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1. Miller, P. W., McDougall, I., O'Rawe, B., & Kirk, R. T. (2007, June). A case series detailing phenomenology, EMDR protocol and clinical outcome of EMDR in severe depression with psychosis, delusional dysmorphobia and schizophrenia. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
The author will by means of oral presentation of clinical case material from patients seen as outpatients; didactic teaching and 'question and answer' explore the efficacy demonstrated by EMDR in a series of patients with disorders including ‘depression, severe with psychosis'; delusional dysmorphophobia and schizophrenia.
There will be detailed description and presentation of case studies. The author will present and discuss clinical cases seen by them and another colleague where EMDR has been used in patients preventing to their facility with ‘depression, severe with psychosis;' delusional dysmorphophobia and schizophrenia.
The author will explore the phenomenology of the case material and discuss how it potentially relates, diagnostically, to the utility of EMDR in such cases. Particular mention will be made of the role EMDR had within the overall treatment plan of these cases and discussion of potential indicators that will aid appropriate targeting of cases for EMDR will be made.
A detailed description of how to apply EMDR protocol in monosymptomatic delusional disorder, including delusional dysmorphophobia will be given. This will include discussion of the use of Floatback; explore the use of affect bridge and the possible role of the unconscious or repressed material in the development of psychotic phenomena.
As patient with psychotic phenomena are often on one if not several psychoactive medications, the author will discuss the impact of EMDR on drug therapy in this group of patients with: schizophrenia, depression, severe with psychosis and delusional dysmorphophobia, illustrating the points from the case material. They will also look at the possible effect of medication on the efficacy of EMDR in this client group.

Keywords: Delusional Dysmorphobia  Depression  Personality Disorders  Phobias  Psychosis  Schizophrenia  

Accuracy Verified: Yes


2. Miller, P. (2006, June). A clinical case example of EMDR in the management of psychosis in a young man with psychotic depression. Presentation at the annual meeting of the EMDR Europe Association, Istanbul, Turkey .

Language: English

Format: Conference

Keywords: Case Study  Psychosis  Psychotic Depression  

Accuracy Verified: Yes


3. DiBerardino, C., & Milardi, M. (2003, May). Consideration on the clinical results in the application of the EMDR in a psychotic subject. Poster presented at the annual meeting of the EMDR Europe Association, Rome, Italy.

Language: English

Format: Conference

Keywords: Poster  Psychosis  

Accuracy Verified: Yes


4. van der Vleugel, B. (2013, April). De behandeling van PTSS bij mensen met een psychotische stoornis [The treatment of PTSD in people with a psychotic disorder]. In Onderzoek track 1 and 2. Presentatie op Het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.

Language: Dutch

Format: Conference

Abstract:
Trauma is een risicofactor voor het ontwikkelen van psychose. Het hebben van een ernstige psychiatrische aandoening verhoogt de kans op het ontwikkelen van een co-morbide posttraumatische stress stoornis. Desondanks wordt een co-morbide PTSS zelden gediagnostiseerd en wanneer dit wél gebeurt is behandeling van deze PTSS bepaald niet vanzelfsprekend. Behandelaren vrezen vaak dat het openlijk bespreken van traumatische levenservaringen zal leiden tot decompensatie, heropname, middelenmisbruik, zelfbeschadigend gedrag en / of suïcidaliteit. Ondertussen werken de PTSS klachten als olie op het vuur van de psychose. Omdat mensen met psychotische klachten over het algemeen werden uitgesloten van deelname aan onderzoek naar de effecten van PTSS behandeling was lang niet bekend of psychologische behandeling conform de Richtlijn Angststoornissen ook bij deze populatie veilig en effectief is. Hier begint verandering in te komen. In deze presentatie komen achtereenvolgens aan bod: - De resultaten van een pilot onderzoek naar de effecten van EMDR bij mensen met een psychotische stoornis en een co-morbide PTSS (Van den Berg & Van der Gaag, 2012). - De resultaten van een gecontroleerde multiple baseline study naar de effecten van EMDR en Prolonged Exposure bij mensen met een psychotische stoornis en een comorbide PTSS (De Bont, Van Minnen & De Jongh, submitted). - De opzet en eerste bevindingen van het onderzoeksproject Treating Trauma in Psychosis (T.TIP), een multicenter RCT naar de behandeling van PTSS bij mensen met een psychotische Trauma is a risk factor for the development of psychosis. Having a severe psychiatric condition increases the chance of the development of a co-morbid post-traumatic stress disorder. Nevertheless, a co-morbid PTSD rarely diagnosed and when this happens, treatment of these PTSD determined not obvious. Clinicians often fear that openly discussing traumatic life experiences will lead to decompensation, reuptake, substance abuse, self-injurious behavior and / or suicidality. Meanwhile, the PTSD symptoms as fuel to the fire of the psychosis. Because people with psychotic symptoms were generally excluded from research into the effects of PTSD treatment was long unknown or psychological treatment in accordance with Directive Anxiety disorders also in this population safely and effective. Here begins to be changing. This presentation will subsequently be discussed: - The results of a pilot study on the effects of EMDR in people with a psychotic disorder and comorbid PTSD (Van den Berg and Van der Gaag, 2012) . - The results of a controlled multiple baseline study on the effects of EMDR and Prolonged Exposure to people with a psychotic disorder and comorbid PTSD (De Bont, Van Minnen & De Jongh, submitted). - The design and initial findings of the research Treating Trauma in Psychosis (T.TIP), a multicenter RCT on the treatment of PTSD in people with a psychotic disorder (De Bont et al, submittedstoornis (De Bont et al., submitted).

Keywords: Posttraumatic Stress DIsorder  PSTD  Psychotic Disorders  

Accuracy Verified: Yes


5. de Bont, P. (2011, August-September). Efficacy and safety of prolonged exposure or EMDR-treatment for PTSD with patients with a vulnerability for psychosis. A multiple baserate N=10 single case design. In Treating PTSD in patients with psychotic disorders. Symposium conducted at the 41st EABCT annual congress, Reykjavík, Iceland.

Language: English

Format: Conference

Abstract:
Objectives: Untill now, only a small number of studies have investigated the safety and effects of psychological treatment for PTSD in psychotic patients. The main aim of this study was to explore the effects of two psychological, highly manualized, guideline PTSD treatments: EMDR and prolonged exposure. Another important aim was to determine if negative side effects would occur as a result of therapy. Among clinicians fear exists of harming vulnerable patients with confronting therapeutic procedures, thus risking psychotic exacerbation, suicidal behaviour or other adverse events. Methods: In a N=10 single case study design the effects of psychological PTSD treatment were studied in psychiatric patients who suffer from psychoses. Participants were randomly assigned to either EMDR or Prolonged Exposure. Weekly measurements of PTSD and psychotic symptoms prior to, during and after treatment, gave a strong impression of how symptoms respond to treatment. The treatment in both conditions consisted of 12 sessions of 90 minutes. Adverse events were monitored weekly. Before, directly after and 3 months after treatment all subjects were tested more extensively for the variables PTSD and psychosis, and for three secondary outcome measures cognitive style, social functioning and quality of life. Results: The results show that PTSD-treatment can be quite effective for both PTSD and even some of the psychotic symptoms. PTSD symptoms dropped considerably, in a number of cases below the point of still having a PTSD. In some cases treatment helped diminish the occurence of harming voices. Not one patient became psychotic as a result of therapy, not even patients that went through the guided reliving of traumatic psychotic events during Prolonged Exposure. No suicide attempts occured. Occasional minor adverse events with medication occurred, but results taken as a whole the treatments were obviously safe. Conclusion: This study shows that PTSD-treatment in psychotic patients is a serious option, next to medical treatment. It can be done safely, effectively and in a manualized fashion. No information can be derived from this study as to which of the two, Prolonged Exposure or EMDR, can be best applied in specific situations. Both seem to be equal in the limited number of cases.

Keywords: PE  Prolonged Exposure  Psychotic Disorders  Single Case Design  Symposium  

Accuracy Verified: Yes


6. Millar, P. (2010, March). EMDR & psychosis. Presentation at the 8th EMDR Association UK & Ireland Annual Conference & AGM, Dublin, Ireland.

Language: English

Format: Conference

Abstract:
Psychotic phenomena are one of the most challenging clinical presentations to treat, the most severe form being schizophrenia and poor outcome schizoaffective disorder. Schizophrenia is a severe enduring mental illness (SMI) and is characterised by core disturbances of thinking, perceptions and the emotions. It is accepted as having a heavy burden, with significant effects on the patient, their families and carers and it is one of the most costly illnesses worldwide. The weight of burden falls with regard to legal problems, stigma and life expectancy: life expectancy in this group of individuals is reduced by 10 years, mostly as a consequence of suicide (Rossler, Salize et al. 2005). Despite more than 100 years of experience of the disease it is still only a minority of individuals who make a full recovery. This workshop aims to give further insight into the role of EMDR in the treatment of schizophrenia - as defined by the genetic epidemiological work by Professor K Kendler (Kendler, Spitzer et al. 1989; Kendler, McGuire et al. 1993; Kendler, Maguire et al. 1993). It follows up a series of three patients with psychosis treated with EMDR one of whom met strict criteria for schizophrenia. All 3 are now over 2 years post-EMDR. Of specific note the man who presented with schizophrenia remains free of medication and symptoms. The workshop will discuss the role of EMDR in the treatment of psychosis, including schizophrenia and discuss case selection and protocol development in this area of practice.

Keywords: Psychosis  Schizoaffective Disorder  Schizophrenia  

Accuracy Verified: Yes


7. 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


8. 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


9. Gonzalez, A., Mosquera, D., & Moskowitz, A. (2012, June). EMDR in psychosis and severe mental disorders [EMDR en psicosis y trastorno mental severo]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Interactions between trauma and biology, dissociation and psychosis are complex. Some cases could be more biologically based, and traumatic events may trigger a psychotic episode or contribute to the low-response to usual interventions. But traumatic experiences could also influence neurodevelopment and brain structure. In some cases past adverse events may be a main factor in the development of psychotic psychopathology. The treatment of psychotic disorders with a specifically trauma-oriented therapy as EMDR, can help us to evaluate the relative contribution of these different factors from clinical results. The empirical research about the application of EMDR will be also reviewed. A relevant point for EMDR therapy in psychotic disorders is the complex relationship between dissociation and psychosis. Patients presenting with the belief of being controlled by an external force, intrusive thoughts and hallucinatory voices that comment on one's thoughts or actions or that have a conversation with other hallucinated voices, are easily diagnosed as schizophrenic or psychotic but can often be best understood and approached as dissociative symptoms. These patients can be treated with EMDR, but the procedures present relevant modifications in relation with the standard EMDR procedure for PTSD. In this workshop we will briefly describe how EMDR can be applied in different examples of psychotic patients, and based on these clinical examples (presented a case-descriptions or videos, we will reflect on the previously described aspects.

Las interacciones entre trauma y biología, disociación y psicosis son complejas. Algunos casos pueden estar más basados en el ámbito biológico, y los eventos traumáticos pueden ser disparadores de un episodio psicótico o contribuir a la baja respuesta ante las intervenciones usuales. Pero las experiencias traumáticas pueden también influenciar el neurodesarrollo y la estructura cerebral. En Algunos casos eventos adversos del pasado pueden ser el principal factor para desarrollar psicosis o una psicopatología. El tratamiento de los trastornos psicóticos con un terapia orientada al trauma como el EMDR nos ayudan a evaluar la contribución relativa de distintos factores a los resultados clínicos. La investigación empírica acerca de la aplicación del EMDR también será revisada. Un punto relevante de la Terapia EMDR en trastornos psicóticos es el resultado complejo de la relación entre disociación y psicosis. Los pacientes que presentan creencias de control por fuerzas externas, pensamientos intrusivos y voces alucinatorias que comentan las acciones o pensamientos o tienen una conversación con otras voces alucinatorias, normalmente son diagnosticadas como esquizofrenia y psicosis pero en algunas ocasiones estarían mejor entendidas desde un enfoque que las considerara síntomas disociativos. Estos pacientes pueden ser tratados con EMDR, pero los procedimientos presentan modificaciones referentes al procedimiento estándar de EMDR para el TEPT.

Keywords: Psychosis  Severe Mental Disorders  

Accuracy Verified: Yes


10. Miller, P. (2009, June). EMDR in psychosis: A two year follow-up and the implications for future protocol development. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Keywords: Psychosis  Severe Psychiatric Disorders  

Accuracy Verified: Yes


11. Hamilton, C. (1999, June). EMDR in the treatment of a client with psychosis and post traumatic stress disorder. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV.

Language: English

Format: Conference

Abstract:
Participants will: 1) increase his/her knowledge about identifying post traumatic stress disorder in persons with psychosis; 2) increase his/her intereste in exploring the potential benefit of EMDR with clients with psychosis and trauma disorders; 3) identify aspects of psychosis that according to this single case study did not appear to benefit from treatment with EMDR.

Keywords: Posttraumatic Stress Disorder  Psychosis  PTSD  

Accuracy Verified: Yes


12. Miller, P. (2011, August). EMDR treatment of psychotic disorders, including schizophrenia: Using the ICONN protocol. Presentation at the annual meeting of the EMDR International Association, Orange County, CA.

Language: English

Format: Conference

Abstract:
Psychotic phenomena are challenging to treat. The most severe psychosis is schizophrenia, which has a heavy burden and reduced life expectancy through physical illness and suicide. Psychotherapy in psychosis is experiencing a renaissance and this workshop will discuss case selection and the application of the ICONN protocol for EMDR with psychosis. The ICONN protocol has been developed from experience with a series of patients with psychotic disorders, including ‘M’, a patient who met Kendler’s strict criteria for schizophrenia. ‘M’ remains in recovery after 4 years.

Keywords: ICONN Protocol  Psychosis  Psychotic Disorders  Schizophrenia  

Accuracy Verified: Yes


13. Hamilton, C. (1998, November). EMDR use in a patient with DDNOS and psychosis. Symposium at the annual conference of the International Society for the Study of Dissociation in Seattle, Washington.

Language: English

Format: Conference

Keywords: DDNOS  Psychosis  Symposium  

Accuracy Verified: Yes


14. Rosenthal, D., & Little, K. (1999, June). EMDR:  PTSD application case studies in a state inpatient forensic facility. Presentation at the annual meeting of the EMDR International Association, Las Vegas, NV.

Language: English

Format: Conference

Abstract:
Participant will be able: 1) describe the application of various test instruments in the appraisal of clinical EMDR response in a correctional inpatient population; 2) desribe at least two variations in EMDR treatment as applied to an inpatient correctional population; and 3) describe at least two clinical and ethical issues in the PSTD treatment of an offender-patient with concurrent psychosis.

Keywords: Correctional Population  Inpatient  Forensic  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


15. Jones, K. R. (2006, June). EMDR:  Warning on safe use. Therapy Today, 17(5), 23.

Language: English

Format: Magazine

Abstract:
For EMDR to be used safely, I strongly agree with the position emphasised during training with the EMDR Institute, that this is an adjunct technique which should only be integrated into existing and appropriate professional practice. Furthermore, practitioners should be qualified to carry out an effective mental health assessment, to screen potential clients for contraindicative effects (eg dissociation or psychosis) prior to treatment, as well as being competent to deal with adverse effects such as strong abreactions. Given the potential for harm with techniques such as EMDR, I believe that it is essential for practitioners to have a 'practising certificate' before offering this approach to clients, rather than simply undertaking 'some training' as noted by the author.

Keywords: Letter  

Accuracy Verified: Yes


16. Fowler, K. B. (2007, January). The first symptoms of psychosis. Schizophrenia Bulletin, 33(1), 16-18.

Language: English

Format: Journal

Abstract:
Episodes of significant depression have been a part of my life for as long as I can recall, but psychosis was unknown to me until I was in my mid-thirties, months after the birth of my second child. At first, all I recognized were the emerging symptoms of postpartum depression in the weeks after the birth: a familiar scenario, since it had also occurred with my first child. My doctor immediately prescribed 50mg of Prozac daily. I took the medication, felt much better, and continued to breastfeed my second daughter with no apparent problems. In fact, for about four months I felt better than I had in years. My therapist, an LCSW, was thrilled with my progress. She had been treating me with a technique called Eye Movement Desensitization and Reprocessing (EMDR). The therapy worked. In this article I present essays. These essays are my recollections of some of the new, and very foreign, moments in the beginning of that process, as my mind gradually turned from sane to psychotic. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Keywords: First Symptoms  Psychosis  Postpartum Depression  Schizophrenia  Symptoms  

Accuracy Verified: Yes


17. 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


18. Maxfield, L. (2012, April). New advances with EMDR: A summary of interesting new research. Presentation at the annual meeting of the EMDR Canada, Montreal, Quebec, Canada.

Language: English

Format: Conference

Abstract:
This presentation reviews new advances in EMDR, reporting on recent research studies which have investigated EMDR's application with new problems, new populations, and/or with new protocols. It looks at EMDR treatment of somatic and physical health problems, such as migraine headaches and chronic pain, as well as the role of EMDR in reducing the stressful impact of life-threatening health problems such as cardiac events and neuromuscular disorders. Preliminary research on new EMDR applications is summarized, including treatment of clients with psychosis and individuals with developmental disorders. An effective new protocol for recent critical events is explained and examined, as well as a new protocol for obsessive-compulsive disorder. The presentation also reviews studies investigating the role of eye movements on memory and physiology, and what these findings reveal about possible mechanisms of action in EMDR.
Learning Objectives: 1. Participants will be able to describe applications for EMDR with non-PTSD populations and related supportive research 2. Participants will be able to summarize clinical practice strategies for EMDR treatment of several somatic and physical health problems 3. Participants will be able to explain the new EMDR Protocol for Recent Critical Events and to recount the differences between this and the standard EMDR protocol, and to summarize the research evidence for this intervention 4. Participants will be able to explain the new EMDR Adapted Phobia Protocol for OCD, and to discuss the theoretical implications of this protocol 5. Participants will develop a basic knowledge of research findings regarding the effects of eye movements, and will be able to apply these to an understanding of EMDR’s mechanisms of action.

Keywords: Research  

Accuracy Verified: Yes


19. Laugharne, R. (2012. January). P-1265 - A role for EMDR (eye movement desensitisation and reprocessing) in the treatment of trauma in patients suffering from a psychosis. European Psychiatry, 27(Supplement 1), 1-1. doi:10.1016/S0924-9338(12)75432-9.

Language: English

Format: Journal

Abstract:
Patients with a functional psychosis are more likely to have a history of trauma, symptoms of PTSD and may have been traumatised by their psychotic symptoms. We present an anonymised case series of patients (who have given consent) suffering from a functional psychotic illness who had a significant history of trauma with symptoms of post traumatic stress disorder (PTSD). After receiving eye movement desensitisation and reprocessing (EMDR), each patient showed an improvement in their PTSD symptoms and reported an improvement in the quality of their lives. As a history of trauma and PTSD symptoms are more frequent in patients with a psychosis, and trauma may be an aetiological component of psychosis, EMDR treatment needs to be researched and explored as a treatment opportunity in this patient group. [Copyright &y& Elsevier]

Keywords: Psychosis  

Accuracy Verified: Yes


20. Agius, M., Middleton, E., & Zaman, R. (2011, January). P02-466 - Audit and re-audit of patients with PTSD in a community team in Bedfordshire, UK. European Psychiatry, 26(1), 1062. doi:10.1016/S0924-9338(11)72767-5.

Language: English

Format: Journal

Abstract:
Post-traumatic stress disorder (PTSD) is a disorder which can develop following exposure to one or more severely traumatic events. Symptoms experienced by PTSD suffers include re-experiencing the trauma through intrusive ‘flashbacks’ and recurrent dreams or nightmares, distress when exposed to reminders of the trauma, hyperarousal and emotional blunting. These symptoms can cause significant impairment of function and reduction in quality of life for suffers. Both psychotherapies, including cognitive behavioural therapies (CBTs) and eye movement desensitisation and reprocessing (EMDR), and pharmacotherapy are used in the treatment of PTSD. Method We audited patients with PTSD in Bedford East performed in November 2008. A re-audit was performed using data from August 2010 patient database. Demographic information, risk factors, co-morbidities, psychological therapy and pharmacotherapy were compared between these audit and re-audit. Results There is increased use of antidepressant augmentation between 2008 and 2010. While no patients in 2008 were on antidepressant augmentations, by 2010, 9 patients were. All 25 patients on anti-psychotics have important identified risk factors. There is no evidence of Psychosis in our PTSD patients except in two cases. There is an increase in Anti-psychotic use in our PTSD Patients. There is an increased use of Mood Stabilisers in our patients with PTSD. Discussion PTSD is being identified more frequently in our patients, probably because of greater awareness and more accurate identification. Conclusion New patients being identified represent a group of more difficult to treat patients who represent severe risks. Present psychotherapies offered are not all recommended in present guidelines.

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


21. van der Vleugel, B. (2011, August-September). Practical guidelines for PTSD treatment in psychotic patients. In Treating PTSD in patients with psychotic disorders, Symposium conducted at the 41st EABCT annual congress, Reykjavík, Iceland.

Language: English

Format: Conference

Abstract:
Objectives: Professionals are very cautious, if not reluctant, to treat trauma-related symptoms in psychotic patients. As is argued by the other speakers there is growing evidence psychotic patients can safely be exposed to PTSD treatment. There are several possible links between trauma and psychosis and an integrative approach to conceptualizing these relationships is needed (Morrisson et al., 2003) Methods: In this presentation practical guidelines are given with respect to gathering information in the assessment phase and presenting this information in an individual case conceptualisation. Choices regarding which experiences to work with and in what way, will be discussed. Treatment processes are illustrated by vignettes and video material. Some difficulties one may encounter when using interventions like EMDR and prolongued exposure with psychotic patients, will be adressed. Results: Attendants will be mindful of an integrative model of trauma and psychosis and will be able to use this to identify the target(s) for intervening. They will be prepared for some diffuclties they may encounter while conducting PTSD treatment. Conclusions: Case formulations aim to explain the development and maintenance of client‘s experienced problems in terms of causal relationships. It is vital that both client and therapist have a shared understanding of the problems that are going to be addressed in therapy and that interventions are guided by this formulation.

Keywords: Posttraumatic Stress Disorder  PTSD  Psychotic Disorders  Symposium  

Accuracy Verified: Yes


22. van der Gaag, M., van der Vleugel, B., van den Berg, D., de Bont, P., de Jongh, A., & van Minnen, A. (2011, August-September). A randomized multicentered trial of trauma focused treatment of psychotic patients with PTSD in the Netherlands; design and research questions. In Treating PTSD in patients with psychotic disorders. Symposium conducted at the 41st EABCT Annual Congress, Reykjavík, Iceland .

Language: English

Format: Conference

Abstract:
Objectives: The prevalence of postraumatic stress disorder (PTSD) in severe mental illness varies from 10 to 60% is the published literature. Probably between 10 to 20% of lifetime psychotic patients, also meet the criteria for having a PTSD. There is not much evidence for the efficacy and safeness of treatment in patients with a lifetime psychotic disorder who also meet the criteria for PTSD. Some pilot studies show promising results. Method: A study is designed to investigate whether treatment of PTSD is effective and safe in a group of people with a psychotic disorder? A multi-site randomised clinical trial with 80 patients Eye Movement Desensitisation and Reprocessing (EMDR) versus 80 patients Prolonged Exposure (PEx) versus 80 patients Treatment as Usual/Waiting list (TAU) is now being performed to answer these research questions. The outcome measures in this study are: Primary: Posttraumatic stress disorder (diagnose and severity) Secundary: psychosis, depression, adverse events. Moderators en mediators of treatment success. Cost-effectiveness will be assessed and expressed in Euro per gained Quality Adjusted Life Years. If no effectivity can be demonstrated, a costminimalisation calculation will be made. Results: Therapist have been trained in EMDR and in PEx during eight days. Therapies are closely supervised an monitored during the study. Fidelity measures are collected from a rond sample of sessions. Conclusions and Discussion: Pilots have been promising in showing effective treatment for PTSD without any adverse events or worsening of the condition in psychotic patients with a chronic course. If this study can demonstrate effectivesness and safety, this can change the treatment for many patients with severe mental illness and reduce suffering from symptoms of PTSD and probably also the burden of psychotic symptoms can be reduced in a subsample of the patients.

Keywords: Netherlands  Posttraumatic Stress Disorder  PTSD  Psychotic Disorders  Symposium  

Accuracy Verified: Yes


23. van den Berg, D. (2011, June). Research on clinical applicaton of EMDR other than PTSD - EMDR with trauma in psychosis: Preliminary findings. Presentation at the 12th European Conference on Traumatic Stress (ECOTS), Vienna, Austria .

Language: English

Format: Conference

Abstract:
Posttraumatic stress disorder is one of the most common comorbid conditions in patients with psychotic disorders. A large proportion of this group indicate that they want to be treated for their PTSD symptoms. Conversely, a psychotic disorder is nearly always used as an exclusion criterion for effective psychotherapeutic treatments. The clinical experience and limited scientific research conducted in this area, however, indicate that these patients can be effectively treated with techniques directly aimed at processing the trauma. However, research in this area is lacking. During this presentation the different interactions between trauma, psychosis and PTSD will briefly be discussed. In addition, the results of a feasibility trial of EMDR in patients with psychosis and comorbid PTSD will be presented. The main finding of this trial was that treatment did not result in any adverse effects. EMDR appeared to be very effective in alleviating PTSD symptoms. Even more surprisingly, other symptomatology, such as symptoms of psychosis and depression decreased significantly. Hence, treating PTSD in patients suffering from psychosis with EMDR appears to be feasible and safe.

Keywords: Psychosis  Trauma  

Accuracy Verified: Yes


24. Moskowitz, A. (2012, June). Trauma, dissociation and psychosis [Trauma, disociación y psicosis]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
What is the relationship between trauma, dissociation and psychosis? In this talk, I will discuss links between the historical concept of schizophrenia and dissociation, the meaning of ‘psychosis’, and interpretations of psychotic symptoms from a trauma/dissociation perspective. It is proposed that auditory verbal hallucinations or ‘voices’ are dissociative in nature, and that other psychotic symptoms may be related to traumatic experiences in a variety of ways.

¿Cuál es la relación entre trauma, disociación y psicosis? En esta charla se abordarán los puntos de conexión entre el concepto histórico de esquizofrenia y disociación, el significado de ‘psicosis’ y las interpretaciones de los síntomas psicóticos desde una perspectiva de trauma/disociación. Se propone que las alucinaciones auditivas verbales o ‘voces’ son de naturaleza disociativa y que otros síntomas psicóticos pueden estar relacionados de distintas maneras con experiencias traumáticas.

Keywords: Dissociation  Psychosis  Trauma  

Accuracy Verified: Yes


25. van der Vleugel, B. M., van den Berg, D. P. G, & Staring, A. B. P. (2012, March-April). Trauma, psicosi, disturbo da stress post-traumatico e l’utilizzo dell’EMDR [Trauma, psychosis, post-traumatic stress disorder and the application of EMDR]. Rivista di Psichiatria, 47(2 Suppl. 1), 33S-38S. doi:10.1708/1071.11737.

Language: Italian

Format: Journal

Abstract:
In questo articolo descriveremo tre interazioni tra trauma, disturbo da stress post-traumatico (PTSD) e psicosi: 1. molti pazienti con disturbi psicotici hanno subito esperienze di vita traumatiche che giocano un ruolo fondamentale nell’insorgenza e nel dar forma al contenuto della loro psicosi; 2. sia l’esperienza psicotica sia il suo trattamento psichiatrico possono causare la sintomatologia da stress post-traumatico; 3. nel caso in cui la psicosi ricorra assieme ad un PTSD, vi è un rischio sostanziale che i due quadri clinici si rinforzino reciprocamente in maniera negativa, oltre a un potenziale protrarsi della traumatizzazione. Sebbene queste interazioni siano clinicamente molto rilevanti, raramente vengono tenute in considerazione durante la pratica clinica di routine. Le tre interazioni verranno illustrate attraverso un caso singolo e una descrizione di un trattamento con EMDR. In conclusione raccomandiamo di prestare attenzione, durante la pratica clinica di routine, alla traumatizzazione e a una co-diagnosi di un PTSD nei casi che presentano un disturbo piscotico, oltre che offrire un trattamento a questi pazienti.

In this article we describe three interactions between trauma, post-traumatic stress disorder (PTSD) and psychosis: 1. many patients with psychotic disorders suffered from traumatic life experiences that play an important role in the onset and content of their psychosis; 2. the experience of psychosis as well as its psychiatric treatment may result in post-traumatic stress symptoms; 3. if psychosis and PTSD occur simultaneously, there is a substantial risk for reciprocal negative reinforcement of both symptom groups as well as for potentially ongoing traumatization. Although these interactions are highly relevant from a clinical perspective, they usually remain unattended in routine care. The three interactions will be illustrated by a case history as well as an impression of the psychological treatment including EMDR. We recommend to pay attention to traumatization and comorbid PTSD in routine care for people with psychosis, as well as to offer them treatment.

Keywords: Posttraumatic Stress Disorder  PTSD  Psychosis  Schizophrenia  Trauma  

Accuracy Verified: Yes


26. van den Berg, D. P. G., van der Vleugel, B., & Staring, A. (2010, December). Trauma, psychose, PTSS en de toepassing van EMDR [Trauma, psychosis, PTSD and the use of EMDR]. Directieve Therapie, 30(4), 303-328. doi:10.1007/s12433-010-0242-9.

Language: Dutch

Format: Journal

Abstract:
In dit artikel beschrijven wij drie interacties tussen trauma, psychose en PTSS: 1. Veel patiënten met psychosen hebben in hun leven traumatiserende ervaringen meegemaakt. Deze traumata spelen vaak een belangrijke rol in hun psychosen en in het ontstaan hiervan. 2. Het meemaken van een psychose en de psychiatrische behandeling zijn voor veel patiënten levensechte en traumatische ervaringen, die kunnen leiden tot posttraumatische stressklachten. 3. Vaak komen psychosen en een posttraumatische stressstoornis gezamenlijk voor, waarbij er sprake is van negatieve wederzijdse beïnvloeding en voortgaande traumatisering. Deze drie interacties hebben een hoge klinische relevantie. Er is in de praktijk van de zorg voor patiënten met psychosen echter weinig aandacht voor traumatisering en comorbide PTSS. Eye Movement Desensitization and Reprocessing (EMDR) is een behandelmethode die effectief is bij de behandeling van traumata en PTSS. Wij beschrijven per genoemde interactie een behandeling waarbij EMDR is ingezet. Daarna bespreken wij een aantal factoren die een EMDRbehandeling bij patiënten met psychosen kunnen bemoeilijken, zoals doorlopende traumatisering door psychotische klachten, cognitieve beperkingen, moeite met oogbewegingen, belemmeringen door antipsychotische medicatie en verminderde affectieve expressie. Wij sluiten het artikel af met het advies om in de zorg voor mensen met psychosen aandacht te hebben voor trauma en comorbide PTSS, en patiënten hier ook voor te behandelen.

In this article we describe three interactions between trauma, psychosis and PTSD: 1. Many patients suffering from psychosis have been traumatized. This trauma often plays an important role in their psychosis and the onset thereof. 2. Having a psychosis and being treated in a psychiatric hospital are traumatic experiences for a lot of patients, and can lead to posttraumatic stress symptoms; and 3. Often psychoses and post-traumatic stress disorder occur jointly, reciprocally influencing one another and leading to ongoing traumatization. These interactions have a great clinical relevance. In the practice of care for patients with psychosis however there is little attention for traumatization and co-morbid PTSD. EMDR is a treatment approach that is effective in treating traumas and PTSD. Per interaction mentioned above we describe a treatment in which EMDR was used. After this we discuss certain factors that may complicate an EMDR treatment in patients with psychosis, such as ongoing traumatization by psychotic symptoms, cognitive impairments, difficulty with eye movements, barriers due to antipsychotic medication, and diminished emotional expression. We end the article with the advise to be aware of the high prevalence of trauma and co-morbid PTSD in the care for patients with psychosis and to treat patients for these complaints.

Keywords: Posttraumatic Stress Disorder  Psychosis  PTSD  Trauma  

Accuracy Verified: Yes


27. van den Berg, D., & van der Vleugel, B. (2011, June). Trauma, psychosis and EMDR. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria .

Language: English

Format: Conference

Abstract:
The associations between trauma and psychosis are diverse and complex. The majority of people suffering from psychosis have been traumatized as a child and trauma appears to be an important causal factor in becoming psychotic later in life. About 35 percent of the people with psychosis suffer from a comorbid Post Traumatic Stress Disorder (PTSD). The psychotic experience itself and the sometimes horrific experiences in psychiatric treatment (e.g., solitary confinement) are traumatizing experiences for many patients. The presence of a comorbid PTSD leads to negative vicious cycles in which the patient can become stuck if effective treatment is not provided. Despite all this, comorbid PTSD is rarely diagnosed, and if so, application of EBP is not common practice. Learning objectives: During this workshop these different interactions between trauma, psychosis and PTSD will shortly be discussed. Evidence from research and practice showing that trauma in psychosis can be treated effectively and safely, will be presented. Further, the workshop will focus on the practical application of EMDR within a general cognitive behavioural treatment plan for psychosis. Moreover, the following questions will be addressed. How is trauma history conceptualized within a case formulation? When can EMDR be used? And how can this be done? General problems one may encounter when using EMDR in patients with psychosis will be discussed. Recommended reading before the workshop: •W. Larkin and A. Morrison (eds.) Trauma and Psychosis: New directions for theory and therapy. 2006 London: Brunner-Routledge. After this workshop attendees will be aware of the great importance of assessing the life histories of patients with psychosis, how to incorporate this in a case formulation and how to use EMDR with these patients.

Keywords: Psychosis  Trauma  

Accuracy Verified: Yes


28. Breitenbach, G., & Requardt, H. (2003). Traumatherapie mit EMDR bei mmenschen mit psychosen in der vorgeschichte [EMDR trauma therapy in people with a history of psychosis]. Institut fur Traumatherapie.

Language: German

Format: Other

Abstract:
In der Arbeit mit chronifizierten Problemstellungen haben wir es immer wieder mit Menschen zu tun, die aufgrund psychotischer Vorerfahrung eine Psychotherapie aufsuchen. In der Regel ist der Leidensweg schon sehr lang. Die Klienten sind insoweit erfahren, dass sie gelernt haben, jede unangenehme und jede starke Gefühlsreaktion, als ein Ergebnis ihrer zu großen Empfindlichkeit zu interpretieren. Das führt dazu, dass sie eigenen Gefühlen misstrauen und so eigentlich ganz ehrlich sind, wenn sie uns sagen: ich habe noch nie etwas Traumatisches erlebt.

In working with chronified problems we are faced again and again with people who, because of psychotic prior experience in psychotherapy. In general, the ordeal is very long. The clients are so far out that they have learned each and every strong unpleasant emotional response, as a result interpret their excessive sensitivity. The result is that they distrust their own feelings and so are actually quite honest when they tell us: I have never experienced something traumatic.

Keywords: Psychosis  

Accuracy Verified: Yes


29. 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


30. Grinbaum, A., & Levy, M. (2007, June). Working with child care in public service. Poster presented at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
Work in child care in a pubic service, brings us to accept all people who come to us whatever their origin (Mediterranean, Black Africa, Asia), their social class (from the most impoverished to the upper class), or any kind of difficulty (from school and socio-educational problems to autism or serious psychosis). We are psychologists, psychoanalysts ad family therapist with more than 25 years of experience. Through our work, we learned listening, patience, neutrality, and interpretation. While sometimes our experience brought us to invent means to come in contact with them, the EMDR method gave us another mode of relation with the child which is at the same time more flexible and closer to them. Since our training in 2004, we noticed a change in our practice ad in the attitude of our colleagues and fellow workers toward us. We would like to describe in this talk the feeling of freedom we felt to work with such a rigid protocol; to work differently with problems like drugs or sexual abuse as well as difficulties in early childhood to work in turn with the parent and the children, to work with the whole family while treating one of their members in from of them. We want to present some clinical examples and share with you the enthusiasm that this new therapy arouses in us after so many years of practice.

Keywords: Children  Child Care  Poster  

Accuracy Verified: Yes