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There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of

Mobile health (mHealth) tools are regularly used in a wide range of mental health domains to assess and monitor patients, potentially increasing patient engagement. Recent studies demonstrated that tailored approaches provide better results than generic approaches. However, the effectiveness of tailoring has not yet been investigated empirically for patients with severe mental illnesses (SMIs). It also remains unclear how personalized goals, which are critical from a treatment point of view, impact engagement. Therefore, we designed a novel mHealth tool to increase SMI patient engagement with their personal goals which we evaluated empirically. We designed a two-period, two-arm within-subject crossover study in which 4 participants were exposed to personalized and non-personalized behavioral goals. Contrary to expectations, personalized behavioral goals did not have a significant impact on engagement levels. When considering our participant feedback and also in the context of flow theory, we rationalized that our goal personalization strategy was too static for SMI patients. Therefore, in our future work, we will investigate dynamic strategies that adapt goal difficulty over time.

Safety behaviors are behavioral responses that aim to prevent or minimize an imminent threat when confronting a feared stimulus. Despite its adaptive purpose, preliminary evidence suggests that unnecessary safety behaviors to a safety stimulus induce threat beliefs to it. By allowing participants to engage in safety behaviors dimensionally, this study tested whether the degree of safety behaviors to a safety stimulus predicts the subsequent level of threat expectancies to it. To this end, participants first acquired safety behaviors to a threat-related stimulus (A). Safety behaviors then became available only for one safety stimulus (C), but not to another safety stimulus (B). After engaging in safety behaviors to C, participants exhibited greater threat expectancies to C compared to B, albeit with a small effect size. Importantly, the degree of safety behaviors predicted an increase in threat expectancies. The current findings suggest that safety behaviors to safety stimuli are linked to the development of threat beliefs.

Emotional cues draw attention, thereby enabling enhanced processing. Electrophysiological brain research in humans suggests that increased gamma band activity and decreased alpha band activity over posterior brain areas is associated with the allocation of attention. However, emotional events can alternate quickly, like rapidly changing news items and it remains unknown whether the modulation of brain oscillations happens in a stimulus induced manner, changing with each individual stimulus, or whether the events lead to prolonged, state-like changes. To investigate this, we measured the electroencephalogram (EEG) during a passive viewing task (N = 32) while emotional pictures International Affective Picture System (IAPS) were presented in blocks containing either pleasant and neutral or unpleasant and neutral pictures. As predicted, we found decreased alpha and increased gamma power over posterior areas in response to unpleasant compared to pleasant pictures (and also compared to neutral pictures for gamma power). When testing the neutral pictures of the unpleasant and pleasant block against each other, we found no significant difference, which speaks to a stimulus induced effect of alpha and gamma power rather than a state effect. In addition, the inter-trial interval (ITI) between the pictures did not differ between the unpleasant and pleasant block either, corroborating this conclusion. Since emotional pictures can at the same time elicit a freezing-like response and we were interested in whether this freezing-like response co-occurs with enhanced attention, we also collected postural sway data. However, within this EEG-setup, postural analyses indicated no stimulus-related effects nor a correlation with EEG-data. We interpret the alpha and gamma band results as reflecting event-related attention toward unpleasant compared to pleasant (and neutral) pictures and discuss this finding in light of previous EEG research and in combination with behavioral research o

Background: Non-rapid eye movement (NREM) parasomnias are often benign and transient, requiring no formal treatment. However, parasomnias can also be chronic, disrupt sleep quality, and pose a significant risk of harm to the patient or others. Numerous behavioral strategies have been described for the management of NREM parasomnias, but there have been no published comprehensive reviews. This systematic review was conducted to summarize the range of behavioral and psychological interventions and their efficacy. Methods: We conducted a systematic search of the literature to identify all reports of behavioral and psychological treatments for NREM parasomnias (confusional arousals, sexsomnia, sleepwalking, sleep terrors, sleep-related eating disorder, parasomnia overlap disorder). This review was conducted in line with PRISMA guidelines. The protocol was registered with PROSPERO (CRD42021230360). The search was conducted in the following databases (initially on March 10, 2021 and updated February 24, 2023): Ovid (MEDLINE), Cochrane Library databases (Wiley), CINAHL (EBSCO), PsycINFO (EBSCO), and Web of Science (Clarivate). Given a lack of standardized quantitative outcome measures, a narrative synthesis approach was used. Risk of bias assessment used tools from Joanna Briggs Institute. Results: A total of 72 publications in four languages were included, most of which were case reports (68%) or case series (21%). Children were included in 32 publications and adults in 44. The most common treatment was hypnosis (33 publications) followed by various types of psychotherapy (31), sleep hygiene (19), education/reassurance (15), relaxation (10), scheduled awakenings (9), sleep extension/scheduled naps (9), and mindfulness (5). Study designs and inconsistent outcome measures limited the evidence for specific treatments, but some evidence supports multicomponent CBT, sleep hygiene, scheduled awakenings, and hypnosis. Conclusions: This review highlights t

Item does not contain fulltext, Emotional cues draw attention, thereby enabling enhanced processing. Electrophysiological brain research in humans suggests that increased gamma band activity and decreased alpha band activity over posterior brain areas is associated with the allocation of attention. However, emotional events can alternate quickly, like rapidly changing news items and it remains unknown whether the modulation of brain oscillations happens in a stimulus induced manner, changing with each individual stimulus, or whether the events lead to prolonged, state-like changes. To investigate this, we measured the electroencephalogram (EEG) during a passive viewing task (N = 32) while emotional pictures International Affective Picture System (IAPS) were presented in blocks containing either pleasant and neutral or unpleasant and neutral pictures. As predicted, we found decreased alpha and increased gamma power over posterior areas in response to unpleasant compared to pleasant pictures (and also compared to neutral pictures for gamma power). When testing the neutral pictures of the unpleasant and pleasant block against each other, we found no significant difference, which speaks to a stimulus induced effect of alpha and gamma power rather than a state effect. In addition, the inter-trial interval (ITI) between the pictures did not differ between the unpleasant and pleasant block either, corroborating this conclusion. Since emotional pictures can at the same time elicit a freezing-like response and we were interested in whether this freezing-like response co-occurs with enhanced attention, we also collected postural sway data. However, within this EEG-setup, postural analyses indicated no stimulus-related effects nor a correlation with EEG-data. We interpret the alpha and gamma band results as reflecting event-related attention toward unpleasant compared to pleasant (and neutral) pictures and discuss this finding in light of previous EEG research and in combination with behavioral research on t

Anxiety disorders are effectively treated with exposure therapy, but relapse remains high. Fear may reinstate after reoccurrence of the negative event because the expectancy of the aversive outcome (unconditioned stimulus [US]) is adjusted but not its evaluation. Imagery rescripting (ImRs) is an intervention that is proposed to work through revaluation of the US. The aim of our preregistered study was to test the effects of ImRs and extinction on US expectancy and US revaluation. Day 1 (n = 106) consisted of acquisition with an aversive film clip as US. The manipulation (ImRs + extinction, extinction-only, or ImRs-only) took place on Day 2. Reinstatement of fear was tested on Day 3. Results showed expectancy learning in both extinction conditions but not in the ImRs-only condition and no enhanced revaluation learning in ImRs. The combination of ImRs and extinction slowed down extinction but did not protect against reinstatement, which pleads in favor of stand-alone interventions in clinical practice.

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.

Objective: A substantial number of sexual assault victims report experiencing some form of peritraumatic tonic immobility (TI). A self-report questionnaire that is widely used to assess TI retrospectively is the Tonic Immobility Scale (TIS). This study explored the factor structure of the TIS in a clinical sample of adolescent and young adults. Method: The sample comprised 131 female rape victims, aged 13–25, who were referred for specialized trauma-focused treatment. An exploratory factor analysis (EFA) was performed. Results: The EFA showed support for a three-factor model, with factors TI, Fear, and Detachment. Item correlations ranged from.32 to.57 for TI, from.14 to.35 for Fear, and.29 for the two Detachment items. Conclusions: We found support for a three-factor solution distinguishing TI, fear, and detachment, suggesting the need to further develop the TIS with different subscales in varying age groups and clinical samples.

Radboud University, 08 april 2022, Promotores : Cillessen, A.H.N., Jensen, O. Co-promotor : Hagenaars, M.A., Contains fulltext : 247900.pdf (Publisher’s version ) (Closed access)

29 september 2022, Contains fulltext : 282601.pdf (Publisher’s version ) (Open Access), Mental imagery plays an important role in the onset and maintenance of psychological disorders as well as their treatment. Therefore, a reliable and valid measure of mental imagery is essential. Andrade and colleagues (2014) developed the Plymouth Sensory Imagery Questionnaire (PsiQ), which contains 35 items (long version) or 21 items (shortened version) measuring the vividness of mental imagery in seven different modalities: vision, sound, smell, taste, touch, bodily sensation, and emotion. Andrade et al. reported a seven-factor structure corresponding to the different modalities for both versions rather than a one-factor model measuring general mental imagery. The current paper reports on the translation and validation of the Dutch version of the PsiQ (PsiQ-NL-35 and PsiQ-NL-21). In two independent samples (student and mixed), the PsiQ-NL-35 showed excellent internal consistency, adequate model fit for the seven-factor model, and a poor fit for the one-factor model. Test-retest reliability (Study 1, student sample) was good. Construct validity (Study 2, mixed sample) was adequate. The PsiQ-NL-21 also showed excellent internal consistency, good test-retest reliability, adequate seven-factor model fit, and adequate construct validity. Measurement invariance between the Dutch and the English version was found, implying that both versions measure the same construct.

21 december 2021, Item does not contain fulltext, Anxiety disorders are effectively treated with exposure therapy, but relapse remains high. Fear may reinstate after reoccurrence of the negative event because the expectancy of the aversive outcome (unconditioned stimulus [US]) is adjusted but not its evaluation. Imagery rescripting (ImRs) is an intervention that is proposed to work through revaluation of the US. The aim of our preregistered study was to test the effects of ImRs and extinction on US expectancy and US revaluation. Day 1 (n = 106) consisted of acquisition with an aversive film clip as US. The manipulation (ImRs + extinction, extinction-only, or ImRs-only) took place on Day 2. Reinstatement of fear was tested on Day 3. Results showed expectancy learning in both extinction conditions but not in the ImRs-only condition and no enhanced revaluation learning in ImRs. The combination of ImRs and extinction slowed down extinction but did not protect against reinstatement, which pleads in favor of stand-alone interventions in clinical practice.

A spinal cord injury (SCI) is a traumatic life-event with significant physical and psychological consequences. SCI patients are found to experience more psychological distress and to be more at risk for developing anxiety or depressive disorders. It is important to reduce these psychological problems, because they may limit physical recovery. This study investigated the effect of illness perception (i.e. cognitive representation of an illness) on anxiety and depression, and whether passive coping mediates this effect. Illness perception was expected to have a direct effect on anxiety and depression, as well as an indirect effect via passive coping. A total of 273 SCI patients admitted to eight Dutch rehabilitation centers with specialized SCI units completed the Brief Illness Perception Questionnaire (BIPQ), Utrechtse Coping Lijst (UCL) and Hospital Anxiety and Depression Scale (HADS) within 2 weeks of admission. The PROCESS tool was used to test the presence of mediation. Results confirmed the expectations; the effect of illness perception was partially mediated by passive coping. Effects of illness perception however were small, whereas the direct effect of the mediator passive coping on anxiety and depression was much larger. Results indicate that the effect of passive coping may be more important than the (mediated) effect of illness perception, and that interventions aimed at improving coping may therefore be more useful than those aimed at improving illness perception

This symposium brings together studies on mechanisms of posttraumatic stress disorder (PTSD) development that may offer clues for therapeutic interventions. Sensory-rich, intrusive trauma memories are a key symptom of PTSD. Cognitive theories posit that these intrusions result from dysfunctions in the encoding and the subsequent consolidation into memory. The studies in the current symposium examine whether sleep and tonic immobility may affect these processes. To maximize experimental control, all studies used an analogue design with aversive stimuli as a model for trauma and intrusive memories as an outcome measure. The questions addressed include whether behavioural control may mitigate detrimental effects of tonic mobility (Hagenaars and colleagues); what aspects of sleep may be important for trauma memory (Sopp and colleagues) and whether brief sleep episodes (naps) 18 ESTSS 2019 Rotterdam Symposium Abstract Book may protect against intrusions (Kleim &Wilhelm). The symposium will be concluded with a general discussion (Hagenaars) on how the results may inform intervention strategies.

Background: Tonic immobility (TI; involuntary motor inhibition during threat) has been implicated in the onset of posttraumatic stress disorder (PTSD) in previous studies, using cross-sectional designs and (retrospectively measured) TI. Only one study examined spontaneous TI responses in a more controlled setting,using experimental trauma (a ‘trauma film’). TI during the ‘trauma film’ was indeed associated with increased frequency of intrusive memories of the film (Hagenaars & Putman, 2011). Interestingly, high attentional control(the ability to focus and switch attention) buffered against this effect. Reduced controllability was indeed proposed to stimulate PTSD development. In experiments, behavioural control was related to reduced stress when anticipating threat. However, findings are less consistent or scarce for the impact period and postthreat period. Objective: Replicate the TI x Controlinteraction1 (but with behavioural control) for the impact and post-threat period. Method: Sixty-four participants watched an experimental trauma (negative pictures) while being allowed to close their eyes or not. Spontaneous TI was measured after picture viewing; intrusions were recorded in a diary in the subsequent week. Informative hypotheses were tested with Bayesian analyses. Results: TI predicted intrusion development. Moderation (TI x Control) and non-moderation (main effect of TI only) were both adequate models, with no preference for either. Conclusions: We replicated earlier cross-sectional findings regarding TIusing a longitudinal trauma-analogue design. The role of behavioural control may be complicated and/or indirect

Patients with post-traumatic stress disorder frequently and involuntarily experience intrusions, which are strongly linked to the trauma hotspot. Voluntary memory characteristics (i.e., vividness and unpleasantness) of this hotspot can be reduced by performing a dual-task, such as making horizontal eye movements, which is frequently used in Eye Movement Desensitization and Reprocessing. We tested whether such dual-task interventions would also reduce involuntary memory (i.e., intrusions). Moreover, we examined if changes in hotspot vividness and unpleasantness predicted intrusion frequency. Additionally, we examined whether the effects were dependent on dual-task modality. We tested this in three experiments. Participants watched a trauma film and performed one of the interventions 10-min post-film (1) Recall + Eye movements, (2) Recall + Counting, or (3) No-Task Control. Before and after the intervention, participants rated the hotspot vividness and unpleasantness. They recorded intrusive memories about the film in a diary for a week. Unexpectedly, we found that hotspot vividness and unpleasantness ratings were not affected by the intervention. However, the prolonged (experiment 2), but not standard (experiment 1), dual-task interventions resulted in a lower number of intrusions, regardless of modality. However, this effect was not replicated in experiment 3. We discuss potential explanations and present suggestions for future research.

Contains fulltext : 206744.pdf (publisher's version ) (Open Access)