Background: Intensified Prolonged Exposure (iPE) therapy has proven its efficacy in reducing PTSD symptoms. However, its effectiveness in naturalistic settings and underlying mechanisms of action...Show moreBackground: Intensified Prolonged Exposure (iPE) therapy has proven its efficacy in reducing PTSD symptoms. However, its effectiveness in naturalistic settings and underlying mechanisms of action are still under investigation. Objective: The current study investigates the effectiveness of iPE in reducing PTSD symptoms in a naturalistic setting. Additionally, the role of trauma-related maladaptive cognitions in predicting changes in PTSD symptoms was examined, thereby testing the cognitive model of PTSD. Methods: The study is based on anonymous data provided by the LUBEC mental health care facility in Leiden, following the iPE procedure outlined by Oprel et al. (2017). Patients with PTSD received 12 sessions of iPE administered over four weeks and two booster sessions at one-month intervals. Assessment of PTSD symptoms, including maladaptive cognitions, was conducted using the PCL-5 questionnaire at eight measurement time points: before the beginning of the treatment (baseline), during each of the four weeks of active treatment, after the two monthly booster sessions, and three months after the end of the treatment (end evaluation). Results: data of 58 participants was included in the study. The treatment resulted in a large improvement in PTSD symptoms, with 43.1% of the patients showing a clinically significant change in symptoms. Maladaptive trauma-related cognitions significantly decreased throughout the course of treatment. In contrast with expectations, preceding changes in maladaptive cognitions did not predict changes in PCL-5 score, while preceding changes in PCL-5 score predicted later changes in maladaptive cognitions. Conclusion: iPE is effective in reducing PTSD symptoms and maladaptive cognitions in a naturalistic setting. Preceding decrease in PTSD symptoms predicts a decrease in trauma-related cognitions; conversely, changes in cognitions do not impact later PTSD symptoms severity.Show less
Background: Childhood maltreatment is a serious issue, leading to posttraumatic stress disorder (PTSD) and eating disorder (ED) symptoms. A proposed mediator is intolerance of uncertainty (IU),...Show moreBackground: Childhood maltreatment is a serious issue, leading to posttraumatic stress disorder (PTSD) and eating disorder (ED) symptoms. A proposed mediator is intolerance of uncertainty (IU), composed of inhibitory and prospective IU, which are differentially related to different symptom profiles. Preliminary research shows that inhibitory IU is associated with PTSD symptoms, while prospective IU with ED symptoms. However, these mechanisms have been scarcely studied, and even less so in relation to childhood maltreatment, which the current study aims to do. Methods: This cross-sectional, self-report study used a non-clinical community sample (N = 413), to assess whether inhibitory and prospective IU differentially mediate childhood maltreatment, PTSD and ED symptoms using scores on IUS-12, CTQ-SF, PCL-5, and EDEQ-SF. Two mediation analyses were done with childhood maltreatment as predictor, inhibitory and prospective IU as parallel mediators and PTSD, respectively ED symptoms as outcomes. Results: Childhood maltreatment was significantly positively associated with PTSD and ED symptoms, and both inhibitory and prospective IU. Only inhibitory IU was further significantly positively associated with PTSD and ED symptoms. Thus, inhibitory IU is a partial mediator between childhood maltreatment and both PTSD and ED symptoms, while prospective IU is not, partly supporting our hypotheses. Conclusion: Histories of childhood maltreatment facilitate an attentional bias to threat and fear of uncertainty. Trauma-related symptoms are alleviated through cognitive avoidance and the fear of uncertainty leads to action paralysis. PTSD and ED symptoms therefore develop and are maintained through inhibitory IU. Clinical interventions should tackle this aspect of IU in maltreated populations.Show less
Violence against women is a persistent problem with deleterious consequences, such as the onset and maintenance of post-traumatic stress disorder (PTSD). There is still little evidence-based...Show moreViolence against women is a persistent problem with deleterious consequences, such as the onset and maintenance of post-traumatic stress disorder (PTSD). There is still little evidence-based research done on the effects of peer support for people with symptoms of PTSD that have experienced domestic violence. Consequently, it is of great clinical interest to investigate if peer support groups are beneficial for this subgroup. This study investigated whether peer support groups are an effective treatment for reducing PTSD symptoms by increasing hopefulness among women who have experienced abuse. Thirteen female participants (Mage = 37.54 years at baseline) attended ten sessions of peer support groups led by an experience expert and completed questionnaires at a pre-measurement and a post-measurement. The methods used in this study were the Life Events Checklist, PTSD checklist for DSM-5, adult hope scale, and childhood trauma questionnaire. We found a reduction in the severity of PTSD symptoms (for intrusion symptoms and negative changes in cognitions and mood) and an increase in hopefulness after participation in the peer support sessions. This increase was seen for both participants' goal orientation and their ability to make plans to achieve their goals. Although we expected a relationship between PTSD symptomology and hopefulness, this was not found. The findings from this study suggest that peer support groups may be a beneficial addition for women with PTSD symptoms who are not in treatment (yet) or have tried established PTSD treatment.Show less
Background: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any...Show moreBackground: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any research that examines the comorbidity rate of PTSD in non-BPD personality disorders (PDs). Knowledge about all clusters of PDs in terms of comorbid PTSD is needed in order to generate a more detailed clinical picture of PDs. Aims: This study is primarily designed to investigate the point-prevalence of comorbid PTSD in clinical practice and, in addition, to explore to what extent the point-prevalence of comorbid PTSD differs between BPD and non-BPD PD patients and gender. Secondly, this study also investigates whether the amount of comorbid disorders is predicted by BPD (versus non-BPD PDs), PTSD and/or gender. Methods: For this retrospective study, data of 183 PD patients was used. During the intake process, the PD diagnosis and comorbid psychiatric disorders were examined using The Structured Clinical Interview for DSM-V and The Mini International Neuropsychiatric Interview Plus. Results: The point-prevalence rates of comorbid PTSD in this non-BPD PD sample is 12.7% and in this BPD sample is 23.1%. Additionally, there was no difference in likelihood of comorbid PTSD in BPD and non-BPD PD patients and between gender. Furthermore, BPD (versus non-BPD PDs), PTSD and gender did not predict the amount of comorbid disorders. Conclusions and implications: The results indicate that in clinical practice, comorbid PTSD and other comorbid disorders might not be recognized so often and thus might be underdiagnosed in PD patients. Hence, there must be more sensitivity in clinical practice for the recognition of comorbid PTSD and other comorbid disorders in PD patients.Show less
Research master thesis | Psychology (research) (MSc)
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Patients that suffer from posttraumatic stress disorder (PTSD) may respond less well to existing PTSD therapies if their PTSD was caused by childhood trauma. A relatively novel treatment, Narrative...Show morePatients that suffer from posttraumatic stress disorder (PTSD) may respond less well to existing PTSD therapies if their PTSD was caused by childhood trauma. A relatively novel treatment, Narrative Exposure Therapy (NET), has shown promising outcomes for refugee and veteran PTSD patients that suffered from multiple and continuous trauma, as is often the case for those with childhood trauma-related PTSD (CTR-PTSD). We aimed to investigate whether NET could be effective for the treatment of CTR-PTSD. Methods: We followed the treatment trajectories of nine adult CTR-PTSD patients in an outpatient setting. A non-concurrent multiple baseline design was used, with a baseline of 4 weeks before treatment started. Participants responded to weekly online questionnaires that assessed their PTSD symptoms (i.e., the Posttraumatic Diagnostic Scale; PDS) and their experienced quality of life (QOL; i.e. the Manchester Short Assessment of quality of life; MANSA). Data were analyzed using visual inspection and a mixed model analysis. Results: Results revealed no significant reduction of PTSD symptoms during NET treatment, nor an increase in QOL, as compared to baseline. Of the nine participants, one lost her PTSD diagnosis after treatment with NET. During the procedure, several participants dropped out due to medical, practical or unknown reasons. Conclusion: Results of this study indicate that NET is not effective for the treatment of CTR-PTSD, in contrast to previous literature.Show less
