Publicaties

Intensive trauma-focused treatment programmes including prolonged exposure, EMDR therapy, and physical activity can be effective for patients suffering from severe PTSD and are associated with low dropout rates.

The results are supportive of the notion that the majority of patients classified as having CPTSD strongly benefit from an intensive trauma- focused treatment for their PTSD.

Either with additional physical or non-physical activities, intensive TFT is very effective for the treatment of (Complex) PTSD, as reflected by large effect sizes and loss of diagnostic status in both groups.

Dissertation: E. M. Voorendonk.
Promotors: A. van Minnen, A. de Jongh.
Co-promotor: S. Sanches. Radboud University, March 15 th , 2024.

The first aim was to further understand whether trauma-focused treatment options could be optimized by intensifying the delivery of trauma-focused treatment. The second aim was to evaluate the additive value of physical activity in the intensive trauma-focused treatment of (C)PTSD. The third aim was to gain a deeper understanding of the possible mechanisms underlying the effects of physical activity on PTSD symptoms.

In this paper, we present a theoretical framework for this treatment approach, based on Shapiro’s Adaptive Information Processing (AIP) model, describe its current empirical basis, and provide guidance on how to formulate a useful case conceptualization that can serve as a basis for the treatment of personality disorders with EMDR therapy. This approach is illustrated with a case example.

In this paper, we present a theoretical framework for this treatment approach, based on Shapiro’s Adaptive Information Processing (AIP) model, describe its current empirical basis, and provide guidance on how to formulate a useful case conceptualization that can serve as a basis for the treatment of personality disorders with EMDR therapy. This approach is illustrated with a case example.

These findings support the potential effectiveness of mifepristone in the treatment of patients with treatment-resistant PTSD. However, our findings must be interpreted with caution, and further studies with larger sample sizes and more rigorous designs are necessary to confirm the promising results.

Psychometric Evaluation of the Dutch International Trauma Questionnaire for the 11th Revision of the International Classification of Diseases Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder.

Internal consistency and convergent validity for the ITQ-12 and ITQ-28 were supported. The factorial validity was good for the ITQ-12 and acceptable for the ITQ-28. The discrepancy in Complex PTSD rates between the ITQ-12 and ITQ-28 calls for further testing of scoring methods against diagnostic clinical interviews for Complex PTSD.

The results of the current study suggest that dissociation-related beliefs do not influence the outcome of trauma-focused treatment, and that trauma-focused treatment does not need to be altered specifically for patients experiencing more dissociation-related beliefs about memory because these beliefs decrease in association with treatment.

The results support the notion that brief, intensive trauma-focused treatment is highly effective for individuals with PTSD and comorbid MDD. Because patients with CPTSD are vulnerable to relapse in depressive symptoms, this target group may require additional treatment.

The results of this uncontrolled study suggest that intensive treatment for PTSD can have beneficial effects on sexual satisfaction and desire in both men and women; however, this may not necessarily be due to a decrease in PTSD symptoms.

The findings of this study, which is the first to examine the effects of psychotherapeutic treatment of PTSD on the presence of a borderline personality disorder one year after treatment, add support to the notion that a brief intensive trauma-focused treatment can be a valuable option for individuals suffering from both PTSD and BPD.

Patients with severe PTSD are more likely to experience painful TMD, AB or SB, whereas type of traumatic event can be of influence. These findings can contribute to selecting appropriate treatment modalities when treating patients with painful TMD, AB and SB.

Victim-perpetrator confrontation using deepfake technology is a promising intervention to influence moral injury- related symptoms in victims of sexual violence. Deepfake technology may also show promise in simulating other interactions between persons involved in morally injurious events.

This study will contribute to the research field of augmentation strategies for PTSD treatment by investigating the effectiveness of physical activity added to intensive TFT.

These results add further support to the notion that the presence of strong somatoform dissociative symptoms in patients with PTSD does not necessarily call for a different treatment approach. Clinical implications are discussed.

These results could further guide interventions for patients with PTSD by taking sequence into account when combining single physical activity and PE sessions in clinical practice.

These results indicate that individuals displaying higher CRF are less prone to develop traumatic memory intrusions. Future studies may want to investigate whether promoting fitness prior to possible trauma exposure can boost resilience against the development of debilitating re- experiencing symptoms of PTSD.

This new treatment model for DID-patients is promising but results should be interpreted cautiously since we described only one patient.

The results suggest that intensive trauma-focused treatment is applicable for older adults with PTSD with a large within- effect size comparable to younger participants. Further research on age- related features is needed to examine whether these results can be replicated in the oldest-old (>80).

The results suggest that intensive, trauma- focused treatment of severe or Complex PTSD delivered via home- based telehealth is feasible, safe and effective, and can be a viable alternative to face- to-face delivered intensive trauma-focused treatment.

The results support the notion that the severity of emotion regulation difficulties is not associated with worse trauma-focused treatment outcomes for PTSD nor with relapse after completing treatment. Further, emotion regulation difficulties improved after trauma-focused treatment, even for individuals who had been exposed to early childhood sexual trauma and individuals with dissociative subtype.

The results of this explorative study are supportive of the notion that PE and EMDR therapy can be successfully combined, and that sequence matters. First applying PE sessions before EMDR sessions resulted in better treatment outcome, and better subjective patient's evaluations in terms of treatment helpfulness and preference.

The results suggest that an intensive trauma- focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.

The results provide no support for the notion that the presence of DS negatively impacts trauma-focused treatment outcomes. Accordingly, PTSD patients with DS should not be denied effective trauma-focused treatments.

The results suggest that an intensive trauma- focused treatment is a feasible and safe treatment for PTSD patients with clinically elevated symptoms of BPD, and that BPD symptoms decrease along with the PTSD symptoms.

Although individuals with PTSD may show an increase in CRF following an intensive TFT programme augmented with physical activity and a decrease of PTSD- symptoms, the current findings do not support the notion that treatment outcome is related to CRF.

The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma- focused treatments for PTSD.

We suggest that therapist rotation is a promising novel approach to improve implementation of TFT for PTSD.

The results of this case series suggest that an intensive program using EMDR therapy is a potentially safe and effective treatment alternative for complex PTSD. The application of massed, consecutive days of treatments using EMDR therapy for patients suffering from PTSD, particularly those with multiple comorbidities, merits more clinical and research attention.

The result supports the notion that intensive, trauma-focused treatment is feasible, safe and associated with a large decrease in PTSD and Complex PTSD symptoms, even when it is brief, and applied fully remote.