Traumagenic Model of Psychosis Revisited (2014)

Read J, Fosse R, Moskowitz A, Perry B. The traumagenic neurodevelopmental model of psychosis revisited. Neuropsychiatry, 4(1), 65-79 (2014).

Together with other international researchers, I recently published a review of recent research and concluded that there is strong support for the hypothesis that early trauma in childhood (including abuse and neglect) can effect brain development in ways that increase the probability of developing psychosis later in life.

To download the article, published in the scientific journal Neuropsychiatry, click on:

Anomalies in the brains of people diagnosed with mental health problems such as ‘schizophrenia’ have traditionally been used to support the notion that such problems are biologically based brain disorders that have little to do with life events.

However, the review of 125 research studies, supports the ‘traumagenic neurodevelopmental’ model of psychosis, which suggests that those differences can be caused by adverse life events, especially those occurring in early childhood.

The review recommends that people experiencing psychosis should be offered evidence-based psychological therapies that address the social causes of their difficulties

Our review concludes that the abnormalities in the brain that have been identified in people diagnosed with ‘schizophrenia’ are not necessarily inherited but can be caused by adverse life events.

These trauma based brain changes should not be thought of as being indicative of having a brain disorder or disease. The changes are reversible. Recent studies have found, for example, that the brain’s oversensitivity to stressors can be reduced by properly designed psychotherapy.

The primary prevention implications are profound. Protection and nurturance of the developing brain in young children would seem to be of paramount importance.

We hope that this vast body of literature will encourage more mental health staff to take more of an interest in the lives of the people they are trying to help, rather than viewing hearing voices and having unusual beliefs as mere symptoms of an ‘illness’ that need to be suppressed with medication.

Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Research into the mechanisms underlying these relationships has focused, productively, on psychological processes, including cognition, attachment and dissociation. In 2001, the traumagenic neurodevelopmental model sought to integrate biological and psychological research by highlighting the similarities between the structural and functional abnormalities in the brains of abused children and adults diagnosed with ‘schizophrenia’. No review of relevant literature has subsequently been published. The aim of this paper, therefore, is to summarize the literature on biological mechanisms underlying the relationship between childhood trauma and psychosis published since 2001. A comprehensive search for relevant papers was undertaken via Medline, PubMed and psycINFO. In total, 125 papers were identified, with a range of methodologies, and provided both indirect support for and direct confirmation of the traumagenic neurodevelopmental model. Integrating our growing understanding of the biological sequelae of early adversity with our knowledge of the psychological processes linking early adversity to psychosis is valuable both theoretically and clinically.