Active Listening Can Help Clinicians Link Childhood Abuse Symptoms to Psychosis in Adults

Therapists use a variety of approaches to solicit information from clients. Different forms of therapy provide different strategies to help clients express emotions and feelings from past experiences. Adults who survived childhood abuse (CA), including childhood sexual, physical, or emotional abuse, may find it difficult to express their feelings related to past abuses. But identifying these emotions and how they relate to current symptoms is essential for therapists. Understanding how their past traumas manifest in the present helps therapists assess current behaviors and diagnose present psychological conditions. Many adult survivors experience anxiety, depression, posttraumatic stress, and other mental health problems as a result of abuse, while others have symptoms of psychosis including hallucinations and delusions (HD) and even dissociation.

It is the latter set of symptoms that interested Marian Reiff of the Department of Sociomedical Sciences at Columbia University. Reiff wanted to determine how symptom content varied in survivors of abuse compared to nonabused clients. Additionally, Reiff examined how content of current HDs differed from previous the circumstances surrounding the childhood abuse. Reiff enlisted 30 individuals and assessed them for CA using a questionnaire that was designed to be open-ended. She asked the participants about specific details of their HDs, past CA, and psychotic symptoms.

Reiff used a “trauma-relevant content score” to measure differences in each group of participants and found that the abuse survivors had much higher trauma-related content in all their responses. This finding suggests that symptoms of trauma may be more evident in individuals currently experiencing HDs and psychosis with a history of CA than in those without. Reiff said, “Identification of trauma-relevant characteristics in symptom content can provide clinicians with an effective means of recognizing trauma-related illness.” Many abuse survivors are hesitant to divulge the details of their abuse because in the past, they may have been shunned by caregivers that didn’t believe their allegations. Reiff believes that when therapists actively listen to clients’ narratives, they provide an environment of acceptance and trust that will encourage disclosure. Therapists will then have a better opportunity to identify any existing links between prior abuse, current symptomology, and psychosis in ways that were not possible through other methods of treatment.

Reiff, M., Castille, D. M., Muenzenmaier, K., Link, B. (2012). Childhood abuse and the content of adult psychotic symptoms. Psychological Trauma: Theory, Research, Practice, and Policy 4.4: 356-369.

Related articles:
Residual Effects of Childhood Abuse in Female Adult Survivors
Experiencing Emotions Will Allow You to Heal
Eliminating the Stigma of Childhood Sexual Abuse

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • luscious lucy

    luscious lucy

    August 8th, 2012 at 11:33 AM

    But how do you really know that one contributes to the other?
    How could you ever distinguish if the abuse victims wouldn’t simply have become psychotic or express thos tendencies even if they had never been abused earlier in life?
    I know that it appears that these two things are correlative, and that one could lead to another. . . but there is always that chance that this would have manifested anyway.
    I just like to play devils advoncate sometimes just to hear what the rest of you out there think. No nastiness please, only responses that are actually helpful and relevant- thanks!



    August 8th, 2012 at 12:56 PM

    This proves one very important thing, something for all parents and caregivers out there. If your child complains of abuse or shows symptoms of abuse, do NOT ignore it. Not only does it push the child to feelings of nonacceptance but can also aggravate the issue on hand. Treatment becomes difficult and they may end up holding that inside them for the rest of their lives. Even future attempts to treat them will be difficult.

  • Maerson


    August 8th, 2012 at 8:53 PM

    i can understand them finding it difficult to xpress their feelings of the abuse,but at least mentioning that they were subjectd to d abuse will give the therapist a fair idea nd he can adopt the appropriate method.If u dont say it,the therapist has no way to know!Its as simple as that-he is a pro not a magician!

  • Marrian F

    Marrian F

    August 9th, 2012 at 4:25 AM

    I knew that childhood abuse could have aprofound effect on someone, but I really had no idea that it could lead to actual mental health problems as the child got older. I mean, I know that depression or maybe even anxiety could be a concern that they faced, but I had no idea that it could develop into psychosis and hallucinations! I am almost stunned to think of the numbers of people who have been through this kind of event in their lives and as a result of someone else being so filled with hate, they are now destined to have to fight so hard for happiness.

  • batteredsoul


    August 9th, 2012 at 9:34 AM

    having your therapist listen to and understand you is just so important.i was emotionally abused by my alcoholic father in childhood but my mother was the one who helped me get away from it all.when I was looking to settle down myself all the memories were so unsettling.i wanted to see a therapist.

    went through many and finally settled for the fourth therapist I saw.yes it took time but I am glad to have found someone who can truly understand me and is open to listening to what I have to say.i want to thank all the therapists out there who approach their clients with concern and practice good methods that are beneficial to the clients in a holistic manner.

  • Sterling


    August 11th, 2012 at 7:19 AM

    Please be mindful however to not make these connections when it really does not exist

  • des


    August 13th, 2012 at 10:58 AM

    One of the most comforting parts of therapy for me was finally feeling like I had found someone that I could talk to and share my feelings and past with without feeling as if he was judging me or looking at my past and making it all my fault. I was a victim of CA at the hands of my own father and I never felt like anyone in the family wanted to hear my side of the story or that they could accept that I did not do anything to get his anger directed at me, that it was just irrational and wrong the way that he treated me when I lived at home. I think that he would even do the same thing to me now had I not hit the road at an early age. I finally found a therapist who makes me feel safe and is hopefully giving me the chance to finally put all of those bad memories behind me for good. It has been quite the process and I know that there are still times that I don’t feel good enough to have anything better than that in my life, but he is teaching me that I deserve far better than that, and I guess I am getting there when it comes to believing that.

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