Burger Simone R, Hardy Amy, Verdaasdonk Inez, van der Vleugel Berber, Delespaul Philippe, van Zelst Catherine, de Bont Paul A J, Staring Anton B P, de Roos Carlijn, de Jongh Ad, Marcelis Machteld, van Minnen Agnes, van der Gaag Mark, van den Berg David
Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands.
Psychol Psychother. 2025 Mar;98(1):25-39. doi: 10.1111/papt.12556. Epub 2024 Nov 4.
Trauma and post-traumatic stress are involved in the aetiology and maintenance of voice-hearing. It has been proposed that trauma-focused therapy (TFT) might affect voice-hearing, but previous studies are limited and remain undecided.
We aimed to investigate the effect of TFT on voice-hearing in people with PTSD and psychosis using experience sampling method (ESM). A secondary aim was to explore how changes in voice-hearing are related to changes in PTSD.
This is an adjunct longitudinal ESM study of a sub-group of participants (N = 39) from a randomised controlled trial that compared TFT to a waiting-list control group.
Voice-hearing participants filled in 10 daily voice-hearing-related questionnaires for six consecutive days at baseline and post-treatment at pseudo-random times during the day. PTSD symptom severity was assessed at baseline and post-treatment. Multilevel linear regression was used to test the effect of TFT on voice-hearing and to analyse the relationship between changes in voice-hearing and changes in PTSD.
The intention-to-treat analysis showed a significant interaction effect between time and treatment condition (p < .00001) with a small effect size (dppc2 = -0.27), indicating a larger decrease in voice-hearing in the TFT group than in the waiting-list control group. Also, a significant association was observed between changes in PTSD symptoms and changes in voice-hearing (p < .00001).
Our findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can alleviate distressing voices.
创伤和创伤后应激与幻听的病因及维持有关。有人提出，以创伤为重点的疗法（TFT）可能会影响幻听，但先前的研究有限且尚无定论。
我们旨在使用经验抽样法（ESM）研究TFT对创伤后应激障碍（PTSD）和精神病患者幻听的影响。次要目的是探讨幻听的变化与PTSD变化之间的关系。
这是一项对来自一项随机对照试验的参与者亚组（N = 39）进行的辅助纵向ESM研究，该试验将TFT与等待名单对照组进行了比较。
有幻听的参与者在基线和治疗后连续六天每天在白天的伪随机时间填写10份与幻听相关的问卷。在基线和治疗后评估PTSD症状严重程度。使用多级线性回归来测试TFT对幻听的影响，并分析幻听变化与PTSD变化之间的关系。
意向性分析显示时间和治疗条件之间存在显著的交互作用（p <.00001），效应量较小（dppc2 = -0.27），表明TFT组的幻听减少幅度大于等待名单对照组。此外，观察到PTSD症状变化与幻听变化之间存在显著关联（p <.00001）。
我们的研究结果初步表明，即使不直接针对幻听，针对PTSD的TFT也可以减轻令人痛苦的幻听。
