Psychomotor diagnostics and treatment for posttraumatic stress disorder

Despite the proven effectiveness of treatments like cognitive behavioural therapy and EMDR, many PTSD patients continue to experience symptoms. A recent meta-analysis showed that these treatments led to sufficient symptom reduction in only 38% of PTSD patients. Symptoms such as hyperarousal, sleep problems, and depression often persist and negatively impact quality of life. This dissertation explores the possibilities of psychomotor therapy (PMT) in diagnosing and treating PTSD. The focus is on body experience and body- and movement-oriented interventions (BMOIs). The aim is to understand the value of PMT for PTSD patients and, if positive, to broaden the range of available treatments. Additionally, the research aims to gather applicable knowledge to bridge the gap between theory and practice. Chapter 2 investigates whether an existing Psychomotor Diagnostic Instrument (PMDI), originally developed for traumatized refugees, can be applied to PTSD patients. The PMDI has been developed into a standardized observation instrument for psychomotor therapists. Although suitable for PTSD patients, further validation is necessary. Chapter 3 studies the relationship between psychological disorders and aspects of body experience, such as body satisfaction, body attitude, and interoceptive awareness. Patients referred to PMT reported lower body satisfaction and more negative body attitude than a non-clinical control group. Female patients and those with PTSD or mood disorders reported lower body satisfaction and more negative body attitude than male patients and those with other diagnoses. PTSD was the sole predictor of reduced interoceptive awareness. Chapter 4 comprises a systematic review and meta-analysis of BMOIs for PTSD and comorbid depressive symptoms. The 15 included studies showed significant reductions in PTSD symptoms with a medium effect size. Six studies assessed secondary depressive symptoms with a small effect size. Chapter 5 provides an update of the study reported in Chapter 4, with essentially the same results. This systematic review and meta-analysis included 29 studies. The analysis confirmed the effectiveness of BMOIs in reducing PTSD and depressive symptoms, with medium effects on PTSD symptoms and small to medium effects on secondary depressive symptoms. Sleep quality, examined in 11 studies, improved significantly with a large effect. Four studies reported measurements of interoceptive awareness, with non-significant effects. The differences in assessment methods and related outcomes highlight the need for comprehensive evaluation and nuanced interpretation of interoceptive awareness. Consequently, it remains unclear how BMOIs affect interoceptive awareness in individuals with PTSD. Chapter 6 describes the state of the art of PMT in the Netherlands for patients with trauma-related psychological symptoms in the Netherlands and highlights recent developments in diagnostic instruments and interventions. Three common factors were distilled from the various interventions: developing adaptive interoceptive awareness, regulating arousal, and improving interpersonal functioning. These factors may be crucial elements in BMOIs, including PMT, for patients with PTSD. The chapter emphasises the potential of PMT as a valuable addition to standard treatments for PTSD. Further research is recommended to confirm and possibly expand the encouraging findings to date. This dissertation provides valuable insights into the role and effectiveness of PMT for PTSD patients. It highlights core components of PMT, such as psychomotor observation and body experience, and the effectiveness of BMOIs, offering practical insights for psychomotor therapists. By strengthening the scientific basis for PMT in PTSD, this work contributes to improving patient care