Impact of traumatic and violent victimization experiences in individuals with schizophrenia and schizoaffective disorder
Newman, Jennifer M. ; Turnbull, Ayme ; Berman, Brady A. ; Rodrigues, Stephanie ; Serper, Mark R.
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UMass Chan Affiliations
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Keywords
Anxiety Disorders
Autistic Disorder
Cognition Disorders
Comorbidity
Crime Victims
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
*Life Change Events
Male
Middle Aged
Psychiatric Status Rating Scales
Psychotic Disorders
Risk Factors
Schizophrenia
*Schizophrenic Psychology
Stress Disorders, Post-Traumatic
Violence
Mental and Social Health
Mental Disorders
Psychiatry
Psychiatry and Psychology
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Abstract
Individuals with schizophrenia or schizoaffective disorder (SZ) experience more violent victimization and noninterpersonal traumatic experiences than the general population. Earlier studies, however, have generally excluded one or grouped together victimization and trauma experiences into single outcome variables, which may obscure their contributory role to SZ symptoms. This issue is important because there is some evidence that intentionally induced violence produces higher rates of psychopathology than nonintentional traumatic experiences. We examined the independent contribution of both types of victimization experiences on SZ patients' symptomatology. We were also interested in determining whether SZ patients' pattern of acute symptom presentation could discriminate between SZ patients with and without posttraumatic stress disorder (PTSD) comorbidity. SZ inpatients (n = 70) were assessed for the presence of comorbid PTSD diagnosis, violent victimization, and noninterpersonal traumatic experiences. Patients were also rated on SZ symptom severity and general psychopathology measures. Past violent victimization experiences predicted severity of dysphoria and anxiety in SZ. Past traumatic experiences, however, predicted severity of psychosis. Victimization predicted severity of patients' autistic/cognitive symptoms. SZ patients with comorbid PTSD presented with significantly more anxiety and dysphoria symptoms and SZ illness chronicity than their non-PTSD counterparts. Discriminant function analysis revealed that the severity of positive, dysphoric, autistic/cognitive, and anxiety symptoms differentiated comorbid PTSD patients from their non-PTSD counterparts, with an overall 72.9% classification rate. Past traumatic and victimization experiences are significantly associated with SZ patients' symptom severity and illness course in partially overlapping domains. Use of common assessment strategies may be employed to increase detection of PTSD in SZ patients presenting for acute treatment.
Source
Newman JM, Turnbull A, Berman BA, Rodrigues S, Serper MR. Impact of traumatic and violent victimization experiences in individuals with schizophrenia and schizoaffective disorder. J Nerv Ment Dis. 2010 Oct;198(10):708-14. doi: 10.1097/NMD.0b013e3181f49bf1. Link to article on publisher's site