Study Protocol: What is the prevalence of post-traumatic stress disorder (PTSD) in parents of babies admitted to the neonatal intensive care units (NICU) in Northern Ireland and is eye movement desensitization and reprocessing (EMDR) therapy feasible to use with this population?

Research output: Contribution to conferencePoster

Abstract

Background
- Stress is exacerbated in parents of babies admitted to the NICU (Yaman and Altay, 2015).
- Bliss and Tiny Life (2018) Policy Report highlighted the lack of psychological support for these parents.
- PTSD is a psychiatric disorder that may develop in people that have witnessed a traumatic event: relive the event through feelings of detachment, anger, sadness and hyperarousal (American Psychiatric Association) (APA) (2000).
- Prevalence in this population is unknown in Northern Ireland.
- Parental PTSD manifestation is disparate between each parent. Mothers: previous miscarriages, in-vitro fertilisation. Fathers: Partners PTSD status, fear concerning well-being of infant.
- One commonality is the alteration of parental roles as a contributory factor of PTSD in this population (Koliouli et al., 2016).
- Father’s stress response is apparent months later after discharge and is equally as severe in comparison to maternal impact (Shaw et al., 2009).
- Parental PTSD can negatively impact on long -term bonding and attachment which may affect the infant’s cognitive and emotional development (Spinelli et al., 2016).

Current Interventions to Overcome Parental Stress
- Expressive writing (Horsch et al., 2015) and activity-based group therapy (John et al., 2018).
- Creating Opportunities for Parent Empowerment (COPE) (Melynk et al., 2006), Cue Program (Zelkowitz et al., 2011), Mother-Infant Transactions Program (Ravn et al., 2012), Auditory-Tactile Visual Vestibular (ATVV) and Kangaroo Care and Skills based interventions (Shaw et al., 2014).
- These interventions are reflected in many of the care strategies adopted by NICUs; focus on positive-infant outcomes but long-term parental trauma is left unaddressed.
- Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) has been studied with the NICU parent with some effect (Bernard et al., 2011).
- TF-CBT requires a parent to forego lengthy therapy sessions with accompanying homework.
- EMDR Therapy involves recalling a traumatic memory whilst a trained practitioner guides the client to follow repetitive bilateral hand movements, finger tapping or audio cues until the client can endorse positive associated cognitions (Shapiro, 2001). Requires no homework and less sessions.
- EMDR has been explored in women with PTSD following childbirth with promising effects (Sandstrom et al., 2008 and Stramood et al., 2012). To date not studied with the NICU parent.
- Not known if EMDR Therapy would be as effective than current NICU strategies or TF-CBT; efficacy as an intervention with the NICU parent must be established with a feasibility study.

Aims and Objectives
- To conduct a systematic review of current up-to-date literature.
- Measure parental anxiety following baby’s birth using a validated tool.
- Measure parental PTSD symptoms at infant’s discharge and again one month later using a validated tool – prevalence.
- Evaluate feasibility of EMDR therapy to treat parental PTSD.
- To explore parent’s feelings about the acceptability of EMDR Therapy.

Study Design
Mixed methods approaches over 3 phases.
Phase 1
- Prevalence of parental PTSD will be established.
- Parental anxiety measured using State Trait Anxiety Scale (Marteau and Bekker, 1992).
- Demographic details.
- Adverse Childhood Experiences (ACE) (Felitti et al., 1998)
- PCL-5 PTSD (U.S. Department for Veterans’ Affairs, 2018) on discharge and one month later.
Phase 2 (Quasi-Experiment)
Purposive sample.
First 10 symptomatic men and women (5each) offered EMDR Therapy

Phase 3
Semi-structured interviews exploring parents feelings on EMDR Therapy.

Original languageEnglish
Publication statusPublished - 07 May 2019
EventEMDR NI Annual Conference and Workshop - Ulster Reform Clube, Belfast, United Kingdom
Duration: 07 May 201907 May 2019

Conference

ConferenceEMDR NI Annual Conference and Workshop
CountryUnited Kingdom
CityBelfast
Period07/05/201907/05/2019

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