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Treatment effect of trauma-focused treatment and/or integrated trauma-focused and personality disorder treatment on brain activation during an emotional face task

Published online by Cambridge University Press:  27 August 2024

I. Aarts ,
C. Vriend ,
O. A. Van Den Heuvel  and
K. Thomaes
I. Aarts*
Affiliation:
1Sinai Centrum, Amstelveen 2Psychiatry 3Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam
C. Vriend
Affiliation:
2Psychiatry 3Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam 4Compulsivity, Impulsivity & Attention Program, Amsterdam Neuroscience, Amsterdam, Netherlands
O. A. Van Den Heuvel
Affiliation:
2Psychiatry 3Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam 4Compulsivity, Impulsivity & Attention Program, Amsterdam Neuroscience, Amsterdam, Netherlands
K. Thomaes
Affiliation:
1Sinai Centrum, Amstelveen 2Psychiatry 3Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam
*
*Corresponding author.

Abstract

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Introduction

Post-traumatic stress disorder (PTSD) and personality disorders are highly comorbid. There is some evidence that trauma-focused treatment normalises activation in brain areas involved in the fear circuit and regions involved in emotion regulation in people with PTSD. Although we assume that working mechanism of personality disorder treatments relies on improving emotion regulation and associated brain regions, there is as of yet little evidence of neurobiological effects of personality treatment on people with PTSD and comorbid PD.

Objectives

To 1) study the effect of trauma-focused and/or trauma-focused and personality disorder treatment n brain activation in participants with PTSD and comorbid personality disorders and 2) relate change in brain activation to symptom improvement.

Methods

Participants with PTSD and comorbid borderline and/or cluster c personality disorders from the PROSPER-trials (Prediction and Outcome Study for PTSD and personality disorders) were randomized to either trauma-focused treatment (TFT) or TFT with personality disorder treatment (TFT+PT). Brain activation was measured with an emotional face task during functional magnetic resonance imaging scanning before and after treatment. Regions of interest for the analyses were the amygdala, dorsal ACC, insula, ventromedial prefrontal cortex (PFC), ventrolateral PFC and dorsolateral PFC. Bayesian multilevel analyses were conducted to analyze change in brain activation. Clinical measures were clinician-administered PTSD severity, self-rated emotion regulation problems, depression severity and dissociation severity.

Results

We included 42 participants with a pre- and posttreatment scan (24 with TFT, 18 TFT+PT). Analyses on the pre-post data are currently being run and will be presented in April.

Conclusions

This is one of the first studies to conduct functional MRI analyses on treatment in participants with both PTSD and personality disorders.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S73 - S74
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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