Posttraumatic Stress Disorder (PTSD) is a highly prevalent and debilitating disorder. The first line treatment for PTSD is prolonged exposure (PE) therapy. Inhibitory learning theory proposes...Show morePosttraumatic Stress Disorder (PTSD) is a highly prevalent and debilitating disorder. The first line treatment for PTSD is prolonged exposure (PE) therapy. Inhibitory learning theory proposes threat expectancy violation as a strategy to enhance effectiveness of PE. No standardized instrument for the assessment of threat expectancies is currently available. The aim of the current study was to assess the psychometric properties of the TREE, a novel instrument to assess threat expectancies. The reliability and factor structure of the TREE were assessed in a non-clinical sample of 158 trauma-exposed individuals. The TREE showed excellent reliability and was found to consist of four subscales: 1. Fear of dying/losing control, 2. Externalizing symptoms, 3. Negative evaluation, 4. Internalizing symptoms. The reliability of all subscales was good with an internal consistency ranging from .75 to .85. The TREE allows clinicians to tailor exposure sessions to the individual threat appraisal profile of their patients. Furthermore, by making threat expectancies explicit, it can aid in further understanding the mechanisms underlying PE. The factor structure of the TREE should be confirmed and its generalizability to the non-clinical and clinical population should be corroborated in future research.Show less
Patients suffering from Posttraumatic Stress Disorder (PTSD) develop self-narratives that are ‘too rigid’ or ‘too coherent’. Narrative therapies are developed to make the self-narrative more...Show morePatients suffering from Posttraumatic Stress Disorder (PTSD) develop self-narratives that are ‘too rigid’ or ‘too coherent’. Narrative therapies are developed to make the self-narrative more flexible by re-telling it (Jongedijk, 2014). However, these therapies are not as effective as some other treatments for PTSD (American Psychiatric Association, 2017). This could be explained by using the hyperreflexivity model (Fuchs, 2011) which illustrates how patients suffering from anxiety, mood- and sleep disorders overly reflect on their life. Therefore, retelling the self-narrative during narrative therapy may rather stimulate the rigidity of the self-narrative than make the self-narrative more flexible. Traumatic events and PTSD symptoms, such as flashbacks, are often experienced in a sensorial and ‘wordless’ way. Therefore, the traumatic experience and symptoms could be treated better by using narratives that include conditions of embodiment (Menary, 2008). Literature on embodied and body narratives (Gallagher & Hutto, 2017) are discussed and applied to the standard concept of narrative therapies. It will be concluded that working with a novel concept of a self-narrative that includes conditions of embodiment leads to better results in the narrative treatments of PTSD.Show less
