Page 94 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 4
translate into changes in behavioural problems (Cuijpers et al., 2020).
Because the focus of EMDR therapy is on reducing PTSD symptoms
by processing participants’ traumatic memories rather than targeting
behavioural problems, the ability to directly address these problems may
be limited. There is presently limited research on the association between
behavioural problems and PTSD symptoms in individuals with MID-BIF.
The current findings suggest that intensive trauma treatment is feasible
and effective despite severe behavioural problems. Further research is
needed to assess whether intensive trauma treatment may augment the
effectiveness of interventions to reduce behavioural problems or vice
versa. Alternatively, trauma treatment and behavioural interventions may
reach their effects independently from each other and may enhance quality
of life also independently.
Study limitations
First, although the randomised non-concurrent multiple baseline design
offers robust insights, it does not provide information on which subgroups
within the MID-BIF population benefit more or less from the intervention.
Second, the PTSD classification was not measured repeatedly across the
different study phases, which prevented us from measuring a statistically
significant loss of PTSD diagnostic status. A third limitation is the potential
selection bias due to loss to follow-up measurements. The design used
in the current study does not account for this bias, as not all participants
were included in the analyses, which may have affected the validity and
generalisability of the results. Fourth, we investigated a specific sample of
adults with MID-BIF, all living in supported housing in one Dutch ID care
service. Further research is needed to determine whether the observed
effects can be replicated in more diverse or larger samples, which would
enhance the applicability of these treatment approaches across various
clinical contexts.
Conclusion
In conclusion, the results of this study support the efficacy and safety
of intensive EMDR therapy using a rotating team of therapists to reduce
PTSD symptoms among adults with MID-BIF and behavioural problems.
Although the treatment demonstrated significant improvements in PTSD
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