symptoms and poorer treatment response.</p> Signup and view all the answers

    Study Notes

    Psychological Trauma and Mental Disorder

    • Freud linked childhood sexual abuse to later mental disorders in the 1890s
    • Freud recognised childhood events have lasting impacts

    Childhood Psychological Trauma - Definition

    • Adverse childhood events include neglect, physical, sexual, or emotional abuse
    • Different terms for this include childhood maltreatment, adverse childhood experiences, early life stress, and developmental trauma

    Childhood Psychological Trauma - Risk Factor

    • Associated with a 3x increased risk of psychosis (Varese, 2012)
    • Population attributable risk for psychosis is 30% (Kirkbride, 2010)
    • Reducing psychological trauma could reduce psychosis prevalence by 30%
    • Trauma is linked to many psychiatric and poor physical health outcomes (Daníelsdótti, 2024; Nelson, 2020)

    Childhood Psychological Trauma - Mechanism

    • Research suggests psychological and neurological processes are involved in trauma and psychosis (Bloomfield, 2021; Pollok, 2022; Yang, 2023)
    • Grey matter volume alterations are observed in those exposed to childhood trauma
    • Individuals with psychosis and a history of trauma show higher (Aas, 2019) or blunted cortisol responses (Bloomfield, 2019)
    • Strong and consistent association between trauma & psychosis (Meta-analysis (Varese, 2012))
    • Trauma exposure precedes psychosis onset (Kelleher, 2013)
    • Biological gradient: more severe trauma leads to more severe symptoms; poorer treatment response
    • Plausible biological mechanisms: alterations in the hypothalamic-pituitary-adrenal (HPA) axis, brain alterations in threat processing, emotion regulation in limbic regions, and dopamine transmission (Merritt, 2024; Egerton, 2016; Bloomfield, 2019)

    Future Work

    • Need deeper knowledge of vulnerability mechanisms (McCroy & Viding, 2015)
    • Importance of risk and resilient factors
    • Integrate bio-psycho-social model
    • Implement trauma-informed therapies

    What is Trauma?

    • The 3 E's: Event, Experience, Effects
    • Trauma is much broader than PTSD criteria
    • Any psychological or physical threat
    • Range of cognitive, emotional, behavioural, physiological, and interpersonal reactions
    • Recurring range of cognitive, emotional, behavioral, physiological, and interpersonal effects
    • Can be a precursor to psychosis; can accompany psychosis; or result from psychosis

    Trauma Informed Care (TIC)

    • Organisational approach addressing trauma-related needs
    • Views trauma as "everybody's business"
    • Acknowledges commonality of trauma
    • Recognises trauma effects and routine enquiry
    • Asking about traumatic experiences
    • Access to trauma-specific support (e.g., EMDR)

    Recommendations for TIC in Psychosis

    • NICE Guidance for Schizophrenia (2014) to assess for PTSD in clients with psychosis
    • NICE Guidance for PTSD (2018) trauma-focused psychological treatment (CBT or EMDR)
    • Trauma-Focused CBT for Psychosis (tf-CBTp) - NICE guidelines followed with support based on individual needs

    Routine Enquiry about Trauma in the UK

    • CPA requires routine enquiry about trauma
    • Only 17% of service users had the abuse question asked in 53 trusts
    • This is not in line with best practice (Brooker et al., 2016)

    Talking Trauma in MDTs

    • Many have experienced trauma but few are assessed
    • Inpatients want routine enquiry
    • Assessing trauma in psychosis: trauma checklist

    Is Trauma-Focused Therapy Safe and Effective for Psychosis?

    • Meta-analysis of studies show some small, positive effects on delusions at follow-up but not on hallucinations and negative symptoms
    • Trauma memory techniques can have beneficial impacts on voices (Brand et al., 2018, 2020a, 2020b)
    • Imagery rescripting is helpful in some cases

    Future of TIC for Psychosis

    • Increasing international attention to TIC
    • Evaluation of optimal TIC approach needed
    • Trauma-focused therapy trials underway (e.g., STAR)

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    Description

    Explore the profound impact of childhood psychological trauma on mental disorders. This quiz addresses definitions, risk factors, and underlying mechanisms linking adverse childhood events to later psychiatric outcomes. Evaluate your understanding of Freud's theories and recent research findings on this critical topic.

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