If you are in danger, it is normal that an anxiety response takes place which initiates processes in the body that prepare you to defend yourself from this danger. This is sometimes called the ‘fight or flight’ response. If you are suffering from PTSD, this response has been changed or damaged as a result of a traumatic event. People with PTSD may experience stress or intense anxiety even though they are no longer in real danger. PTSD can develop following a traumatic event in which someone experiences or witnesses physical violence or the threat of physical violence.
You can view our PTSD study poster by clicking on the following link: Poster (pdf)
Paula de Jong and Mellony van Hemert are affiliated with the VUMC as external researchers, further info.
PTSD study criteria
If you are interested in participating in our PTSD study, we would like you to first ask yourself the following questions. If all 7 points are applicable to you, you are most probably eligible for our study and we would very much like you to register with us.
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To register for our PTSD treatment study
P&M is carrying out a research study which compares Imaginal Exposure and Imagery Rescripting, two evidence-based treatment methods for PTSD.
If you experience problems as a result of stressful events that took place in your youth and you would like to take part in the study, please enter your contact details at the bottom of this page. We will send you an email shortly afterwards together with a blank registration form. Once we have received an email from you with the completed registration form and a referral letter from your general practitioner requesting specialised mental healthcare (GGZ ), we can arrange a date with you for the intake appointment. We need the referral from your GP because the study concerns a situation in which treatment is given. Below is further information about what participation in this study means for you.
After you have registered, an intake appointment will be arranged. This consultation is intended to assess your problems and to determine whether there is any question of post-traumatic stress disorder as a result of interpersonal abuse during childhood which was committed before you reached the age of 16 by one or more persons in your immediate social environment. During this intake session, if there is any suspicion of PTSD, you will be informed about the study in which you will be participating. At the end of the session, you will be given a form containing information about the study (patient information).
After the intake, we will carry out an inclusion assessment. During this assessment, you will be asked to complete several questionnaires (SCID-I / MINI, SCID-II and a CAPS (Clinically Administered PTSD Scale) assessment) in order to determine whether you meet our criteria for participation in this study. Once the gathered information has been processed, an appointment will be made for you to discuss the results of these psychological tests.
During this session we will explain to you why you can or cannot take part in the study. If you can take part, we will give you a consent form in which you state in writing that you wish to participate in the study. It is possible that, based on the inclusion assessment, you do not meet the inclusion criteria for participation in the study. If this is so, we will explain why, and we will discuss an alternative treatment plan with you.
If you can take part in the study, and based on a computer randomised selection, you will be allocated to one of the various treatment routes, namely:
- Imaginal Exposure TreatmentYou will be confronted, repeatedly and at length, with anxiety-evoking memories of the trauma by recounting the traumatic event in your mind. When you are confronted with your anxieties systematically and in a safe environment, you can learn how to deal with those anxieties in a different way than avoiding them. You will learn that the anxiety and tension gradually decrease when you confront yourself repeatedly with the things you have avoided. In other words, you will start to feel more relaxed in those situations. We call this adaptation. Adaptation is a process in which the anxiety automatically decreases if someone remains in the anxious situation for long enough, and repeats the exercise often enough.
- Imagery Rescripting TherapyOne of the main objectives of imagery with rescripting is to help you discover that it was not you, but your social environment that was ‘at fault’. Another important objective is to process the emotions relating to the stressful events. Unlike with Imaginal Exposure, the aim is not to relive the entire event. Imagery rescripting involves keeping exposure to the traumatic event as short as possible. In the imagination you learn how to better understand and recognise your needs and feelings, and how to deal with them differently. You then learn to ask for support and help from people you trust. For example, you will find the freedom you need to express the anger and sadness you feel because your rights were violated, and you will learn how, as a healthy adult, to intervene in situations in which you were mistreated as a child.
- Control group
(in this group you will be monitored during the first stage using questionnaires)
Start of intervention
After randomisation has taken place, and you have been assigned to a treatment route, therapy can begin: Imaginal Exposure, Imagery Rescripting or the control group. You will find out which group you have been assigned to during the first session. Each therapy session will last for 90 minutes, twice a week for the first 5 weeks, and once a week for the last 6 weeks. Clients in the control group will be monitored at 3 set times during the first 11 weeks using questionnaires only. PTSD therapy will start immediately following this period.
Both during and after treatment, we use various outcome measurements to determine what effect the therapy has had on reducing the symptoms you have as a result of PTSD. We use these results to examine which treatment method is the most effective.
If people have been attacked, threatened, raped, held hostage, or have witnessed murder or violence, they sometimes develop what are known as post-traumatic stress symptoms.
The symptoms listed below may develop following a traumatic event. The following self-administered questionnaire is about your personal response to the traumatic event you experienced.
Answer ‘yes’ if you have experienced the following at least twice in the last week.
Fill in the following form and we will contact you within 48 hours to discuss the options.
- Disturbing thoughts or memories of the event that enter your mind against your will?
- Disturbing dreams about the event?
- You behave or feel as if the event is happening again?
- You are upset by things that remind you of the event?
- Physical responses (such as increased heart rate, a knot in the pit of your stomach, sweating, dizziness) when you are reminded of the event?
- Difficulty falling asleep, or waking up too early?
- Irritability or fits of anger?
- Difficulty concentrating?
- Increased awareness of potential dangers for yourself and others?
- Feeling tense or easily startled by something unexpected?
Did you answer ‘yes’ to 6 or more questions? Then you are probably suffering from post-traumatic stress disorder (PTSD).
Trauma Screening Questionnaire See: Brewin, C.R., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S., and Foa, E.B. (2002). Brief screening instrument for post-traumatic stress disorder. The British Journal of Psychiatry, 181, 158-162. Translation into Dutch: M.Olff.