The effectiveness of Visual Schema Displacement Therapy in treating patients with PTSD.

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence based
therapy often indicated for patients suffering from post traumatic stress
disorder (PTSD). A new therapy that shows resemblence with EMDR therapy is
Visual Schema Displacement Therapy. Results from two recent studies among
healthy participants comparing the two treatments showed that VSDT was more
effective in reducing the emotional intensity of emotional memories. The
question remains if and to what extent VSDT is effective in reducing PTSD
symptoms in patients who are diagnosed with PTSD.

Determine if VSDT is effective in reducing PTSD symptoms, both directly and at
1- and 3-month follow-up. This will be investigated in a Randomized Controlled
Trial (RCT).

The study employs a mixed design with both within and between subjects factors.
57 PTSD patients will be randomly assigned to one of three conditions (EMDR,
VSDT, waiting list). Both the VSDT and the EMDR condition include 6 sessions of
90 minutes each. PTSD symptoms will be monitored weekly using the Psychotrauma
Checklist for DSM-5 (PCL-5), during and following the intervention until the
last follow-up measurement after 3 months. A clinical interview for PTSD
(Clinician-administered PTSD Scale for DSM-5; CAPS-5) will be conducted upon
inclusion, after one month, and after three months after the treatment
sessions.

The study has three conditions: EMDR, VSDT and a Waitlist control condition
(WL). All patients will be randomly assigned to one of the three conditions.
Both active interventions conist of six weekly sessions of 90 minutes. The
waiting list conditions consists of 6 weeks of no intervention. All conditions
are followed by a 12-week period, during which self-report measures are
conducted. Follow-up measurements using the CAPS-5 will be conducted four and
twelve weeks after the treament period.

Patiens might find it difficult to recollect an emotionally loaded memory of a
traumatic event, or might be overwhelmed by it; the memory refers to the
traumatic event. This might happen in every form of trauma treatment. The
participating therapists are used to deal with these situations. It should be
realised that patients suffering from PTSD are used to the activation of the
emotional memory by all kinds of triggers in daily life. Usually, PTSD patients
recover quickly. There are few contro-indications known for traumafocused
treatment with EMDR therapy. On grounds of niether theoretical considerations
and practical experience should it be expected to be different for VSDT. That
is why we deem the burden and risks placed upon participants justified.
Nevertheless, we will first complete Study I with the aim of testing the safety
of the therapy and its effect on PTSD symptoms, before we start Study II.
Because of this study, patients will receive treatment a few months earlier
than patients who are on the regular waiting list. Moreover, patients in the
study are offered traumafocused therapy upon completion of the study when they
still experience residual complaints.