Prevalence and severity of posttraumatic stress symptoms in psychosis: associations with affective and patient-centered variables in those referred for psychological services

Individuals with psychosis and comorbid posttraumatic stress disorder typically present with more severe forms of illness. Subthreshold posttraumatic stress symptoms (PTSS) are also likely to cause significant distress. The spontaneous disclosure of abuse history is unlikely, which is problematic given that PTSS often go unnoticed due to psychotic symptom overlap, yet when asked, most individuals desire treatment even for subthreshold PTSS. if associations are found between PTSS severity, clinical symptomology, and patient-centered variables, it will further justify the need to enhance PTSS screening during routine care to encourage appropriate referral to specialized services. One hundred and two individuals with psychosis participated in an intake evaluation following referral for psychological services at a clinic specializing in psychological interventions for psychosis, which included the PTSD Checklist for DSM-5. Prevalence of trauma exposure was explored in conjunction with PTSS severity and referral-type. Clinical variables were entered in a multivariate analysis of variance with low, moderate, and high PTSS severity. Of the 102 participants, 21.6% did not report trauma and 14.7% reported events not meeting DSM-5 PTSD criterion A. Data from 65 participants were included; 6.2% of which were referred for trauma. Main effects emerged for all variables except wellbeing and delusional severity. Depression, anxiety, and stress were all significantly higher in the severe compared to low PTSS categories. Quality of life was significantly lower in the severe versus low PTSS category. Severe PTSS were associated with depression, anxiety, and stress, and lower QoL. A severe PTSS category captures a broader range of people likely requiring services and speaks to an important need to improve referral rate for trauma intervention.