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Sealing over as a recovery style: a response to the trauma of psychosis?

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HarperSF_1999redux.pdf (16.60Mb)
Date
1999
Author
Harper, Sean Findlay
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Abstract
 
 
Integration and sealing over have been described as clinically distinct coping styles after psychosis. An integrative recovery is characterised by the patients awareness of the continuity of their mental activity and personality before and through recovery from psychosis. Patients who seal over at recovery tend to isolate the psychotic experience. They view it as alien and disruptive to their lives and consequently seek to encapsulate it (McGlashan, 1975). These descriptions represent opposite ends of a continuum where people who tend to seal over generally have poorer long term functional outcomes (McGlashan, 1987). The symptomatic aspects of psychosis could be described as traumatic as could the experiences often associated with a psychotic episode, e.g. involuntary hospitalisation, seclusion or sedation. Further, sealing over appears to parallel the avoidance component of post traumatic stress disorder (PTSD). This study is an attempt to investigate possible links between recovery style after psychosis and experience of psychosis as a traumatic event. It is hypothesised that people who seal over after psychosis are more likely to have experienced their psychosis as traumatic, to have low perceived control over illness, and be more likely to be depressed. Subjects who had experienced a psychosis within the last year were given four self report questionnaires to complete: the Impact of Event Scale (Horowitz, 1979), the Personal Beliefs about Illness Questionnaire (Birchwood, Mason, MacMillan and Healy, 1993), the Recovery Styles Questionnaire (Drayton, Birchwood and Trower, 1998), and the Beck Depression Inventory (Beck & Beamesderfer, 1974). Integration and sealing over was also measured by an independent rater using the Integration/Sealing Over Scale (McGlashan, 1987). Statistical analysis was completed. Results indicated that intrusions were predictive of a tendency towards sealing over; intrusions, avoidance and low perceived control over illness were predictive of depression. Conclusions were drawn and discussed in the context of the relevant literature.
 
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http://hdl.handle.net/1842/29142
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  • Health in Social Science thesis collection

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