We still have limited knowledge about why some therapists outperform others. This may be due to our little understanding about which variables predict higher facilitative interpersonal skills (FIS)...Show moreWe still have limited knowledge about why some therapists outperform others. This may be due to our little understanding about which variables predict higher facilitative interpersonal skills (FIS). With the aid of a Pearson correlation analysis, we aimed to determine whether therapists with higher self-efficacy (GSE) were more likely to perform better in the FIS-task. Previous literature that has analysed self-efficacy’s effect on performance is contradictory and incomplete in the therapist population. We also still have little understanding on whether and to what extent therapists’ physiological arousal impacts their performance. Hence, we also aimed to determine whether skin conductance mediated the relationship between therapists’ self-efficacy and their FIS-scores. In this randomised, counterbalanced study, 74 therapists filled in the general self-efficacy scale (GSE-S) and participated in the FIS-task, which measured their verbal and non-verbal behaviours while responding to pre-recorded video clips of benign and difficult client case stories. Inconsistent with a priori expectations, our results revealed that in the challenging condition, therapists with higher GSE performed worse in the FIS-task. Furthermore, skin conductance did not mediate the relationship between therapists’ self-efficacy and their FIS-performance. We suggested the possibility of an inverted U-model relationship between GSE and therapists’ FIS-scores, and the importance of including more therapists with low GSE in future replications. We also addressed several limitations in our study, which if remedied, hold promising prospects for future investigations regarding the effect of therapists’ self-efficacy and physiological arousal on therapists’ performance.Show less
Background: A common consequence after a traumatic injury is the development of a depressive disorder and one of the known risk and protective factors are the coping styles used to control the...Show moreBackground: A common consequence after a traumatic injury is the development of a depressive disorder and one of the known risk and protective factors are the coping styles used to control the distress. Objective: The aim of this study was to examine the predictive value of the use of passive and active coping styles on the development of depressive symptoms within the first year after trauma. It also aimed to assess potential gender differences within this association. Methods: 556 traumatic injury patients participated in the study. They were recruited from two academic hospitals in NL completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) and the Utrechtse Coping Lijst (UCL) questionnaire at T2. The UCL contained the active coping styles Active Approach, Social Support, Emotional Expression and Reassuring Thoughts and the passive coping styles Palliative Reaction, Avoidance Behaviour and Passive Reaction Pattern. Linear Mixed Models were used to analyse the data. Results: Greater use of Emotional Expression style predicted higher overall depressive symptoms. Greater use of Avoidance Behaviour and Passive Reaction Pattern predicted higher overall depressive symptoms and Palliative Reaction predicted lower depressive symptoms over time. A higher score on Active Approach significantly predicted lower depressive symptoms specifically for men. Conclusions: Different effects have been found in men and women for active coping styles. Most passive coping styles create a risk factor for depressive symptom severity regardless of gender. Implications entail risk monitoring and possible training interventions. Inconsistent results make implementation of intervention strategies difficult.Show less
This study investigates the results of a high intensive residential trauma-focussed therapy programme. The main hypotheses were that (1) PTSD patients with a history of CSA report a clinically...Show moreThis study investigates the results of a high intensive residential trauma-focussed therapy programme. The main hypotheses were that (1) PTSD patients with a history of CSA report a clinically significant decrease in their PTSD symptoms after treatment, and (2) PTSD patients with a history of CSA would profit equally from trauma-focused treatment as PTSD patients without a history of CSA. Methods: Patients were 76 individuals who participated in a five-day treatment program consisting of eye movement desensitization and reprocessing (EMDR), prolonged exposure (PE) sessions, and trauma-sensitive yoga. The severity of PTSD symptoms was assessed with the PCL-5 at pre- and post-treatment, at one-week follow-up, and at a one-month follow-up. Pre-post differences were calculated and compared between the two trauma conditions (i.e., patients with a history of CSA, and no CSA). Results: Treatment resulted in a significant short term decrease of PTSD symptoms, which was mostly maintained at follow-up. Although patients with a history of CSA showed significantly higher PTSD symptom severity at pre- and post-treatment compared to those without a history of CSA, no significant pre-post differences were found between the two groups. Longer term decrease in PTSD symptoms was significant for patients without a history of CSA, but was not strong enough to be significant for patients with a history of CSA. Clinical significance of the treatment was demonstrated for half of the participants. Conclusion: Results suggest that intensive treatment for PTSD might be a possible therapeutic option for PTSD patients with a history of CSA.Show less
Physical pain and error processing have indicated a neurophysiological overlap. They both activate the anterior cingulate cortex (ACC) through which is originated the error-related negativity (ERN)...Show morePhysical pain and error processing have indicated a neurophysiological overlap. They both activate the anterior cingulate cortex (ACC) through which is originated the error-related negativity (ERN), a reflection of error sensitivity. Thus, our research was based on the hypothesis that people who are more sensitive to one type of alarm - pain - might also be more sensitive to a different kind of alarm signal - errors. Impulsivity was also investigated, since it has been related to the same neural network, and small ERN amplitudes have been linked to high rates of impulsiveness in reaction-time tasks, indicating dysfunctional inhibitory learning. Healthy volunteers (N = 65, mean age = 20.3 years), performed the Error Responsibility task, a variant of the Eriksen Flanker task, during EEG data recording, and filled in the Barratt Impulsiveness Scale (BIS-11) and the Pain Sensitivity Questionnaire (PSQ). No significant relation was found between pain and error sensitivity. Attention impulsiveness was significantly associated with ERN and pain sensitivity. The absence of the neural shared sensitivity might not be warranted due to the measurement of pain only with a self-report questionnaire. Notably, it was replicated that highly impulsive people show reduced ERN, indicating inefficient error processing. Future studies could research whether the type of instrument for pain measurement influences the depiction of a common sensitivity between pain and error processing. Lastly, the results regarding impulsivity could assist existing treatment guidelines for clinical populations that lack inhibition control, being at risk of adopting dangerous methods to heal painful experiences.Show less
People with social anxiety symptoms (SAS) have an inflated sense of responsibility towards the mistakes that might cause them embarrassment or humiliation. This event-related potential (ERP) study...Show morePeople with social anxiety symptoms (SAS) have an inflated sense of responsibility towards the mistakes that might cause them embarrassment or humiliation. This event-related potential (ERP) study examined individual differences in SAS in social performance monitoring through focusing on the role of perceived responsibility in error-related negativity (ERN) and error positivity (Pe). Healthy volunteers with low (N = 22), specific (N = 26), or generalized (N = 17) SAS took part in the study. Participants completed a Flanker task under the observation of a co-actor in three conditions where their errors resulted in one of the following negative monetary consequences: no harm, harm to oneself, or harm to the other. Behavioural findings suggested an opposite direction of responding to errors between two groups where the low showed more impulsive response patterns, while the specific one showed a cautious one. Moreover, ERP results showed no group differences and unaffected ERN and Pe across conditions. However, an exploratory analysis comparing only generalized and low SAS groups showed that people with generalized SAS displayed enhanced ERNs when they were responsible for other’s compared to their own bonus, but not after controlling for OCD symptoms. These findings suggest that inflated sense of responsibility in generalized SAS is more relevant to situations that involve responsibility towards others compared to oneself. The study also highlights the need for investigating the impact of perceived responsibility in social performance monitoring of people with SAS, but then by explicitly focusing on mistakes that trigger embarrassment.Show less
Background: Early studies show promising evidence for the feasibility and effectiveness of intensive Trauma-Focused Therapy (TFT) programs for patients with Posttraumatic Stress Disorder (PTSD)....Show moreBackground: Early studies show promising evidence for the feasibility and effectiveness of intensive Trauma-Focused Therapy (TFT) programs for patients with Posttraumatic Stress Disorder (PTSD). Little is known about the most effective treatment formats with regard to the therapy dose and frequency. The current study examines the effects of the High Intensive Trauma-focused Therapy (HITT) on the feasibility, tolerability, safety, and symptom outcomes. Methods: A Pragmatic Clinical Trial (PCT) was conducted with 16 treatment-resistant patients with PTSD who failed to respond sufficiently to previous treatment. The HITT treatment consisted of two five-day inpatient programs with Eye Movement Desensitization and Reprocessing, exposure, and trauma-sensitive yoga. Primary outcome was measured with the PCL-5 at the beginning and end of both HITT-weeks (T1 to T4). Clinically Significant Changes (CSC) and Reliable Change Indexes (RCI) were calculated. Results: No patients dropped out of treatment and no symptom exacerbations or adverse effects occurred. RCI and CSC from T1 to T4 showed that four patients recovered, two patients improved, and ten patients remained unchanged after treatment. The corresponding effect size on the PCL-5 between T1 and T4 was large (Cohen’s d = 0.88). Conclusions: Results demonstrated that the HITT-program was feasible, tolerable, and safe for all treatment-resistant patients and beneficial for six of these patients. Randomized controlled trials are needed to replicate these results and study the effectiveness of this treatment to further improve TFT formats. Also, future research is necessary to early select treatment-resistant patients who benefit from treatment to develop more cost- and time-effective treatments.Show less
