Post-traumatic growth in psychosis: a systematic review and narrative synthesis

Fiona Ng, Nashwa Ibrahim, Donna Franklin, Gerald Jordan, Felix Lewandowski, Fan Fang, David Roe, Stefan Rennick-Egglestone, Christopher Newby, Laurie Hare-Duke, Joy Llewellyn-Beardsley, Caroline Yeo, Mike Slade

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objective: People with psychosis report experiences of highly traumatic events. Positive change or post-traumatic growth (PTG) can occur as a result of traumatic experiences. Yet there is limited attention on PTG in psychosis, possibly due to the negative impact of psychotic symptoms on functioning and quality of life. The aim of this review was to identify significant correlates and mediators of PTG in psychosis, and to develop a conceptual framework synthesising facilitators of PTG in psychosis. Method: Ten electronic databases were searched in seven languages, and five journals and grey literature were searched in English. Quantitative studies were eligible if examining correlates, mediators, or the temporal relationship between PTG and one or more variables. Qualitative studies were eligible if describing PTG arising from experiences of psychosis. Findings from quantitative papers were grouped by analysis method, with significant correlates, mediators, and temporal relationships descriptively reported upon. Narrative synthesis was conducted on findings in qualitative papers. Results: Thirty-seven papers were included. Significant correlates and mediators of PTG were identified. Mediators of PTG in psychosis included meaning in life, coping self-efficacy, core beliefs, and self-reported recovery. No studies describing the temporal relationship between PTG and psychosis were identified. The narrative synthesis identified seven facilitators of PTG in psychosis: Personal identity and strength, Receiving support, Opportunities and possibilities, Strategies for coping, Perspective shift, Emotional experience, and Relationships, giving the acronym PROSPER. Conclusions: Individuals with psychosis can be supported to grow from traumatic experiences. Clinicians can support PTG through the provision of trauma-informed care that supports positively valued identity changes. For researchers, the findings provide an evidence-based theoretical framework for conceptualising PTG, which can be validated through longitudinal cohort studies and underpin the development of new clinical interventions.

Original languageEnglish
Article number607
JournalBMC Psychiatry
Volume21
Issue number1
DOIs
StatePublished - Dec 2021

Bibliographical note

Funding Information:
This article is independent research funded by the NIHR under its Programme Grants for Applied Research Programme (Programme Grants for Applied Research, Personal experience as a recovery resource in psychosis: Narrative Experiences Online (NEON) Programme, RP-PG-0615-20016). GJ has received funding from the Canadian Institutes of Health Research, Fonds de Recherche Québec – Santé, McGill University, and the Franke Program in Science and Humanities. MS acknowledges the support of the Centre for Mental Health and Substance Abuse, University of South-Eastern Norway and the NIHR Nottingham Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2021, The Author(s).

Keywords

  • Narrative synthesis
  • Positive changes
  • Post-traumatic growth
  • Psychosis
  • Systematic review

ASJC Scopus subject areas

  • Psychiatry and Mental health

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