I no longer see psychosis in relation to long-term traumatization as a related disorder, but as part of traumatization, such as dissociation. Various studies in EU, UK and other countries have clearly demonstrated a link. Unfortunately, I have to say, many have and will continue to look for it exclusively in genes and brain-abnormalities. Why don't most people say it and yet intuitively they will agree that there must be more. But people always come back to genes. This is partly due to the fact that people are educated in this way, and thus think and do research. The secret to life is all kinds of mechanisms, more than just genes. Unfortunately I have to say to these people. But the real reality of live is much more complex and not so limited to genes only. Genes are also regulated and that is how it works, chronic childabuse and thus chronic trauma alters the epegenetics. It would be very shocking/ surpricing in fact or embarrassing to acknowledge that genes researchers have not come up with Holly-grail of psychosis research either, but why this obstinacy, short-sightedness and blindness has how nature and therefore brains have mechanisms to regulate gene expression to adapt, what is going on among these psychiatrists and scientists.
Epigenetic Mechanisms in the Pathophysiology of Psychotic Disorders
Epigenetics is the study of chromatin–the physical material that forms chromosomes, composed of DNA wound around specialized histone proteins–and of how the modification of chromatin acts to establish stable states of gene expression in a cell-specific manner. Chromatin is regulated through three mechanisms: DNA methylation, histone modification, and RNA interference. These basic biological processes form the molecular interface between the genome and the environment, contributing to the regulation of gene expression in health and disease. Investigation of epigenetic mechanisms is yielding exciting insights in many areas of medicine, and a large and rapidly growing
literature describes epigenetics as central to many aspects of the pathophysiology of psychotic disorders. This article first discusses speculative points as to why the mechanisms of epigenetics may be satisfying explanatory mechanisms in the etiology of psychotic disorders, then details emerging experimental evidence of roles for the three types of epigenetic mechanisms in these illnesses, and finally discusses these mechanisms as potentially compelling areas of research for the development of future treatments.
Source : NCBI
The neurological cause of psychosis is not known yet.
Prof Iris Sommer showed that ordinary people can have hallucinations under certain circumstances. This seems a surprise for many. It is in fact true that our brain creates input in the absence of sensory input. For example hypnopompic hallucinations as some people know as "Did I hear the doorbell or phone?", while waking up or in a dormant state. But the real neurological reasons is not known. I suspect it is not localized in the brain, but a network problem, in which the brain which is used to make sense of sensory input forms a explanation or consciousness
we interpret as real. It is good that scientists and psychiatrists discuss what centuries of knowledge about psychosis or the schizo-disorder has produced so far and if we are on the right track. Just thinking in merely genetic causes seems reasonable but explaining how genes by means of epigenetics and brain development - an adaptive organ - ultimately leads to a schizo-disorder or psychosis is not understood or made clear. The latter a disorder which can be prevalent among the whole patient population.
Scientific proof relation; psychosis and trauma:
When you are familiar with the scientific world or research and thus know where to find and read research of the relationship between psychosis and trauma, the scientific evidence is overwhelming and internationally known. I'm not going to bore you with a number of surveys. You should Google on "Trauma Psychosis Research." It took a long time for academics to consider the importance of research into relationships between psychosis and child abuse. The tendency was generally research into a biological cause or brain anomaly. Nevertheless, psychosis or psychotic episodes occur in the entire population of psychiatric patients.
But still, there are many who are striving for a medical treatment, biological and genetically research and thus medical treatment, co-paid and stimulated by the pharmacy that attaches great importance to medical treatment. After all, research and treatment involve millions and even billions. A very important and especially economical drive. Research on results of psychotherapy will be for the time being of no interest at all and not funded. It is bad for the pharmacy if psychotherapy is even a better treatment. A treatment that makes psychosis forever disappear in relation to (chronic) psycho trauma or child abuse.
My own experience
To convince scientists that social and psychological stress together with isolation and therefore not being understood can lead to psychosis is very hard to do. If one does, the answer is most of the time, that there must always be a underlying genetic or biological reason. Many people with a traumatic background and thus psychosis are often considered to have a poor prognosis and thus are difficult to treat, but that is often not the case. I fact they are considered to have a double poor prognosis. First recovering from a psychosis and second in relation to their disorder a very poor prognosis in recovery from trauma. So the answer clients get is a depressing one. My psychosis are completely gone for more than three years. I suspect that many clinicians often have no idea what the cause of a psychosis is and that social and psychological stress conditions can trigger it. One often does not ask clients "what happened to you?" Some and perhaps most clinicians are convinced that psychotic forms of PTSD and sometimes flashbacks disappear when clients start to use their medication. One often have no faith in treating patients with EMDR, when they are delusional. The consensus among clinicians is that medication and thus stabilizing is the first treatment.
Although research has shown that CBT has the same results and often longer lasting. Often one has no insight into how great the reality testing the client is. The assumption that psychotic clients have no reality testing at all seems the assumption. It is striking how little clinicians know how clients perceive their psychosis and their views often does not reflect those of psychotic clients. Finally, I will never claim that all psychotic symptoms solely are the result of social and psychological stressors, but that these factors are too little seen as causes and that not all psychotic symptoms are purely caused by genetics or a biological reason, but that the shared nature and nurture influences may vary. There are clients whose traumatic experiences are so extreme that getting psychotic seems to be in that sense reasonable. Only when we develop a balanced view, we will also consider other causes, causes that often doesn't have the scientific interest of scientists and unfortunately many clinicians. But the most depressive truth is that many client with trauma and psychosis are not treated, because one falsely believes that the outcome is worse f.i. suicideattemps or getting psychotic.
Psychosis may accompany PTSD and often there is a lot of overlap. Psychosis are often seen as part of a schizo-spectrum, such as, for example, schizophrenia or schizoaffective disorder, when mood problems also play a role. Emeritus professor Onno van der Hart argues for a new category of PTSD in the DSM and also professor van der Gaag, because many clients present a mixed picture of psychosis and PTSD. The current consensus among clinicians is that traumatic experiences can result in schizophrenia or schizoaffective disorder. That makes therapies such as EMDR, which are proven to be safe for clients with psychotic symptoms save in reducing psychosis. Still, one can see in this group that genetics is partly responsible. In schizophrenia genes, epigenetics, social environment and mental stress forms a complex interaction.
It is fairly new in terms of insight that therapy focused on trauma that psychotic symptoms can disappear into the background. Yet many clients see their traumatic experiences as the cause of their psychoses. There's something to be said, when the experiences are so severe that the psychosis may have a psychogenic cause, without having the need to label it as a schizo-disorder. Take for instance a psychosis due to a depression or deep grief. It is also known that those with
Despite increasing evidence for the role of psychosocial factors in the onset and continuance of psychosis, the experiences involved are still largely considered the result of a biogenetic anomaly for which medication is the first-line treatment response. This review summarizes the extensive literature demonstrating that adverse events involving trauma, loss, stress, and disempowerment have a central etiological role in psychosis. Evidence is further presented to show that many neurological changes traditionally considered indicative of a disease process can in fact be accounted for as secondary effectsto the physiology of stress or the residual of long-term neuroleptic prescription. Particular emphasis is given to the
traumagenic neurodevelopmental model of psychosis, which illustrates how many of the structural and functional cerebral anomalies observed in adult patients with psychosis (including dopamine dysregulation, atrophy, hippocampal damage, and overactivity of the hypothalamic-adrenal-pituitary axis) closely correspond to those in the brains of abused children. Finally, research is discussed that demonstrates how trauma may manifest in characteristic symptoms of psychosis, particularly hallucinations and delusions. It is suggested that if social adversities are of central importance in psychosis, then psychotherapy that addresses the long term sequelae of those adversities should be considered an essential aspect of treatment.