Existing data suggest that both trauma and Post-Traumatic Stress Disorder (PTSD) are very common among individuals with psychosis. The presence of PTSD symptoms in psychosis is associated with worse clinical outcomes and poorer social functioning. However, PTSD is a poorly attended and poorly studied condition among this population. Research to date indicates that trauma-focused treatments are safe and effective for PTSD, even when psychotic comorbidity is present. Recent systematic reviews of psychological interventions for trauma in psychosis found that are effective in reducing trauma symptoms, suggesting that they should be implemented in front-line services. Nonetheless, larger confirmative trials are required to form robust conclusions.The aim of this project is to examine the efficacy of comprehensive third-generation protocol for people with comorbid trauma and psychosis.
This study is a randomized clinical trial at psychiatric rehabilitation services of the Public Network of Care for people with serious mental disorders. We hypothesize that participants receiving the intervention, in comparison with controls, will show a reduction in general, PTSD and psychotic symptomatology, an improvement in levels of functioning and well-being, a greater ability to regulate emotions with more help-seeking behaviours. Given the complexity of both psychosis and PTSD and the reluctance of professionals to treat it, we plan to develop a precise comprehensive protocol. In order to address all issues associated with both psychosis and comorbid PTSD, the protocol will be developed following the three stages of recovery from trauma: first, focusing on establishing the therapeutic alliance and safety; second, focusing on recounting and re-processing the traumatic event; and third, focusing on reconnecting with others and with life despite the trauma experienced. The therapy will be adapted to the characteristics of people with SMD and administered in 11 90-minute individual sessions per week, combining strategically ACT, Mindfulness, EMDR as well as Positive Psychology interventions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
This is a individual intervention with with a total of 12 sessions: Session 1. Constructing the Therapy Experience. Session 2. Life history and immediate reactions to trauma. Session 3. Preparing to deal with trauma. Session 4. Regulating emotions. Session 5-9. Focusing on retelling and processing the traumatic event (EMDR PHASES\_PHASE 3: Evaluation of the traumatic memory. EMDR PHASE 4: Desensitization. EMDR PHASE 5: Positive Belief Installation. PHASE 6: Body Scan). Session 9. Re-evaluating traumatic memory and self-care through positive emotions. Session 10. Cultivating self-kindness. Session 11. Developing a healthy identity. Session 12. Building a better future
Treatment as usual
Carmen Valiente
Pozuelo de Alarcón, Madrid, Spain
Change from posttraumatic symptoms at 12 weeks and 6 months
International Trauma Questionnaire (ITQ; Cloitre, et al., 2018).Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from psychotic symptoms at 12 weeks and 6 months
Psychotic Symtoms Rating Scale (Haddock et al., 1999).Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from psychopathological symptoms at 12 weeks and 6 months
Symptom Checklist 45-SCL-90\_r brief (Davison et al., 1997). Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from dissociative symptoms at 12 weeks and 6 months
The Dissociative Experience Scale Taxon (DES-T; Waller \& Ross, 1997). Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from Personal and Social functioning at 12 weeks and 6 months
Personal and Social Performance Scale (PSP; Morosini y cols., 2000). Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from Wellbeing at 12 weeks and 6 months
Scales of Psychological Well-Being (SPWB; Ryff \& Keyes,1995). Higher scores mean a better outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from satisfaction with life at 12 weeks and 6 months
Satisfaction with Life Scale (SWLS; Diener et al., 1985). Higher scores mean a better outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from Attachment at 12 weeks and 6 months
Psychosis Attachment Measure (PAM; Berry et al., 2006; Sheinbaum et al., 2013). Higher scores mean a worse outcome.
Time frame: Change baseline, 12 weeks, and 6 months
Change from Emotion Regulation at 12 weeks and 6 months
Cognitive Emotion Regulation Questionnaire (CERQ; Garnefski \& Kraaij, 2007). Higher scores mean a worse outcome for disfunctional dimensions and a better outcome for functional dimensions
Time frame: Change baseline, 12 weeks, and 6 months
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