TARGETING THE MISSING LINK: THE NEXUS OF EARLY PHASE PSYCHOSIS, SUBSTANCE MISUSE, AND ADVERSITY

Abstract

Adverse events (AEs; e.g., bullying) and substance misuse (SM) are prevalent among individuals with psychotic disorders (PDs). Limited information exists about the overlap of AEs and SM within PDs, especially in early phase psychosis (EPP). Study 1 reviewed 57 studies on PDs, SM, and AEs, finding frequent associations among variables, but the role of SM in this relationship was unclear. Studies focused on mixed illness duration samples, child abuse, and cannabis/alcohol, limiting the scope of findings. Study 2 surveyed 110 young adults with EPP, finding consistent overlap between psychosis, SM, and AEs. Most participants experienced AEs (97%) and SM (77%); SM consistently co-occurred with adversity. Study 3 trialed a modified prolonged exposure (PE+) intervention targeting shared mechanisms between psychosis, AE sequelae, and SM; there were significant decreases in AE sequelae (e.g., dissociation, anxiety), with varied effects on SM. The dissertation highlights the need for integrated AE-focused interventions for EPP individuals.