Masterclass “Network theory and network models in clinical psychology”
Dr. Talya Greene
The network perspective offers a novel way of understanding the structure and dynamics of psychopathology. According to the network theory framework, symptoms do not primarily result as passive consequences of underlying mental disorders. Rather, causally connected symptoms may interact with each other over time, potentially producing mental disorders as emergent phenomena. The new field of network psychometrics has been used in recent years to investigate the complex structure of various psychiatric disorders, including posttraumatic stress disorder, depression, schizophrenia, and anxiety. The aim of this masterclass is to provide a conceptual overview of network theory and network modeling, to describe some of the key findings that have emerged from this approach, and to discuss potential clinical implications of network approaches, including the identification of particularly central or influential symptoms, the exploration of mechanisms of comorbidity and transdiagnostic phenomena, and for use in therapeutic interventions. A list of resources and more detailed reading will be made available, and there will also be some time to ask questions about current or future network projects.
Dr. Talya Greene is a senior lecturer in the Department of Community Mental Health, University of Haifa. She investigates daily life mental health symptoms, longitudinal effects of trauma exposure, conflict-related mental health, and psychopathological symptom networks. She has a multi-disciplinary background comprising skills in psychiatric epidemiology (specifically trauma-related), military and conflict-related stress, and public mental health. Dr. Greene focuses on the use of innovative data collection methods, such as experience sampling/ecological momentary assessment, combined with advanced statistical techniques including network analysis and dynamic multilevel models to explore the relations between symptoms in individuals’ natural environments and in near-real time. She has used network modeling to investigate various aspects of psychopathology, including dynamic networks of PTSD symptoms and negative affect, the dynamic relations of depression symptoms in daily life, the associations of risky behaviors with PTSD, the emerging construct of maladaptive daydreaming, and to investigate peritraumatic distress.
Masterclass “A revival of psychedelics in psychotrauma?”
Prof.dr. Eric Vermetten
Psychedelics have a long history in medicine. After the discovery of the psychedelic properties of LSD in the early 1950s, their use in psychiatry was explored. Results of these early investigations were mixed and often the studies suffered from poor design. Due to class I scheduling, the research into the therapeutic use of these substances was impeded, and definitive conclusions were never reached. Recently an urgency was addressed to advance the pharmacotherapeutic treatment of posttraumatic stress disorder (PTSD). Novel opportunities were needed to be addressed to ‘prime the pump’ for PTSD, with the focus on treatment-resistant illness. In looking into new methodologies the focus has also moved to psychedelics. In this masterclass focus will be on 4 compounds, ketamine, MDMA, psilocybin and cannabis. I will briefly review these ‘old’ known compounds and the rationale and possible effectivity in PTSD treatment. Each of these compounds is different in use and they all have different constraints on the clinical process. These drugs are propagated as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This may be different for cannabis as this may have symptom based effects on sleep and irritability and is recommended for daily use. The model of medication-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. I will identify differences in uses and outline an agenda for research since these studies may contribute to novel and rational development of drug-assisted approaches to PTSD.
Prof.dr. Vermetten, MD, PhD (1961), was first trained as a physiotherapist and is now a clinical psychiatrist working with veterans and other uniformed officers as Strategic Advisor of Research at the Military Mental Health Service with the Dutch Ministry of Defense, Arq Psychotrauma Research Group and at UMC Utrecht. He holds an endowed chair in Psychiatry at the Department Psychiatry at Leiden UMC. He also has an Adjunct Professorship at the Department Psychiatry of New York UMC. He is trained in the Netherlands as well as in the USA in psychiatry and neuroscience. He has clinical as well as a research positions with a focus on medical/biological as well as psychiatric aspects of complex psychotrauma in military as well as civilian populations. He has published over 200 papers, over 30 book chapters and edited several books on this topic. His research is in the field of stress, trauma, complex PTSD and neuroscience. He is interested in the history of war and has special focus on combining biological-based interventions in psychotraumatology with novel technology and novel drug developments. He is PI of a new research initiative on a roadmap for medication-assisted psychotherapy in Netherlands and Europe, including use of a variety of psychedelics. Prof Vermetten is an ad hoc reviewer for numerous journals and granting agencies. He has lectured on the topic of PTSD, resilience, military and veterans issues as well as novel approaches to therapy across the globe.
Masterclass “Clinical Management of Alcohol Use in the Context of Trauma Focused Therapies”
Dr. Debra Kaysen
Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) are frequently comorbid and represent a major public health concern (Lai et al., 2015). There is poorer AUD treatment outcomes when comorbid PTSD is untreated including higher alcohol relapse, use, and consequences. Recent reviews highlight that trauma focused cognitive behavioral therapies (CBT’s) for comorbid PTSD/AUD are more effective for reducing PTSD symptoms and reducing alcohol use than treatment as usual and other comparison conditions (Simpson et al., 2017). However, for many trauma clinicians, assessment and management of substance use is outside of their typical practice. Dr. Kaysen will review the research evidence regarding the use of trauma focused CBT’s to address PTSD/AUD. Then, using the evidence-based intervention Cognitive Processing Therapy (CPT) as an example, she will describe her empirical and clinical efforts to address alcohol use in the context of providing a trauma-focused CBT. This will include results from her recently completed RCT’s testing the use of CPT for PTSD/AUD (Pearson et al., in press). Specifically, clinical guidance (based on these empirical results) will be provided on ways to assess and monitor drinking, when not to provide CPT, and on strategies clinicians can use to help clients manage their drinking over the course of CPT. The objective is to provide clinicians with a model more broadly in applying these strategies to other trauma focused cognitive-behavioral interventions while working with comorbid AUD.
Dr. Kaysen is a clinical psychologist, and a Professor in the Department of Psychiatry & Behavioral Sciences at the University of Washington. She is the Director of the Trauma Recovery Innovations Program at the University of Washington, a division dedicated to developing and testing more robust interventions for trauma-exposed populations. Dr. Kaysen is board certified in in cognitive and behavioral psychology by the American Board of Professional Psychology. Dr. Kaysen’s area of specialty both in research and clinical work is in the care of those who have experienced traumatic events. Her research is situated at the interface of PTSD and addictions, and includes both etiologic and prevention/treatment-oriented studies. Her body of research is also notable for her work on adapting evidence based interventions for diverse populations. Dr. Kaysen is a prolific researcher, publishing over 100 refereed articles. Her research has received support from the National Institute of Alcohol Abuse and Alcoholism, the National Institutes of Drug Abuse, the Department of Defense, and USAID. Dr. Kaysen is currently the President-Elect for the International Society for Traumatic Stress Studies.