Francine Shapiro Library

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1. van den Berg, D., & Staring, T. (2011, April). EMDR bij patiënten met psychosen, wie durft? [EMDR in patients with psychosis, who dares?]. Presentatie op de 5e jaarlijkse conferentie van EMDR Vereniging.

Language: Dutch

Format: Conference

Abstract:
Patiënten met psychosen hebben vaak ernstige trauma’s meegemaakt. PTSS is bij hen een van de meest voorkomende co-morbide stoornissen. De meeste therapeuten hanteren een psychotische stoornis echter als contra-indicatie voor EMDR. Tijdens deze presentatie tonen wij dat EMDR ondanks psychotische problematiek gewoon kan worden toegepast en dat dit slechts minimale aanpassingen vergt. Wij zetten daarna uiteen wat de verschillende toepassingsgebieden bij deze doelgroep zijn. EMDR kan namelijk niet alleen veilig en effectief toegepast worden bij psychosen met co-morbide PTSS, het kan ook een belangrijke rol hebben binnen CGT bij stemmen en wanen. Traumatische (leer)ervaringen zijn immers vaak betrokken bij het ontstaan van wanen en hallucinaties. Daarnaast liet recent onderzoek zien dat niet alleen retrospectieve targets behandeld kunnen worden met EMDR, maar ook situaties in de toekomst, de zogenoemde ‘flash forwards’. Dit is nuttig voor patiënten die herhaaldelijk geconfronteerd worden met stemmen of met situaties waarin paranoide gedachten worden getriggerd. Videomateriaal wordt getoond om de presentatie te ondersteunen. Tot slot is er aandacht voor obstakels in de toepassing van EMDR bij deze doelgroep. Aan het einde is er ruimte voor vragen en discussie.

Patients with psychoses often experienced severe trauma. PTSD is with them one of the most common co-morbid disorders. Most therapists use a psychotic disorder but as a contraindication to EMDR. During this presentation we demonstrate that EMDR despite psychotic problems can easily be applied and that it requires only minimal adjustments. We then set out what the different application of this target group. EMDR can not safely and effectively used in psychoses with co-morbid PTSD, it can also have an important role in CBT for voices and delusions. Traumatic (learning) experiences are often involved in the pathogenesis of delusions and hallucinations. In addition, recent studies showed that not only retrospective targets can be treated with EMDR, but also situations in the future, called "flash forwards". This is useful for patients who are repeatedly confronted with situations in which voices or paranoid thoughts are triggered. Video material is shown to support the presentation. Finally, consideration of obstacles in the application of EMDR with that audience. At the end there is room for questions and discussion.

Keywords: Pyschosis  

Accuracy Verified: Yes

2. van den Berg, D. P. G. (2011, August-September). EMDR in patients with psychotic disorders and PTSD: A pilot study. In PTSD in patients with psychotic disorders. Symposium conducted at the 41st EABCT Annual Congress, Reykjavík, Iceland.

Language: English

Format: Conference

Abstract:
Introduction: Mueser at al. (2008) showed that a treatment program that was predominantly based on cognitive restructuring was effective and safe in treating PTSD in patients with Serious Mental Illness. However, only 15.7% of the participants in this study had a psychotic disorder. Frueh et al. (2009) conducted a pilot study into PTSD treatment in patients with schizophrenia and schizoaffective disorders (n=20). At three month follow-up twelve out of thirteen completers no longer met criteria for PTSD. Treatment caused no adverse events. Unfortunately psychosis measures were not included in this study. A third therapy with strong empirical support for its efficacy in treating PTSD is Eye Movement Desensitization and Reprocessing (EMDR, Bisson et al., 2007; Bradley, Greene, Russ, Dutra, & Westen, 2005; Seidler & Wagner, 2006). In this presentation the results of a feasibility trial (n=27) of EMDR in patients with psychosis and comorbid PTSD will be presented. Method: An open pilot trial of EMDR in treating PTSD symptoms in participants with a diagnosis of schizophrenia or an other psychotic disorder. Participants were all outpatients from community mental health centres in the Netherlands. After referral to the study patients were screened for PTSD with the Clinician Administered PTSD Scale (CAPS, Blake et al., 1990). If PTSD was diagnosed baseline measurements were performed after which an informed consent was obtained. Treatment consisted of a maximum of six weekly EMDR sessions, after which post measurements were taken. Results: EMDR was effective in alleviating PTSD symptoms. Out of the 25 completers, only 7 still met criteria for PTSD at post measurement. Treatment did not result in adverse events. In fact, other symptoms, such as delusions, auditory verbal hallucinations, anxiety and depression decreased significantly, e.g. only four out of the nine participants that reported voices at baseline still reported voices at end of treatment. Conclusions: The preliminary conclusion is that treating PTSD in patients suffering from psychosis with EMDR is feasible, is safe and has a positive influence on other symptoms.

Keywords: Pilot Study  Postraumatic Stress Disorder  PTSD  Psychotic Disorders  Symposium  

Accuracy Verified: Yes

3. van der Berg, D., van der Vleugel, P., & de Bont, P. (2013, June). How to treat trauma in psychosis. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland.

Language: English

Format: Conference

Abstract:
Research shows that the majority of people with hallucinations or delusions have been the victimized during childhood. Experiencing childhood trauma triples the chance of psychosis in adulthood. Cognitive research shows that negative basic ideas about self and others are important mediators of the relationship between trauma and psychosis. Paranoia appears to be related to childhood interpersonal victimisation and emotional neglect and auditory verbal hallucinations are strongly linked to childhood sexual abuse.
EMDR can be used to desensitize traumatic experiences that keep intruding into awareness with strong negative emotional valence (first method) and to target experiences that have led to negative core beliefs about self and others (second method). We have developed a model for implementing the two method approach of EMDR in a broader cognitive behavioural therapy for psychosis. The rationale of this model will be shown and conceptualizing EMDR for psychosis will be practiced. Clinical vignettes will be shown to illustrate EMDR for psychosis.
Learning objectives: Know that trauma influences psychotic symptoms, Understand how EMDR can influence paranoia and hallucinations, and Be able to conceptualize EMDR for these symptoms

Keywords: Psychosis  

Accuracy Verified: Yes

4. Liggan, D. Y., & Kay, J. (1999, Spring). Some neurobiological aspects of psychotherapy:  A review. Journal of Psychotherapy Practice and Research, 8(2), 103-114.

Language: English

Format: Journal

Abstract:
Ever since the idea was accepted that memory is associated with alterations in synaptic strength, studies on the cellular and molecular mechanisms responsible for the plastic changes in neurons have attracted wide interest in the scientific community. This article explores the process of memory consolidation leading to persistent modifications in synaptic plasticity as a mechanism by which psychotherapy facilitates changes in the permanent storage of information acquired throughout the individual's life. The psychobiological interrelationships of affect, attachment, and memory offer a perspective regarding the etiology and treatment of clinical disturbances of affect. Analogies between brain physiology and modes of psychotherapy provide the foundation for a review of psychiatric disorders involving the inability to control fear, obsessions, compulsions, and delusions, all of which respond to psychotherapeutic interventions.

Keywords: Brain Physiology  Compulsions  Delusions  Fear  Modes of Psychotherapy  Obsessions  

Accuracy Verified: Yes

5. van den Berg, D. P. G., & van der Gaag, M. (2012, June). Treating trauma in psychosis with EMDR: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 664-671. doi:10.1016/j.jbtep.2011.09.011.

Language: English

Format: Journal

Abstract:
Background: Initial studies have shown that posttraumatic stress disorder (PTSD) can be effectivelytreated in patients with a psychotic disorder. These studies however used adapted treatment protocols, avoided direct exposure to trauma related stimuli or preceded treatment with stabilizing techniques making treatment considerably longer in duration. Method: An open trial in which adult subjects with a psychotic disorder and a comorbid PTSD (n = 27) received a maximum of six Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions. PTSD symptoms, psychotic symptoms and additional symptoms were assessed at baseline and end-of-treatment. Results: The dropout rate was 18.5 percent (five subjects). Only five of the twenty-two completers (22.7%) still met criteria for PTSD after treatment. PTSD symptoms, auditory verbal hallucinations, delusions, anxiety, depression, and self-esteem all improved significantly. Paranoid ideation and feelings of hopelessness did not improve significantly. Treatment did not lead to symptom exacerbation in subjects. There were no adverse events, such as suicide attempts, self-mutilation, aggressive behavior or admission to a general or psychiatric hospital. Conclusions: This pilot study shows that a short EMDR therapy is effective and safe in the treatment of PTSD in subjects with a psychotic disorder. Treatment of PTSD has a positive effect on auditory verbal hallucinations, delusions, anxiety symptoms, depression symptoms, and self-esteem. EMDR can be applied to this group of patients without adapting the treatment protocol or delaying treatment by preceding it with stabilizing interventions.

Keywords: Auditory  Delusions  Pilot  Posttraumatic Stress  PTSD  Psychosis  Psychotic Disorder  Self-Esteem  Treatment  Verbal Hallucination  

Accuracy Verified: Yes