Exploring Attachment, Trauma, and Cannabis Use in Psychotic Disorders: A Qualitative Study of Patient and Family Perspectives
Bibliographic record
Abstract
Background: Psychotic disorders are debilitating mental illnesses that affect individuals in physical, emotional, psychological, and social ways. Both biological and environmental factors are thought to play a role in illness occurrence and severity. Previous studies suggest that insecure attachment, trauma, and cannabis use are major environmental factors contributing to the severity of psychotic illness. Despite the known vulnerabilities created by these risks, little is known about the understanding that patients and families have with respect to these risks. It remains unclear how the interplay of these risks unfolds, creates pathways of vulnerability, and whether these pathways are recognized and addressed by patients and their families. While many researchers and clinicians are aware of these problems, it seems that not all patients are, indicating a disconnect in knowledge translation between patients and healthcare providers. Research also highlights the critical role that family members play in recovery for those with psychotic disorders, making their perspectives an important tool to consider in clinical treatment. Although resources for patients and family members currently exist, recovery remains challenging, prompting the emergence of specialized clinics focused solely on psychotic disorders, such as the Early Psychosis Intervention Program (EPIP) in Saskatoon, SK. Therefore, the primary aim of this study is to qualitatively examine the understanding that patients and family members have regarding these risks in relation to their illness, and to explore the role of the EPIP clinic in their recovery. Method: Patients and family members were recruited from the EPIP clinic at Royal University Hospital or from the Schizophrenia Society of Saskatchewan. Semi-structured qualitative interviews were conducted with patients experiencing first-episode psychosis (17) and their family members (9). Interviews were recorded, transcribed, coded, and analyzed using thematic analysis based on Braun and Clarke’s six-phase framework. An inductive, reflexive, constructivist approach was utilized in the analysis. Results: Five major themes were generated 1) Cannabis use: From early appeal to lasting harm; 2) Shifts in relationships mirror shifts in recovery; 3) When it comes to risk factors for psychosis, more is always more; 4) Clear as mud: Patients’ and families’ understanding of things that matter; and 5) The rocky road to recovery: From initial confusion to final healing. The final themes reflect mixed levels of understanding regarding the risks from both patients and family members. The study suggests that those who are more aware of the risks and implement changes to address them— such as quitting cannabis, developing stable and trustworthy relationships, and adopting a trauma-informed approach — seem to recover better than those who do not. Overall, the current study reflects that the literature might not always accurately translate into the lives of those affected, highlighting a need for clinical steps to address this gap in knowledge translation. Furthermore, the unanimous success of the EPIP clinic is clearly evident in all the patients and family members interviewed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.012 | 0.009 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".