Systematic Review: Are Complex Posttraumatic Stress Disorder and Dissociation Associated With Early-Onset Psychosis?

Area of Science:

• Psychiatry
• Psychology
• Neuroscience

Background:

• Early-onset psychosis (EOP) presents greater challenges than adult-onset psychosis.
• Trauma, including complex posttraumatic stress disorder (cPTSD) and dissociation, is increasingly implicated in adolescent psychosis.
• The precise relationship between these trauma-related mechanisms and EOP requires further clarification.

Purpose of the Study:

• To systematically review the literature on the associations between cPTSD, dissociation, and EOP.
• To elucidate the nuances of trauma-related processes in the emergence of psychotic symptoms during adolescence.
• To identify specific psychotic symptoms linked to cPTSD and dissociation.

Main Methods:

• A systematic review following PRISMA guidelines.
• Searches conducted across MEDLINE, PsycINFO, and Scopus databases.
• Inclusion of 21 cross-sectional and longitudinal studies of children and adolescents.

Main Results:

• Significant positive associations found between dissociation and psychotic experiences (r = .34-.80), particularly positive symptoms.
• Longitudinal data suggested concurrent rather than predictive associations for dissociation.
• cPTSD symptom clusters, especially affect dysregulation and interpersonal disturbances, were consistently linked to psychosis.

Conclusions:

• Dissociation and specific cPTSD symptom clusters are positively associated with EOP.
• Methodological heterogeneity and limited longitudinal data necessitate unified measurement frameworks.
• Clarifying trauma-psychosis mechanisms is crucial for informing early interventions for EOP.