We are writing a paper on Prolonged Exposure Therapy for people with schizophrenia and PTSD, and can't find any theoretic arguments/litterature for NOT using PE with people with schizophrenia? We can see that they are often excluded from studies but we can't find any theoretic reason why?
Perhaps concepts such as aberrant salience are relevant: would you risk exacerbation of the symptoms of the thought disorder to deal with the PTSD?
The following include more reasoning.
Examining potential contraindications for prolonged exposure therapy ...
www.ncbi.nlm.nih.gov/.../PMC34062...
National Center for Biotechnology Information
by A van Minnen - 2012 - Cited by 67 - Related articles
Jul 25, 2012 - Although prolonged exposure (PE) has received the most empirical ...... cognitive-behavioral treatment of PTSD in adults with schizophrenia or ...
[PDF]Prolonged exposure therapy for post-traumatic stress disorder: a ...
https://www.div12.org/.../Prolonged-exposure-therapy-for-post-traumatic-stress-disor...
by CP McLean - 2011 - Cited by 44 - Related articles
Prolonged exposure is a specific exposure therapy program that is considered a first-line evidence- based treatment for PTSD. ... lying exposure therapy in the treatment of chronic PTSD has been linked to the ...... patients with schizophrenia or.
HTML] Examining potential contraindications for prolonged exposure therapy for PTSD
A van Minnen, MS Harned, L Zoellner, K Mills - European Journal of …, 2012 - ejpt.net
... the effects of PE were studied in patients with a past year history of schizophrenia or
schizoaffective disorder (n=20; Frueh et al., 2009). Treatment consisted of a pre-exposure
treatment phase (14 sessions containing psycho-education, anxiety management therapy and ...
A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness.
KT Mueser, SD Rosenberg, H Xie… - Journal of consulting …, 2008 - psycnet.apa.org
... Childhood trauma, psychosis and schizophrenia: A literature review with theoretical and clinical
implications. Acta Psychiatrica Scandinavica, 112, 330-350. ... A comparison of cognitive processing
therapy with prolonged exposure and a waiting condition for the treatment of ...
Cited by 235 Related articles All 11 versions Cite Save
Does imaginal exposure exacerbate PTSD symptoms?
EB Foa, LA Zoellner, NC Feeny… - Journal of consulting …, 2002 - psycnet.apa.org
... relationship and those with primary diagnoses of organic mental disorder, schizophrenia, bipolar
disorder ... The data regarding symptom change following introduction of imaginal exposure were
derived from ... and after treatment, which consisted of either 9 or 12 therapy sessions. ...
A multidimensional meta-analysis of psychotherapy for PTSD
R Bradley, J Greene, E Russ, L Dutra… - American journal of …, 2005 - Am Psychiatric Assoc
... and suggest the possibility of adding modules to cognitive behavior therapy approaches to ... in
community settings not to use empirically supported therapies such as exposure for PTSD ... clinician
in practice would impose (eg, organic brain disorders, schizophrenia) and use ...
Cited by 1216 Related articles All 14 versions Cite Save
Regards
Have a look at van Minnen A et al. (2012) Examining potential contraindications for prolonged exposure therapy for PTSD. European Journal of Psychotraumatology 3: 18805 - http://dx.doi.org/10.3402/ejpt.v3i0.18805
I think all treatments for PTSD are worth trying in persons with comorbid PTSD and schizophrenia.
Article Symptom-Specific Group Therapy for Inpatients with Schizophre n i a
Article Comorbid: Posttraumatic Stress Disorder and Schizophrenia
Not only is PE safely used in those with psychosis
van den Berg, D. P., de Bont, P. A., van der Vleugel, B. M., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M. (2015). Trauma-Focused treatment in PTSD patients with psychosis: Symptom exacerbation, adverse events, and revictimization. Schizophrenia Bulletin. doi:10.1093/schbul/sbv172
So is EMDR therapy
van den Berg, D. P., de Bont, P. A., van der Vleugel, B. M., de Roos, C., de Jongh, A., Van Minnen, A., & van der Gaag, M. (2015). Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: A randomized clinical trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.2637
de Bont, P. A., van Minnen, A., & de Jongh, A. (2013). Treating PTSD in patients with psychosis: A within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols. Behavior Therapy, 44(4), 717-730. doi:10.1016/j.beth.2013.07.002
http://schizophreniabulletin.oxfordjournals.org/content/42/3/693
http://archpsyc.jamanetwork.com/article.aspx?articleid=2091663
http://www.sciencedirect.com/science/article/pii/S000578941300066X
The available data do not suggest that exposure therapy exacerbates psychotic symptoms. In an open trial of clients with co-occurring PTSD and schizophrenia, a PTSD treatment that included exposure (along with skill training, cognitive restructuring, and relaxation) resulted in significant improvements in PTSD symptoms, with no reported adverse events.
Frueh, B. C., Grubaugh, A. L., Cusack, K. J., Kimble, M. O., Elhai, J. D., & Knapp, R. G. (2009). Exposure-based cognitive-behavioral treatment of PTSD in adults with schizophrenia or schizoaffective disorder: A pilot study. Journal of Anxiety Disorders, 23, 665-675.
The reason for the absence of such studies is due to the lack of conceptions of the one-dimensionality of the human being, and this, in psychology, education, rehabilitation and other disciplines. Mental illness, mental imbalances and schizophrenia are essentially effects of no developments, of asphyxia or distortions of drives, emotions, feelings and affections of individuals. Physical, moral, pedagogical, educational, psychological and mental education, should have, in consideration, stimulation and development, to the harmonious whole of the individual.
Here is a relevant recent review and meta-analysis.
Brand, R. M., McEnery, C., Rossell, S., Bendall, S., & Thomas, N. (2018). Do trauma-focussed psychological interventions have an effect on psychotic symptoms? A systematic review and meta-analysis. Schizophr Res, 195, 13-22.
Article Do trauma-focussed psychological interventions have an effec...
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