The bumpy road of trauma-focused treatment: Posttraumatic stress disorder symptom exacerbation in people with psychosis.


Journal

Journal of traumatic stress
ISSN: 1573-6598
Titre abrégé: J Trauma Stress
Pays: United States
ID NLM: 8809259

Informations de publication

Date de publication:
04 2023
Historique:
revised: 29 11 2022
received: 02 08 2022
accepted: 29 11 2022
medline: 13 4 2023
pubmed: 1 2 2023
entrez: 31 1 2023
Statut: ppublish

Résumé

Concern for symptom exacerbation and treatment drop-out is an important barrier to the implementation of trauma-focused therapy (TFT), especially in people with a psychotic disorder. This study, which was part of a multicenter randomized controlled trial, investigated posttraumatic stress disorder (PTSD) symptom exacerbation during eye movement desensitization reprocessing (EMDR) therapy and prolonged exposure (PE) in a sample of 99 participants with PTSD and psychosis. Symptom exacerbations during the first four sessions (early exacerbation) and between-session exacerbations over the course of therapy were monitored using the PTSD Symptom Scale-Self Report. Analyses of covariance and chi-square tests were conducted to investigate exacerbation rates and their associations with treatment response and drop-out. Both early exacerbation and between-session exacerbation were relatively common (32.3% and 46.5%, respectively) but were unrelated to poor treatment response or an increased likelihood of treatment drop-out. Both clinicians and patients need to be aware that symptom exacerbation during TFT is common and not related to poor outcomes. Symptom exacerbation can be part of the therapeutic process, should be acknowledged and guided, and should not be a barrier to the implementation of TFT in people with psychosis.

Identifiants

pubmed: 36719408
doi: 10.1002/jts.22907
doi:

Types de publication

Randomized Controlled Trial Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

299-309

Informations de copyright

© 2023 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.

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Auteurs

Simone R Burger (SR)

Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department of Psychosis research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands.

Amy Hardy (A)

Institute of Psychiatry, Psychology, and Neuroscience; King's College London, London, United Kingdom.
South London & Maudsley NHS Foundation Trust, London, United Kingdom.

Tineke van der Linden (T)

Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department of Research and Innovation, GGzE Mental Health Institute, Eindhoven, the Netherlands.

Catherine van Zelst (C)

Department of Psychosis research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands.

Paul A J de Bont (PAJ)

GGZ Oost-Brabant Mental Health Institute, Boekel, the Netherlands.

Berber van der Vleugel (B)

GGZ Noord-Holland-Noord Mental Health Institute, Alkmaar, the Netherlands.

Anton B P Staring (ABP)

Altrecht Mental Health Institute, Utrecht, the Netherlands.

Carlijn de Roos (C)

Academic Centre for Child and Adolescent Psychiatry Levvel, Amsterdam University Medical Centre (location AMC), The Netherlands.

Ad de Jongh (A)

Behavourial Science Institute, Radboud Universiteit Nijmegen, the Netherlands.
PSYTREC Mental Health Institute, Bilthoven, the Netherlands.

Machteld Marcelis (M)

Department of Research and Innovation, GGzE Mental Health Institute, Eindhoven, the Netherlands.
Departement of Psychiatry and Neuropsychology, Maastricht University, the Netherlands.

Agnes van Minnen (A)

Behavourial Science Institute, Radboud Universiteit Nijmegen, the Netherlands.
PSYTREC Mental Health Institute, Bilthoven, the Netherlands.

Mark van der Gaag (M)

Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department of Psychosis research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands.

David P G van den Berg (DPG)

Department of Psychosis research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands.
Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Department of Behavioural Sciences, Amsterdam, the Netherlands.

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