First episode psychosis and psychological development in young adulthood

Despite the consistent emergence of a psychotic illness during late adolescence and young adulthood, attempts to understand first episode psychosis and psychological disturbances and needs have historically neglected this rich developmental context. When present, disturbances in a young adults' psychological functioning are likely to interfere with the successful negotiation of age-appropriate tasks and complicate the recovery process following a first episode of psychosis. The current study sought to identify developmentally significant and clinically meaningful disturbances in the psychological functioning of young adults recovering from a first episode of psychosis. To accomplish this goal, 27 young adults who were recovering from a first episode of psychosis were compared to 27 young adults whose upward developmental growth trajectory had not been disrupted by psychosis on measures investigating sense of interpersonal relatedness and self-definition, parent representations, and depressive symptoms. Associations between illness characteristics and the various measures of psychological functioning were also examined. Results suggest that the young adults recovering from a first episode of psychosis are more likely to expect and fear rejection in interpersonal encounters, experience difficulties in peer relationships, lack balance in a sense of self and other, feel engulfed and controlled by parents, internalise parent representations characterised by less warmth and slightly more overprotection, and endorse depressive symptoms. Depressive symptoms appear to significantly contribute to expectations of rejection and callousness, and parent representations characterised by less warmth and care. Age of illness onset appears to demonstrate stronger relationships with several disturbances in psychological functioning than does duration of untreated psychosis. Findings of this study are considered in terms of implications for future research, developmental theory, and clinical practice. Early psychosis programs are urged to incorporate psychological interventions that foster positive self-development, the establishment of healthy peer relationships, individuation from parents, and mature identity formation.