Abstract
High rates of trauma and post-traumatic stress disorder (PTSD) are reported in people who hear voices (auditory hallucinations). A recent meta-analysis of trauma interventions in psychosis showed only small improvements in PSTD symptoms and voices. Imagery Rescripting (ImRs) may be a therapy that is more effective in this population because it generalizes over memories, which is ideal in this population with typically repeated traumas. The primary aims of this study were to investigate whether ImR reduces (1) PTSD symptoms, and (2) voice frequency and distress in voice hearers. We used a single arm open trial study, case-series design. Twelve voice hearers with previous traumas that were thematically related to their voices participated. Brief weekly assessments (administered in sessions 1-8, post-intervention, and at 3-month follow-up) and longer measures (administered pre-, mid- and post-intervention) were administered. Mixed regression analysis was used to analyse the results. There was one treatment drop-out. Results of the weekly measure showed significant linear reductions over time in all three primary variables - voice distress, voice frequency, and trauma intrusions - all with large effect sizes. These effects were maintained (and continued to improve for trauma intrusions) at 3-month follow-up. On the full assessment tools, all measures showed improvement over time, with five outcomes showing significant time effects: trauma, voice frequency, voice distress, voice malevolence and stress. The findings of the current study suggest that ImRs for PTSD symptoms is generally well tolerated and can be therapeutically beneficial among individuals who hear voices.
Highlights
There has been a recent increase in the awareness of the high prevalence of traumatic life events experienced by people who have been diagnosed with a psychotic disorder, with approximately 75% reporting a trauma history, and 16–25% meeting criteria for post-traumatic stress (PTSD; Anketell et al, 2010; Brewin and Patel, 2010; de Bont et al, 2015; Hardy et al, 2016)
The data reported here are taken from clients attending Perth Voices Clinic (PVC) for therapy to work on trauma and voices
The current study suggests that imagery rescripting for post-traumatic stress disorder (PTSD) symptoms is generally well tolerated and can be clinically beneficial for individuals whose voice hearing is distressing
Summary
There has been a recent increase in the awareness of the high prevalence of traumatic life events experienced by people who have been diagnosed with a psychotic disorder, with approximately 75% reporting a trauma history, and 16–25% meeting criteria for post-traumatic stress (PTSD; Anketell et al, 2010; Brewin and Patel, 2010; de Bont et al, 2015; Hardy et al, 2016). High rates of trauma and post-traumatic stress disorder (PTSD) are reported in people who hear voices (auditory hallucinations). Aims: The primary aims of this study were to investigate whether ImR reduces (1) PTSD symptoms, and (2) voice frequency and distress in voice hearers. Results of the weekly measure showed significant linear reductions over time in all three primary variables – voice distress, voice frequency, and trauma intrusions – all with large effect sizes. These effects were maintained (and continued to improve for trauma intrusions) at 3-month follow-up. Conclusions: The findings of the current study suggest that ImRs for PTSD symptoms is generally well tolerated and can be therapeutically beneficial among individuals who hear voices
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