Alle Onderzoeken & Publicaties van Lobregt-van Buuren, Ella

Onderzoek

Research shows that rates of cooccurring emotional and behavioural problems are high in children and adolescents with autism spectrum disorder (ASD). Parents of children with ASD often report higher levels of parental stress. Understanding parental stress is crucial because increased parental stress also effects the wellbeing of their child. The study by Stewart et al (2016) shows that a significant amount of mothers of children with ASD have experienced traumatic events related to their childs ASD and reported post-traumatic stress disorder (according to the criteria by DSM-5), related to the behavioural problems of their child. Parents with PTSD are more likely to have parental problems, such as being less emotional available and perceiving their child more negatively, associated with emotional and behavioural problems in their child (Van Ee et al., 2016), leading to a vicious circle of increasing child’s behavioural problems and increasing parental stress.
In the current single case study parents who have PTSD related to adverse events they have experienced while raising a child with ASD are treated with EMDR. This study focuses on the effects of parents treatment on their child with ASD. The first aim of this study is to investigate whether the level of parental stress decreases and the level of mentalization and reflecting abilities increases post-treatment. The second aim of the present study is to investigate whether family functioning improves after EMDR-therapy. The third aim was to investigate whether behavioural and emotional problems of the child with ASD will decrease after their parents EMDR-therapy. 

 


BACKGROUND:
Individuals with autism spectrum disorder (ASD) are at risk to develop more pervasive emotion-dysregulation and as a consequence maladaptive coping as compared to non-autistic people (Conner et al., 2020; Maddox, Trubanova & White, 2017). Sensory differences and impaired interoceptive body-awareness may influence emotion-dysregulation. Maladaptive coping is reflected by a variety of harmful behaviours, particularly strong social avoidance, obsessive-compulsive symptoms, disordered eating, substance abuse, agitation, non-suicidal-self-injury (NSSI), and suicidal ideation and behaviour. For a part of these individuals, treatment as usual does not have any effect at all, causing a vicious circle of isolation, demoralization, life-long psychiatric treatments, and crisis.
As of yet, there is no empirically tested conceptual framework for the continued existence and treatment of severe emotion-dysregulation in individuals with autism. As a consequence, research into treatment of adults with severe emotion-dysregulation is scarce, and it remains unknown which are the potential factors and mechanisms that predict, advance, and hinder the pathway to recovery.
Dialectical Behaviour Therapy (DBT) is an empirically supported psychotherapy to treat emotion-dysregulation, particularly in individuals with borderline personality disorder (Linehan, 1993). An effective inpatient treatment for adults with ASD and severe emotion-dysregulation is lacking, as well insight in the development of the process of self-regulation, particularly the role of sensory hyper- and hyposensitivity and interoceptive body-awareness. Therefore, an integrated, mostly inpatient treatment program based on DBT is developed and outcomes will be evaluated in the currently presented research. Standard DBT is used, adapted to adults with ASD, and augmented with a body-oriented DBT- skills training, because of their possible impairments of interoceptive body-awareness. Experiences of participants with the treatment program, the mechanisms and processes that hinder and advance the pathway to recovery will be studied, in order to make the treatment more tailored and effective for this target group.


In het onderzoek staat de vraag centraal wat het effect is van EMDR op symptomen van PTSS en van typische ASS-kenmerken bij normaal begaafde volwassenen met ASS. Aanleiding van het onderzoek vormen aanwijzingen dat er sprake is van onderbehandeling van aan trauma gerelateerde klachten bij mensen met ASS. Symptomen die door behandelaars worden beschouwd als symptomen van ASS kunnen manifestaties zijn van stressreacties op het hebben meegemaakt van akelige of bedreigende gebeurtenissen, ook wel diagnostic  overshadowing genoemd.


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