CLINICAL HANDBOOK OF SCHIZOPHRENIA

43. Trauma and Posttraumatic Stress Syndromes 457KEY POINTS• Trauma exposure is ubiquitous in clients with schizophrenia, as is PTSD, but trauma historyand posttraumatic syndromes are rarely assessed and treated in this population.• Trauma history and PTSD are associated with more severe symptoms (especially depression,anxiety, and psychosis), worse functioning, and a more severe course of illness in clientswith schizophrenia.• Reliable and valid evaluations of trauma exposure and PTSD can be obtained in clients withschizophrenia through the use of standardized assessment instruments, including interview,self-report, and computer-administered formats.• The assessment of traumatic experiences and PTSD in schizophrenia rarely leads to symptomexacerbations or other untoward clinical effects.• Treatment programs for trauma and PTSD in schizophrenia, based on effective interventionsfor posttraumatic syndromes in the general population, have recently been developedand are being evaluated.• Preliminary experience with these treatment programs suggests that people with schizophreniacan be engaged and retained in treatment, and experience benefits from their participation.REFERENCES AND RECOMMENDED READINGSBlanchard, E. P., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric propertiesof the PTSD Checklist. Behavior Therapy, 34, 669–673.Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumaticstress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.Cusack, K. J., Frueh, B. C., & Brady, K. T. (2004). Trauma history screening in a community mentalhealth center. Psychiatric Services, 55, 157–162.Da Costa, J. M. (1871). On irritable heart: A clinical study of a form of functional cardiac disorderand its consequences. American Journal of the Medical Sciences, 61, 17–52.Frueh, B. C., Buckley, T. C., Cusack, K. J., Kimble, M. O., Grubaugh, A. L., Turner, S. M., et al. (2004).Cognitive-behavioral treatment for PTSD among people with severe mental illness: A proposedtreatment model. Journal of Psychiatric Practice, 10, 26–38.Harris, M. (1998). Trauma Recovery and Empowerment: A clinician’s guide for working with womenin groups. New York: Free Press.Harris, M., & Fallot, R. (Eds.). (2001). New directions for mental health services: Using trauma theoryto design service systems. San Francisco: Jossey-Bass.Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York:Free Press.Mueser, K. T., Bolton, E. E., Carty, P. C., Bradley, M. J., Ahlgren, K. F., DiStaso, D. R., et al. (2007).The Trauma Recovery Group: A cognitive-behavioral program for PTSD in persons with severemental illness. Community Mental Health Journal, 43(3), 281–304.Mueser, K. T., Rosenberg, S. D., Goodman, L. A., & Trumbetta, S. L. (2002). Trauma, PTSD, and thecourse of schizophrenia: An interactive model. Schizophrenia Research, 53, 123–143.Mueser, K. T., Rosenberg, S. D., Jankowski, M. K., Hamblen, J., & Descamps, M. (2004). A cognitive-behavioraltreatment program for posttraumatic stress disorder in severe mental illness.American Journal of Psychiatric Rehabilitation, 7, 107–146.Mueser, K. T., Salyers, M. P., Rosenberg, S. D., Ford, J. D., Fox, L., & Carty, P. (2001). A psychometricevaluation of trauma and PTSD assessments in persons with severe mental illness. PsychologicalAssessment, 13, 110–117.Myers, A. B. R. (1870). On the etiology and prevalence of diseases of the heart among soldiers. London:Churchill.