Substantial empirical evidence supports the efficacy of (exposure-based) psychological treatments for PTSD ( 8– 10). Research shows that the burden of PTSD is high for both the individual (poor quality of life, chronic physical conditions) and society ( 4– 7). For those exposed to traumatic events the lifetime, 12-month and 30-day prevalence is estimated at 5.6, 2.8, and 1.4%, respectively ( 2), although this may depend on type of trauma exposure ( 3). The cross-national lifetime prevalence of PTSD in the general population is estimated at 3.9%.
These symptoms occur in response to exposure to (threat of) death, serious injury or sexual violation. Posttraumatic stress disorder (PTSD) is a serious mental disorder characterized by intrusive symptoms, persistent avoidance, changes in cognition, affect, arousal and reactivity ( 1).
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As such, the trial adds to the development of an empirically informed and individualized treatment indication process.Ĭlinical Trial registration:, NCT03833531. Additionally, biopsychosocial variables will be used to predict treatment outcome. Additionally, machine-learning techniques will be used to predict treatment outcome using biopsychosocial variables.ĭiscussion: This study protocol outlines the first RCT aimed at directly comparing the clinical efficacy and cost-effectiveness of imagery rescripting and integrated imagery rescripting and schema therapy for treatment seeking adult patients with PTSD and comorbid cluster C personality pathology. The main outcome is PTSD severity at 12 months. Predictors, mediators and outcome variables are measured at regular intervals over the course of 18 months. This trial is part of a larger research project on PTSD and personality disorders. Methods: An RCT with two parallel groups design will be used to compare the clinical efficacy and cost-effectiveness of “standalone” imagery rescripting ( n = 63) with integrated imagery rescripting and schema therapy ( n = 63). Present study design describes a randomized controlled trial (RCT) directly comparing trauma focused treatment with integrated trauma focused and personality focused treatment. Whether integrated treatment is more effective than treatment focused on PTSD alone is important, since (1) no evidence-based guideline for PTSD and comorbid CPD treatment exists, and (2) treatment approaches to CPD are costly and time consuming. However, no studies directly comparing the efficacy of regular PTSD treatment and treatment tailored to PTSD and comorbid CPD are available. An integrated PTSD and CPD treatment may be needed to increase treatment efficacy. PTSD and Cluster C personality disorders (avoidant, dependent or obsessive-compulsive personality disorder CPD) are highly comorbid and there is evidence for suboptimal treatment effects in this subgroup of patients. Whereas evidence-based treatments are available, dropout and non-response rates remain high. 8Department of Anatomy and Neurosciences, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center, Amsterdam, Netherlandsīackground: Posttraumatic stress disorder (PTSD) is a serious and relatively common mental disorder causing a high burden of suffering.7Amsterdam Neuroscience, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center, Amsterdam, Netherlands.6Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, Netherlands.4Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, Netherlands.3Arkin Mental Health Care, Amsterdam, Netherlands.2Department of Psychiatry, Academic Medical Center, Location Vrije Universiteit Medical Center, Amsterdam, Netherlands.1Sinai Centrum, Amstelveen, Netherlands.van den Heuvel 7,8 and Kathleen Thomaes 1,2,3 Beekman 2,5, Inga Aarts 1,2, Aishah Snoek 1,2, Matthijs Blankers 3,6, Chris Vriend 7,8, Odile A. Arne van den End 1,2 *, Jack Dekker 3,4, Aartjan T.
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