Psychosis, Trauma, Psychological
Conditions
Keywords
Psychosis, Trauma, Psychological Intervention, EMDR
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALTAU + A comprehensive third-generation intervention
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
BEHAVIORALTAU
Treatment as usual
Sponsors
Universidad Complutense de Madrid
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Those showing a high risk of PTSD (TSQ ≥6) will be further evaluated to determine whether they meet the inclusion criteria. Participants must: * Be between the ages of 18 and 65 fluent enough in Spanish language; * Meet the criteria for a diagnosis of a psychotic spectrum disorder or a mood disorder with psychotic symptoms according to MINI (Sheeman et al., 1997); * Meet PTSD diagnostic criteria according to the Clinician-Administered PTSD Scale (CAPS; Blake et al., 1995)
Exclusion criteria
* Those who have a diagnosis of substance or alcohol abuse or dependence in the 30 days prior to participation in the study * To have a severe neurocognitive problems or brain damage that interfere with the basic processing of information in psychotherapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from posttraumatic symptoms at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | International Trauma Questionnaire (ITQ; Cloitre, et al., 2018).Higher scores mean a worse outcome. |
| Change from psychotic symptoms at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Psychotic Symtoms Rating Scale (Haddock et al., 1999).Higher scores mean a worse outcome. |
| Change from psychopathological symptoms at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Symptom Checklist 45-SCL-90\_r brief (Davison et al., 1997). Higher scores mean a worse outcome. |
| Change from dissociative symptoms at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | The Dissociative Experience Scale Taxon (DES-T; Waller & Ross, 1997). Higher scores mean a worse outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Personal and Social functioning at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Personal and Social Performance Scale (PSP; Morosini y cols., 2000). Higher scores mean a worse outcome. |
| Change from Emotion Regulation at 12 weeks and 6 months | Change baseline, 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 |
| Change from Wellbeing at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Scales of Psychological Well-Being (SPWB; Ryff & Keyes,1995). Higher scores mean a better outcome. |
| Change from satisfaction with life at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Satisfaction with Life Scale (SWLS; Diener et al., 1985). Higher scores mean a better outcome. |
| Change from Attachment at 12 weeks and 6 months | Change baseline, 12 weeks, and 6 months | Psychosis Attachment Measure (PAM; Berry et al., 2006; Sheinbaum et al., 2013). Higher scores mean a worse outcome. |
Countries
Spain
Outcome results
None listed