Post traumatic Stress disorder Trauma
Conditions
Interventions
Participants will receive a maximum of twelve EMDR sessions of ninety minutes.
Early completion is allowed. For each participant, a case conceptualization
based upon the Two Method Approach (ten Bro
Sponsors
GGZ Oost Brabant (Rosmalen)
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Recruited for this study will be ten participants who are between 18 and 65 years of age and who are patients of a mental health facility (i.e., GGZ Oost Brabant). They receive health care from the specialist department for persons with mild ID and psychiatric problems (LVB-P circuit). Patients are receiving outpatient care or inpatient care. Those who receive outpatient care, receive care of the GGZ and of an organization specialized in the care for individuals with intellectual disabilities. All participants are diagnosed with a mild to bordeline ID on the basis of results of an intelligence test (e.g., WAIS-III, WAIS IV) and a questionnaire for adaptive functioning, the Sociale RedZaamheids schaal voor verstandelijk gehandicapten (SRZ-P; Kraijer & Kema, 2004). Participants have a current PTSD, as assessed by the Anxiety Disorder Interview Schedule *Children section PTSD adapted for Adults with MBID (ADIS-C-PTSD-LVB-Adult version).
Exclusion criteria
Exclusion criteria: Exclusion criteria are an IQ below 60, no competence of the Dutch language, severe substance abuse and not having a support system. The support system is this study can be delivered by the clinic were the participant stays, family/friends or care givers from an other organization. For safety, participants with a BDI-score higher than 35 and a suicide attempt in the past three months, and patients deferring further treatment, are excluded as well. All participants have full mental competence, and people with mental incompetence are excluded. (See figure 1, appendix). Patients are not excluded based on the severity of other symptoms or problems related to their mental health condition.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| PTSD symptoms The Adapted Anxiety Disorder Interview Schedule-Adults, PTSD section (ADIS-C-PTSD-LVB-Adult version; unpublished) is used to measure type and severity of PTSD symptoms in adults with mild to bordeline ID. Mevissen et al. (2014) developed the Adapted ADIS-C -PTSD for the assessment of PTSD in children and adolescents with mild to bordeline ID. A recent study showed good interrater reliability, content and convergent validity (Mevissen et al., submitted). Next to the child version, the ADIS-PTSD- LVB-Adult version Interview was developed. At this moment a study on its psychometric characteristics is in progress ( Mevissen et al in press) The first part of the ADIS-PTSD-LVB-Adult version consists of 29 questions addressing different types of traumatic events. The response format for each question is *yes*, *no* or *otherwise*. When participant responds to the question about one of the traumatic events in the affirmative, the participant is asked three more questions: *what happened?*, *how did you react to that* and *how old were you when it happened?* Events the participants are exposed to are visualized on a time line, to help the participant to keep in mind the events when symptoms are asked for. Next, the participant is asked which event actually is the worst to think about. The second part of the interview consists of 40 questions about PTSD symptoms and several questions addressing atypical symptoms. For these questions, the response format is *yes*, *no* or *otherwise*. The participant is then asked to rate his or her subjective level of daily life impairment. To this end a thermometer card is used. The entire interview is conducted by an EMDR therapist, trained in administering the interview to diagnose PTSD. To monitor the weekly changes in PTSD symptoms only the second part of interview will be used. The monitoring of the weekly changes will be carried by a research assistant, trained in administering the interview. | — |
Secondary
| Measure | Time frame |
|---|---|
| Depressive symptoms Participants* depressive symptoms will be measured with the Becks Depression Inventory-II (BDI-II) (Beck, Steer, Ball, & Ranieri, 1996). The BDI-II consists of 21 items and scores range between zero (symptom not present) and three (symptom clearly present). A higher total score indicates more severe depressive symptoms. External validity and test-retest reliability have shown to be good. Internal consistency is also high (* = .91). Results of studies in persons with mild to borderline ID suggest that the BDI-II can be used in this target group and that the BDI-II is reliable and valid (Lindsay, Skene & Danielle, 2007). The BDI-II will be administrated by a research assistant during the selection process of the participants, at baseline, posttreatment and follow up. General psychopathology The Health of the Nation Outcome Scales (HoNOS) (Wing, Beevor, Curtis, Park, Hadden & Burns, 1998) in Dutch translation (Mulder, Staring, Loos, Buwalda, Kuijpers, Sytema, & Wierdsma, 2004) will be used to assess overall mental health and social functioning. The nurse assesses the participant*s situation with the inpatients or an counselor for the outpatients. The HoNOS has 12 items and contains four subscales: behavioral problems, limitations, symptomatology and social problems. These items can be scored between zero (*no problem present*) and four (*severe to very severe problem*) (Mulder et al., 2004). Research results on the HoNOS vary for both test-retest (Orrel, Yard, Handysides, Schapira, 1999) and interrater reliability (Bebbington, Brugha, Hill, Marsden, Window, 1999; Brooks, 2000). Training before using the HoNOS is advisable (Amin et al., 1999) and increases interrater reliability (Brooks, 2000). The HoNOS measures social functioning and general psychopathology and is sensitive to change (Wing et al., 1998), especially in chronic and more severe psychiatric problems (Amin et al., 1999). In Dutch research with participants wi | — |
Countries
Netherlands
Outcome results
None listed