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Victimization in psychosis

A body-oriented and social cognitive approach
PhD ceremony:dr. E.C.D. (Elise) van der Stouwe
When:October 28, 2019
Supervisors:prof. dr. G.H.M. (Marieke) Pijnenborg, prof. dr. A. (Andre) Aleman
Co-supervisor:dr. J.T. van Busschbach
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Victimization in psychosis

In the movies, newspapers and other media sources, psychosis is often linked to violence and aggression. However, contrary to popular belief, people diagnosed with a psychotic disorder are more often the victim than the perpetrator of a crime. Although victimization can have a major impact on people’s lives, no evidence-based intervention targeted at victimization in psychosis is available. To prevent victimization of individuals with a psychotic disorder a body-oriented resilience therapy has been developed, based on pre-defined putative associated factors derived from the literature.

In this dissertation Elise van der Stouwe firstly assessed the efficacy of this therapy at the behavioral level. In a pilot study aimed at testing the therapy, patients subjectively indicated a positive effect of BEATVIC on (risk factors of) victimization. However, in the subsequent multi-center randomized controlled trial van der Stouwe and her colleagues found no differences between the BEATVIC group and the befriending group (control) directly after the intervention period on validated questionnaires assessing victimization, aggression regulation, social cognition, interpersonal behavior, illness insight, self-esteem and self-stigma.

In the second part of her dissertation van der Stouwe focuses on the neural level. Based on her fMRI sub study victimization is associated with more deactivation of the sensorimotor network in response to angry faces in victimized patients, possibly indicating a ‘freeze’ reaction. Following the therapy changes in activation patterns in specific  brain networks were found; findings that may indicate more elaborate processing of visual information and/or an increased alertness for potentially dangerous faces, and enhanced action readiness in response to indirect threat. By reviewing studies on the effect of exercise interventions on the brain, it was shown that these interventions in general have a positive effect on different brain regions and connections.