@Article{info:doi/10.2196/mental.5697,
author="G{\"o}rg, Nora
and Priebe, Kathlen
and Deuschel, Tilman
and Sch{\"u}ller, Martin
and Schriner, Friederike
and Kleindienst, Nikolaus
and Lud{\"a}scher, Petra
and Schmahl, Christian
and Bohus, Martin",
title="Computer-Assisted In Sensu Exposure for Posttraumatic Stress Disorder: Development and Evaluation",
journal="JMIR Ment Health",
year="2016",
month="Jun",
day="08",
volume="3",
number="2",
pages="e27",
keywords="dissociative disorders; behavior therapy; posttraumatic stress disorder; technology",
abstract="Background: Dissociative states during psychotherapy sessions reduce the benefit of exposure-based therapy for posttraumatic stress disorder (PTSD). Thus, in evidence-based therapeutic programs such as dialectical behavior therapy for PTSD (DBT-PTSD), therapists apply specific antidissociative skills to reduce dissociative features during in sensu exposure. In addition to therapist-guided sessions, exposure protocols often require that the patients listen to audio recordings of exposure sessions in self-management. The problem of how to prevent dissociative features during such self-administered exposure exercises has not been resolved yet. Hence, we developed the computer program MORPHEUS that supports the application of self-administered exposure exercises. MORPHEUS continuously monitors the level of dissociative states and offers state-related antidissociative skills. Objective: This study sought to examine the acceptance and feasibility of the MORPHEUS program. Methods: Patients who underwent 12 weeks of residential DBT-PTSD treatment used MORPHEUS during exposure exercises in self-management. After the treatment, they filled out evaluation questionnaires. Results: In sum, 26 patients receiving a 12-week standard DBT-PTSD program participated in this study; 2 participants could not be analyzed because of missing data. All the patients used MORPHEUS as often as it was required according to the DBT-PTSD treatment (2 to 5 times a week). The overall acceptance and feasibility as rated by the patients was high: for example, patients found the skills useful to block dissociation (mean 4.24 on a scale from 0 to 5, SD 0.24) and stated that they would use the program again (mean 4.72 on a scale from 0 to 5, SD 0.11). Furthermore, patients indicated that they would recommend MORPHEUS to a friend (mean 4.44 on a scale from 0 to 5, SD 0.12). In 82{\%} (32/39) of the cases, the use of antidissociative skills was related to a decrease in dissociation. In 18{\%} (5/39), dissociation remained unchanged or increased. Conclusions: The evaluative data suggest high acceptability and feasibility of MORPHEUS. Further studies should evaluate the effectiveness of the skills applied during the program. Trial Registration: World Health Organization International Clinical Trials Registry Platform: DRKS00006226; http://apps.who.int/trialsearch/Trial2.aspx?TrialID= DRKS00006226 (Archived by WebCite at http://www.webcitation.org/ 6hxuFbIUr) ",
issn="2368-7959",
doi="10.2196/mental.5697",
url="http://mental.jmir.org/2016/2/e27/",
url="https://doi.org/10.2196/mental.5697",
url="http://www.ncbi.nlm.nih.gov/pubmed/27277899"
}