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
Background: Suicidality is precipitated by a variety of mental vulnerabilities. There has been a dearth in knowledge about the interactions between psychological variables that can jeopardise...Show moreBackground: Suicidality is precipitated by a variety of mental vulnerabilities. There has been a dearth in knowledge about the interactions between psychological variables that can jeopardise university students into becoming suicidal. Aim: By exploring these interactions cross-sectionally using network analysis, this study sought to deduce risk profiles for student suicidality from 464 university students with self-reported mood and stress problems. Methods: Suicidality and clinical risk factors such as depression, anxiety, and posttraumatic stress were assessed using 13 self-report questionnaires. Interactions between those variables were analysed via connectivity and centrality indices in 114 and 74 participants identified at high risk for suicidal thoughts and suicidal attempts, respectively. Results: Symptoms of depression, posttraumatic stress, and anxiety displayed large interconnections in either centre. Perceived burdensomeness connected heavily with suicide thoughts and subjective symptoms of depression. Study-related stressors demonstrated centrality only at risk for suicide attempts. Conclusions: Suicide prevention programs for university students may benefit from targeting critical interactions between mental vulnerabilities for suicidality. Suicidal thoughts may be influenced especially by affecting perceived burdensomeness. Changes in depression may be crucial for achieving effects on perceived burdensomeness, posttraumatic stress, and anxiety.Show less
BACKGROUND: Child maltreatment is a global health problem affecting children across the globe, that can result in serious impairments in later life, taking the form of serious psychological...Show moreBACKGROUND: Child maltreatment is a global health problem affecting children across the globe, that can result in serious impairments in later life, taking the form of serious psychological disorders or impoverished social skills. Empathy belongs to one of these fundamental skills. The current study aims to replicate previous findings that childhood maltreatment history is associated with lower empathy levels. Generally, research distinguishes between affective and cognitive empathy. Hence, this study explores possible differences in impact of child maltreatment history on cognitive versus affective empathy. METHOD: This cross-sectional design involved 218 healthy participants between 18 and 79 years of age. To assess child maltreatment, the Dutch version of the Childhood Trauma Questionnaire (CTQ) was used. The Interpersonal Reactivity Index (IRI) and the Multifaceted Empathy Test (MET) were used to assess both cognitive and affective empathy. The sample was divided into maltreated and non-maltreated participants, by applying cut-off scores, and where compared with multivariate ANOVAs on MET mean arousal level, MET total accuracy, perspective taking (PT), empathic concern (EC), fantasy (FS) and personal distress (PD). RESULTS: The present study failed to replicate previous findings of associations between child maltreatment and lowered empathy. Furthermore, a difference in impact on the two forms of empathy was not identified. However, after the exclusion of outliers, an indication was found for impaired cognitive empathy in individuals with maltreatment history. DISCUSSION: The present study shows that possible selective effects of child maltreatment on either cognitive or affective empathy may exist. Knowing how maltreatment differentially affects individuals in later adulthood, can help to optimize both prevention measures as well as treatments dealing with the consequence of child maltreatment, e.g. individual training focusing on either type of empathy. Limitations of the present study are discussed.Show less
Suicide is the second leading cause of death among university students. Insomnia symptoms have been established as a risk factor for suicidal ideation and feelings of thwarted belongingness have...Show moreSuicide is the second leading cause of death among university students. Insomnia symptoms have been established as a risk factor for suicidal ideation and feelings of thwarted belongingness have been proposed to explain the link between insomnia symptoms and suicidal ideation. The purpose of this study was to investigate the association between insomnia symptoms and suicidal ideation, with thwarted belongingness mediating the relationship, in a sample of Dutch university students. The study assessed participants crosssectionally (n = 218) and after six months (n = 83). Participants completed the Insomnia Severity Index, Beck Scale for Suicide Ideation, the Interpersonal Needs Questionnaire, Beck Depression Inventory, and the Beck Anxiety Inventory. Logistic regression and mediation analyses were conducted. Symptoms of depression and anxiety were controlled for. Crosssectionally, insomnia symptoms were significantly associated with suicidal ideation. When adjusting for symptoms of depression and anxiety, the association became nonsignificant and only symptoms of depression emerged as an independent predictor. Thwarted belongingness mediated the relationship between insomnia symptoms and suicidal ideation cross-sectionally. When depressive symptoms were controlled for, the mediation model became nonsignificant. Longitudinally, results suggested no predictive effect of insomnia symptoms on suicidal ideation and no mediation effect of thwarted belongingness on the relationship. The results did not support insomnia symptoms as an independent risk factor for suicidal ideation in university students, which underscores the need for more rigorous research to clarify this relationship for the future.Show less
