Trauma-Focused Treatment in PTSD Patients With Psychosis: Symptom Exacerbation, Adverse Events, and Revictimization

van den Berg, David P. G.; de Bont, Paul A. J. M.; van der Vleugel, Berber M.; de Roos, Carlijn; de Jongh, Ad; van Minnen, Agnes; van der Gaag, Mark

doi:10.1093/schbul/sbv172

Cited by 153Posttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology ResearchPsychotherapy Techniques and Applications

Trauma-Focused Treatment in PTSD Patients With Psychosis: Symptom Exacerbation, Adverse Events, and Revictimization

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van den Berg, David P. G., de Bont, Paul A. J. M., van der Vleugel, Berber M., de Roos, Carlijn, de Jongh, Ad, van Minnen, Agnes, van der Gaag, Mark·2016·Schizophrenia Bulletin

DOI 10.1093/schbul/sbv172PMC PMC4838096

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Abstract

OBJECTIVES: Most clinicians refrain from trauma treatment for patients with psychosis because they fear symptom exacerbation and relapse. This study examined the negative side effects of trauma-focused (TF) treatment in patients with psychosis and posttraumatic stress disorder (PTSD). METHODS: Analyses were conducted on data from a single-blind randomized controlled trial comparing TF treatment (N = 108; 8 sessions prolonged exposure or eye movement desensitization) and waiting list (WL; N = 47) among patients with a lifetime psychotic disorder and current chronic PTSD. Symptom exacerbation, adverse events, and revictimization were assessed posttreatment and at 6-month follow-up. Also investigated were symptom exacerbation after initiation of TF treatment and the relationship between symptom exacerbation and dropout. RESULTS: Any symptom exacerbation (PTSD, paranoia, or depression) tended to occur more frequently in the WL condition. After the first TF treatment session, PTSD symptom exacerbation was uncommon. There was no increase of hallucinations, dissociation, or suicidality during the first 2 sessions. Paranoia decreased significantly during this period. Dropout was not associated with symptom exacerbation. Compared with the WL condition, fewer persons in the TF treatment condition reported an adverse event (OR = 0.48, P = .032). Surprisingly, participants receiving TF treatment were significantly less likely to be revictimized (OR = 0.40, P = .035). CONCLUSIONS: In these participants, TF treatment did not result in symptom exacerbation or adverse events. Moreover, TF treatment was associated with significantly less exacerbation, less adverse events, and reduced revictimization compared with the WL condition. This suggests that conventional TF treatment protocols can be safely used in patients with psychosis without negative side effects.

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Previous adversity-focused trials among people with chronic psychosis observed few psychotic symptom exacerbations.
“Although previous adversity-focused trials among people with chronic psychosis similarly observed few psychotic symptom exacerbations [20]”
From Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial (2024) · cites this paper as [20]
Preliminary evidence suggests PE reduces symptoms of psychosis and PTSD and does not lead to symptom exacerbation.
“Preliminary evidence suggests that PE treatment reduces symptoms of psychosis and PTSD, and does not lead to symptom exacerbation [15, 20].”
From Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial (2024) · cites this paper as [20]
Evidence on PE has focused almost exclusively on chronic psychosis rather than early phase psychosis, and SM outcomes have rarely been considered.
“However, the evidence has thus far focused almost exclusively on people with chronic psychosis rather than early phase psychosis (EPP; i.e., first 5 years of a psychotic disorder), and SM outcomes have rarely been considered. [20].”
From Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial (2024) · cites this paper as [20]

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Dissociative Symptoms In Posttraumatic Stress Disorder: A Systematic Review
Atchley, R., & Bedford, C. E. (2020) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2020.1760410 · Cited by 41 · see citing works
First, do no harm: An intensive experience sampling study of adverse effects to mindfulness training
Aizik-Reebs, A., Shoham, A., & Bernstein, A. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103941 · Cited by 41 · see citing works
Addressing co‐occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence‐based psychotherapies for adults: A systematic review
Rozek, D. C., Baker, S. N., Rugo, K. F., Steigerwald, V. L., Sippel, L. M., Holliday, R. P., Roberge, E. M., Held, P., Mota, N. P., & Smith, N. B. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22774 · Cited by 43 · see citing works
Negative effects in randomized controlled trials of psychotherapies and psychological interventions: A systematic review
Honkalampi, K. M., Urhonen, H.-R., & Virtanen, M. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2301972 · Cited by 36 · see citing works
Effectiveness of trauma-focused treatment for patients with psychosis with and without the dissociative subtype of post-traumatic stress disorder
van Minnen, A., van der Vleugel, B. M., van den Berg, D. P. G., de Bont, P. A. J. M., de Roos, C., van der Gaag, M., & de Jongh, A. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.116.185579 · Cited by 36 · see citing works
Trauma‐focused imaginal exposure for auditory hallucinations: A case series
Brand, R. M., Bendall, S., Hardy, A., Rossell, S. L., & Thomas, N. (2020) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12284 · Cited by 36 · see citing works
“The effects seen here are in line with those from previous studies (van den Berg et al., 2015a) and suggest that participants received a sufficient ‘dose’ of imaginal exposure to act on the mechanisms of interest.”
Result
Effect of child abuse and neglect on schizophrenia and other psychotic disorders
Chaiyachati, B. H., & Gur, R. E. (2021) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2021.173195 · Cited by 34 · see citing works
Cognitive behavioral therapy for posttraumatic stress disorder in individuals with severe mental illness and borderline personality disorder
Kredlow, M. A., Szuhany, K. L., Lo, S., Xie, H., Gottlieb, J. D., Rosenberg, S. D., & Mueser, K. T. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2016.12.045 · Cited by 33 · see citing works
The potential role of EMDR on trauma in affective disorders: A narrative review
Perlini, C., Donisi, V., Rossetti, M. G., Moltrasio, C., Bellani, M., & Brambilla, P. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.001 · Cited by 33 · see citing works
Barriers to delivering trauma‐focused interventions for people with psychosis and post‐traumatic stress disorder: A qualitative study of health care professionals’ views
Chadwick, E., & Billings, J. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12387 · Cited by 33 · see citing works
Health–economic benefits of treating trauma in psychosis
de Bont, P. A. J. M., van der Vleugel, B. M., van den Berg, D. P. G., de Roos, C., Lokkerbol, J., Smit, F., de Jongh, A., van der Gaag, M., & van Minnen, A. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1565032 · Cited by 29 · see citing works
Eye movement desensitization and reprocessing (EMDR) therapy for posttraumatic stress disorder in adults with serious mental illness within forensic and rehabilitation services: a study protocol for a randomized controlled trial
Every‐Palmer, S., Flewett, T., Dean, S., Hansby, O., Colman, A., Weatherall, M., & Bell, E. M. (2019) · Trials · doi:10.1186/s13063-019-3760-2 · Cited by 29 · see citing works
The Current Status of EMDR Therapy Involving the Treatment of Complex Posttraumatic Stress Disorder
de Jongh, A., Bicanic, I., Matthijssen, S. J. M. A., Amann, B. L., Hofmann, A., Farrell, D. P., Lee, C. W., & Maxfield, L. (2019) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.13.4.284 · Cited by 26 · see citing works
Pathways to aggression and violence in psychosis without longstanding antisocial behavior: A review and proposed psychosocial model for integrative clinical interventions
Adams, S. W., & Yanos, P. T. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113427 · Cited by 28 · see citing works
The bumpy road of trauma‐focused treatment: Posttraumatic stress disorder symptom exacerbation in people with psychosis
Burger, S. R., Hardy, A., van der Linden, T., van Zelst, C., de Bont, P. A. J. M., van der Vleugel, B. M., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M. C., et al. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22907 · Cited by 27 · see citing works
Treatment of Intrusive Suicidal Imagery Using Eye Movements
van Bentum, J. S., Sijbrandij, M., Huibers, M. J. H., Huisman, A., Arntz, A. R., Holmes, E. A., & Kerkhof, A. J. F. M. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14070714 · Cited by 23 · see citing works
Stabilizing group treatment for childhood-abuse related PTSD: a randomized controlled trial
Bækkelund, H., Karlsrud, I., Hoffart, A., & Arnevik, E. A. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1859079 · Cited by 23 · see citing works
Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma
Blom, J. D., & Mangoenkarso, E. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00193 · Cited by 21 · see citing works
Untangling the complex relationships between symptoms of schizophrenia and emotion dynamics in daily life: Findings from an experience sampling pilot study
Westermann, S., Grezellschak, S., Oravecz, Z., Moritz, S., Lüdtke, T., & Jansen, A. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.08.023 · Cited by 20 · see citing works
‘Twisting the lion's tail’: Manipulationist tests of causation for psychological mechanisms in the occurrence of delusions and hallucinations
Brown, P., Waite, F., & Freeman, D. H. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.12.003 · Cited by 20 · see citing works
Treating the “E” in “G × E”: Trauma-Informed Approaches and Psychological Therapy Interventions in Psychosis
Gianfrancesco, O., Bubb, V. J., & Quinn, J. P. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00009 · Cited by 20 · see citing works
Trauma-focused therapies for post-traumatic stress in psychosis: study protocol for the RE.PROCESS randomized controlled trial
Burger, S. R., van der Linden, T., Hardy, A., de Bont, P. A. J. M., van der Vleugel, B. M., Staring, A. B. P., de Roos, C., van Zelst, C., Gottlieb, J. D., Mueser, K. T., et al. (2022) · Trials · doi:10.1186/s13063-022-06808-6 · Cited by 19 · see citing works
Posttraumatic Stress Disorder Symptoms and Social and Occupational Functioning of People With Schizophrenia
Ng, L. C., Petruzzi, L. J., Greene, M. C., Mueser, K. T., Borba, C. P. C., & Henderson, D. C. (2016) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000523 · Cited by 17 · see citing works
Growth parameters of the invasive lionfish (Pterois volitans) in the Colombian Caribbean
Bustos-Montes, D., Wolff, M., Sanjuan-Muñoz, A., & P., A. (2020) · Regional Studies in Marine Science · doi:10.1016/j.rsma.2020.101362 · Cited by 9 · see citing works
Predicting trauma-focused treatment outcome in psychosis
van den Berg, D. P. G., van der Vleugel, B. M., de Bont, P. A. J. M., Staring, A. B. P., Kraan, T. C., Ising, H. K., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.07.016 · Cited by 17 · see citing works
Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies
van den Berg, D. P. G., van der Vleugel, B. M., de Bont, P. A. J. M., Thijssen, G., de Roos, C., de Kleine, R. A., Kraan, T. C., Ising, H. K., de Jongh, A., van Minnen, A., et al. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.31712 · Cited by 17 · see citing works
Treating patients with severe mental illness with narrative exposure therapy for comorbid post-traumatic stress disorder
Mauritz, M. W., van Gaal, B. G. I., Goossens, P. J. J., Jongedijk, R. A., & Vermeulen, H. (2020) · BJPsych Open · doi:10.1192/bjo.2020.124 · Cited by 16 · see citing works
Reductions in reported persecutory ideation and psychotic-like experiences during exposure therapy for posttraumatic stress disorder
Buck, B., Norr, A. M., Katz, A. C., Gahm, G. A., & Reger, G. M. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.12.022 · Cited by 16 · see citing works
Does cortical brain morphology act as a mediator between childhood trauma and transition to psychosis in young individuals at ultra-high risk?
Rapado‐Castro, M., Whittle, S., Pantelis, C., Thompson, A. D., Nelson, B., Ganella, E. P., Lin, A. P., Reniers, R. L. E. P., McGorry, P. D., Yung, A. R., et al. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.09.017 · Cited by 15 · see citing works
Eye Movement Desensitization and Reprocessing (EMDR) in a forensic patient with Posttraumatic Stress Disorder (PTSD) resulting from homicide: a case study
Fleurkens, P., Hendriks, L., & van Minnen, A. (2018) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/14789949.2018.1459786 · Cited by 14 · see citing works
Implementation of evidence-based treatment for PTSD in Norway: clinical outcomes and impact of probable complex PTSD
Bækkelund, H., Endsjø, M., Peters, N., Babaii, A., & Egeland, K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2116827 · Cited by 11 · see citing works
Clinical and cost‐effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post‐traumatic stress disorder in adults: A systematic review and meta‐analysis
Simpson, E. L., Carroll, C., Sutton, A., Forsyth, J. E., Rayner, A., Ren, S., Franklin, M. K., & Wood, E. (2025) · British Journal of Psychology · doi:10.1111/bjop.70005 · Cited by 16 · see citing works
Adding EMDR for PTSD at the onset of treatment of borderline personality disorder: A pilot study
Wilhelmus, B., Marissen, M. A. E., van den Berg, D. P. G., Driessen, A., Deen, M. L., & Slotema, K. (2023) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2023.101834 · Cited by 12 · see citing works
A systematic review and meta-analysis of the traumatogenic phenotype hypothesis of psychosis
Onyeama, F., Melegkovits, E. A., Yu, N., Parvez, A., Rodrigues, A., Billings, J., Kelleher, I., Cannon, M. D., & Bloomfield, M. (2024) · BJPsych Open · doi:10.1192/bjo.2024.52 · Cited by 12 · see citing works
Attachment‐focused iMAgery therapy for PSychosis (A‐iMAPS) : A case series targeting psychosis‐related trauma
Airey, N. D., Berry, K., & Taylor, C. D. J. (2023) · British Journal of Clinical Psychology · doi:10.1111/bjc.12433 · Cited by 12 · see citing works
Exploring the impact of adverse childhood experiences on symptomatic and functional outcomes in adulthood: advances, limitations and considerations
Cotter, J., & Yung, A. R. (2017) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2017.53 · Cited by 12 · see citing works
The effectiveness and tolerability of trauma‐focused psychotherapies for psychotic symptoms: A systematic review of trauma‐focused psychotherapies
Reid, J., Cole, C. L., Malik, N., Bell, V., & Bloomfield, M. (2024) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.2005 · Cited by 11 · see citing works
‘Like jumping off a ledge into the water’: A qualitative study of trauma‐focussed imaginal exposure for hearing voices
Feary, N., Brand, R. M., Williams, A., & Thomas, N. (2021) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12372 · Cited by 12 · see citing works
Trauma Therapies in Psychosis
van den Berg, D. P. G., van de Giessen, I., & Hardy, A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815012-2.00019-5 · Cited by 10 · see citing works
Imaginal exposure exacerbation revisited: Deconstructing patient characteristics associated with worse reactions to the initiation of imaginal exposure in PTSD
Walker, R. S. W., Marks, E. H., Jaeger, J. A., Duax, J. M., Feeny, N. C., & Zoellner, L. A. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103747 · Cited by 10 · see citing works
Psychosis: An Emerging Field for EMDR Research and Therapy
de Bont, P. A. J. M., de Jongh, A., & van den Berg, D. P. G. (2019) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.13.4.313 · Cited by 10 · see citing works
EMDR treatment in patients with personality disorders. Should we fear symptom exacerbation?
Hafkemeijer, L., de Jongh, A., Starrenburg, A., Hoekstra, T., & Slotema, K. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2407222 · Cited by 9 · see citing works
Significant improvement of posttraumatic stress disorder and psychotic symptoms after inpatient Eye Movement Desensitization and Reprocessing treatment: A case report with 6-month follow-up
Kratzer, L., Heinz, P., & Schennach, R. (2017) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_318_16 · Cited by 9 · see citing works
Gender differences in medication prescribing patterns for veterans with posttraumatic stress disorder: A 10‐year follow‐up study
Hadlandsmyth, K., Bernardy, N. C., & Lund, B. C. (2022) · Journal of Traumatic Stress · doi:10.1002/jts.22861 · Cited by 8 · see citing works
Childhood Trauma in Clozapine-Resistant Schizophrenia: Prevalence, and Relationship With Symptoms
Dudley, R. E. J., Turkington, D., Coulthard, N., Pyle, M., Gumley, A. I., Schwannauer, M., Kingdon, D., & Morrison, A. P. (2023) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgad030 · Cited by 7 · see citing works
Childhood trauma and real-world social experiences in psychosis
Steenkamp, L. R., Parrish, E. M., Chalker, S. A., Badal, V. D., Pinkham, A. E., Harvey, P. D., & Depp, C. A. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2022.12.039 · Cited by 7 · see citing works
A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design
Valiente-Gómez, A., Pujol, N., Moreno‐Alcázar, A., Raduà, J., Monteagudo-Gimeno, E., Gardoki-Souto, I., Hogg, B., Álvarez, M.-J., Safont, G., Lupo, W., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.01023 · Cited by 7 · see citing works
“org 7 exposure therapy in patients with PTSD and chronic schizophrenia (66, 67) and other severe mental disorders (23, 26).”
Background
Extrasynaptic Localization Is Essential for α5GABA A Receptor Modulation of Dopamine System Function
McCoy, A. M., Prevot, T. D., Mian, M. Y., Sharmin, D., Ahmad, A. N., Cook, J. M., Sibille, E. L., & Lodge, D. J. (2024) · eNeuro · doi:10.1523/eneuro.0344-23.2023 · Cited by 6 · see citing works
Psychological Interventions for Persons With Co-occurring Psychotic and Traumatic-Stress Symptoms: A Systematic Review and Meta-analysis
Niemeyer, H., Opper, F., Sabé, M., Holmes, E. A., & Böge, K. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf185 · Cited by 6 · see citing works
Development of an Intervention Aimed at Increasing Awareness and Acknowledgement of Victimisation and Its Consequences Among People with Severe Mental Illness
Albers, W. M. M., Nijssen, Y. A. M., Roeg, D. P. K., Bongers, I. M. B., & van Weeghel, J. (2021) · Community Mental Health Journal · doi:10.1007/s10597-021-00776-y · Cited by 6 · see citing works
Beyond Psychopharmacology: Emerging Psychosocial Interventions for Core Symptoms of Schizophrenia
Weiden, P. J. (2016) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20160014 · Cited by 6 · see citing works
A tale of two outcomes: Remission and exacerbation in the use of trauma‐focused imaginal exposure for trauma‐related voice‐hearing. Key learnings to guide future practice
Brand, R. M., Hardy, A., Bendall, S., & Thomas, N. (2019) · Clinical Psychologist · doi:10.1111/cp.12202 · Cited by 6 · see citing works
Diagnostik und Behandlung der posttraumatischen Belastungsstörung
Schäfer, I., Ehring, T. W., Knaevelsrud, C., Maercker, A. R. A., Michael, T., & Schellong, J. (2020) · Psychotherapeut · doi:10.1007/s00278-020-00459-1 · Cited by 6 · see citing works
A brief intervention for PTSD versus treatment as usual: Study protocol for a non-inferiority randomized controlled trial
Stavland, H., Refvik, C., Eid, J., Lockhat, R., & Hammar, Å. (2021) · Trials · doi:10.1186/s13063-021-05674-y · Cited by 6 · see citing works
Narrative Exposure Therapy in challenging and conditions
Breinlinger, S., Pütz, A.-K., Stevens, N. R., Mier, D. U., Schalinski, I., & Odenwald, M. G. (2021) · MALTRATTAMENTO E ABUSO ALL INFANZIA · doi:10.3280/mal2020-003004 · Cited by 5 · see citing works
Scientific Evaluation of EMDR Psychotherapy for the Treatment of Psychological Trauma Summary: Scientific evaluation of EMDR psychotherapy
Haour, F., Dobbelaere, E., & Beaurepaire, C. (2019) · Journal of Neurology and Neuromedicine · doi:10.29245/2572.942x/2019/2.1234 · Cited by 5 · see citing works
Trauma-focused psychological interventions for psychosis: Meta-analytic evidence of differential effects on delusions and hallucinations
Toutountzidis, D., Ricketts, E., & Laws, K. R. (2026) · Psychological Medicine · doi:10.1017/s0033291725103036 · Cited by 4 · see citing works
The complex care of a torture survivor in the United States
Berthold, S. M., Polatin, P. B., Mollica, R. F., Higson-Smith, C., Streets, F. J., Kelly, C. M., & Lavelle, J. (2020) · Torture Journal · doi:10.7146/torture.v30i1.113063 · Cited by 4 · see citing works
“However, this has not been found to be the case, and it is recommended that trauma-focused therapies be initiated early on (van den Berg et al., 2016).”
Background
Is there an association between caregiver antipathy and psychosis? A systematic review
Barnes, G. L., Garety, P. A., Emsley, R., Jameel, L., & Hardy, A. (2021) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12328 · Cited by 4 · see citing works
BEATVIC, a body-oriented resilience therapy for individuals with psychosis: Short term results of a multi-center RCT
van der Stouwe, E. C. D., de Vries, B., Steenhuis, L. A., Waarheid, C. O., Jans, R., de Jong, S., Aleman, A., Pijnenborg, G. H. M., & Busschbach, J. T. V. (2022) · PLoS ONE · doi:10.1371/journal.pone.0279185 · Cited by 4 · see citing works
Letter to the Editor: Targeting adverse stress-related consequences of the COVID-19 crisis in individuals with psychotic disorders and childhood maltreatment
Fares‐Otero, N. E., Trautmann, S., Pfaltz, M. C., & Rodríguez–Jiménez, R. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.04.031 · Cited by 4 · see citing works
Risk factors for suicidality across psychosis vulnerability spectrum
Stephan, N. M., van Sprang, E. D., Wiebenga, J. X. M., Dickhoff, J., Schirmbeck, F. N., de Haan, L., van Amelsvoort, T., Veling, W., Alizadeh, B. Z., Simons, C. J. P., et al. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.09.021 · Cited by 3 · see citing works
Foundations of Prolonged Exposure
Foa, E. B., Hembree, E. A., ROTHBAUM, B. O., & Rauch, S. A. M. (2019) · doi:10.1093/med-psych/9780190926939.003.0001 · Cited by 3 · see citing works
Corrigendum: A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design
Valiente-Gómez, A., Pujol, N., Moreno‐Alcázar, A., Raduà, J., Monteagudo-Gimeno, E., Gardoki-Souto, I., Hogg, B., Álvarez, M.-J., Safont, G., Lupo, W., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00283 · Cited by 3 · see citing works
Correction to: Development of an Intervention Aimed at Increasing Awareness and Acknowledgement of Victimisation and Its Consequences Among People with Severe Mental Illness
Albers, W. M. M., Nijssen, Y. A. M., Roeg, D. P. K., Bongers, I. M. B., & van Weeghel, J. (2021) · Community Mental Health Journal · doi:10.1007/s10597-021-00795-9 · Cited by 3 · see citing works
How first-episode psychosis patients' subjective beliefs about their childhood trauma's causal effect provide support for potential schizophrenia subtypes
Schaug, J. P., Storebø, O. J., Pedersen, M. B., Haahr, U., & Simonsen, E. H. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.11.005 · Cited by 2 · see citing works
Revictimisation Across Types of Interpersonal Violence: A Meta‐Regression Analysis of PTSD and Associated Factors
Kühner, C., Emmelkamp, J., Goudriaan, A. E., de Waal, M. M., & Thomaes, K. (2025) · Stress and Health · doi:10.1002/smi.70079 · Cited by 2 · see citing works
Narrative exposure therapy in early intervention in psychosis services (NETp): protocol of a multi-site feasibility randomised controlled trial study
Fornells‐Ambrojo, M., Plaistow, J., Hardy, A., Martin, P., Lyons, N., Khan, Z., Mberi, A., Morris, T., & Johnson, S. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-121914 · Cited by 2 · see citing works
Trauma―Focused Treatment for PTSD With Comorbid Psychosis: A Case Report
Cherestal, S., & Herts, K. L. (2020) · Clinical Case Studies · doi:10.1177/1534650120980069 · Cited by 2 · see citing works
“…reduction in PTSD symptomatology in patients also presenting with psychotic symptoms following traumafocused treatment, with no significant differences in adverse events or symptom exacerbation between treatment and control groups (Grubaugh et al., 2016, 2017; van den Berg et al., 2015, 2016).”
Background
Internet-based emotion regulation training aimed at reducing violent revictimization and depressive symptoms in victimized depressed patients: Results of a randomized controlled trial
Christ, C., van Schaik, A., Kikkert, M., de Waal, M. M., Dozeman, E., Hulstijn, H. L., Koomen, L. E. M., Krah, I. M., Schut, D. M., Beekman, A. T. F., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.028 · Cited by 2 · see citing works
Feasibility of trauma-focused cognitive behavioural therapy for patients with PTSD and psychosis
Buhmann, C., Mortensen, E. L., Græbe, F. L., Larsen, S. K., Harder, S. K., Arnfred, S., & Austin, S. F. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1375972 · Cited by 3 · see citing works
The effects of a specialized staff training on trauma-sensitivity in professionals working with patients with a psychotic disorder: A pilot study
Visser, M. S. G., Boonstra, N., de Bont, P. A. J. M., van der Vleugel, B. M., & van den Berg, D. P. G. (2021) · Psychosis · doi:10.1080/17522439.2021.1994635 · Cited by 2 · see citing works
The Clinical Characteristics of Patients With Borderline Personality Disorder in Different Treatment Settings
Ward, M., Benjamin, I., & Zimmerman, M. A. (2021) · Journal of Personality Disorders · doi:10.1521/pedi_2021_35_536 · Cited by 3 · see citing works
Trauma and Psychosis: A Qualitative Study Exploring the Perspectives of People with PsychosisPreprint
Campodonico, C., Varese, F., & Berry, K. (2021) · Research Square · doi:10.21203/rs.3.rs-568000/v1 · Cited by 2 · see citing works

The bumpy road of trauma‐focused treatment: Posttraumatic stress disorder symptom exacerbation in people with psychosis
Burger, S. R., Hardy, A., van der Linden, T., van Zelst, C., de Bont, P. A. J. M., van der Vleugel, B. M., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M. C., et al. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22907 · Cited by 27 · see citing works
Predicting trauma-focused treatment outcome in psychosis
van den Berg, D. P. G., van der Vleugel, B. M., de Bont, P. A. J. M., Staring, A. B. P., Kraan, T. C., Ising, H. K., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.07.016 · Cited by 17 · see citing works
In response
Torrey, Ε. F., Simmons, W. W., & Yolken, R. H. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.08.005
Do trauma-focussed psychological interventions have an effect on psychotic symptoms? A systematic review and meta-analysis
Brand, R. M., McEnery, C., Rossell, S. L., Bendall, S., & Thomas, N. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.08.037 · Cited by 117 · see citing works
Trauma‐Focused Treatment in Psychosis: A Systematic Review
Hellen, I., Døsvig, S. G., Liseth, B. E., Mørkved, N., Johannessen, J. O., & Løberg, E. ‐. (2025) · Early Intervention in Psychiatry · doi:10.1111/eip.70064 · Cited by 5 · see citing works

Authors: van den Berg, D. P. G., de Bont, P. A. J. M., van der Vleugel, B. M., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M.
Venue: Schizophrenia Bulletin
Publisher: Oxford University Press (OUP)
Published: 2015-11-24
Volume: 42
Issue: 3
Pages: 693-702
ISSN: 0586-7614 (ISSN-L)
1745-1701
DOI: 10.1093/schbul/sbv172
PMC: PMC4838096
OpenAlex: W2179855908
Cited by: 153
References: 47
Citations by year: 2026: 9 · 2025: 8 · 2024: 10 · 2023: 10 · 2022: 15 · 2021: 20 · 2020: 17 · 2019: 32 · 2018: 12 · 2017: 13 · 2016: 7
FWCI: 13.23
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Schizophrenia Bulletin (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
UvA-DARE (University of Amsterdam) (publishedVersion)
VU Research Portal (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: trauma-focused psychotherapy, post-traumatic stress disorder
MeSH terms: Adult, Female, Follow-Up Studies, Humans, Implosive Therapy, Male, Middle Aged, Psychotic Disorders, Stress Disorders, Post-Traumatic, Comorbidity, Single-Blind Method, Outcome Assessment, Health Care, Eye Movement Desensitization Reprocessing

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Trauma-Focused Treatment in PTSD Patients With Psychosis: Symptom Exacerbation, Adverse Events, and Revictimization

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