Self-esteem may be regarded as a transdiagnostic factor in various mental health problems presented by patients in primary healthcare. Self-esteem consists of two dimensions, namely self-competence and self-liking, and can be conceptualised within the predictive processing framework. Predictions are based on exteroceptive and interoceptive information. Interoceptive awareness is the subjective experience of internal bodily signals. This study examined the extent to which interoceptive awareness explains variance in self-esteem. In this quantitative cross-sectional study, the Multidimensional Assessment of Interoceptive Awareness 2 (MAIA-2-NL) and the Self-Liking, Self-Competence Scale-Revised (SLCS-R-NL) were administered to 102 participants recruited from a primary care setting. With the use of both single and multiple regression analyses, the role of interoceptive awareness in self-esteem was investigated. Almost half of the variance, 47

Psychomotor therapy is an experiential therapy using movement- and body-oriented interventions to diminish psychiatric symptoms and improve psychosocial functioning. However, routine evaluation of patient-reported outcomes (PROs) and standardisation of patient-reported outcome measures (PROMs) in psychomotor therapy research and practice in adult mental healthcare are lacking, resulting in a gap in systematic research and evaluation of psychomotor interventions. This study aims to select the five most relevant outcome domains with underlying PROs for psychomotor therapy from the perspective of psychomotor professionals and patients. A multi-phased qualitative study was conducted in the Netherlands, consisting of three sub-studies: (i) the selection of the five most relevant outcome domains with underlying PROs from the perspective of psychomotor professionals (N = 53), using a modified Nominal Group Technique in an adapted serial design; (ii) the selection of the five most relevant outcome domains with underlying PROs from the perspective of patients (N = 27) using a narrative approach in (focus) groups; and (iii) the synthesised selection from (i) and (ii). Psychomotor professionals selected body experience, movement experience, emotion regulation, stress regulation, and sensory awareness as the most relevant outcome domains. Patients selected body experience, social interaction, movement experience, emotion regulation, and integration of thinking, feeling and behaviour. After synthesising both selections, the five most relevant outcome domains for psychomotor therapy are body experience, movement experience, emotion regulation, social interaction, and stress regulation. The five most relevant outcome domains with underlying PROs in psychomotor therapy in adult mental healthcare in the Netherlands have been identified and are broadly supported by psychomotor professionals and patients. These outcome domains provide the foundation for selecting PROMs for evaluating interventions and monitoring outcomes in psychomotor therapy.

Prolonged and repeated psychotrauma can result in enduring problems in affect regulation, negative body experience, persistent interpersonal problems and low self-image; consequences that are not always treated effectively with regular cognitively oriented treatment options for PTSD. Body- and movement-oriented interventions may be an addition or an alternative. This study describes and evaluates a body- and movement-based intervention designed to supplement trauma treatment as suggested in the guidelines. The intervention focuses on: (1) recognising and tolerating bodily sensations, (2) arousal regulation techniques, and (3) (re)-establishing a sense of control. A pilot study was conducted to assess outcomes on trauma symptoms, general symptoms of psychopathology and body experience. Preliminary findings suggest that the intervention effectively reduces trauma symptoms and may offer a valuable complement to more verbally and cognitively oriented trauma therapies, particularly for patients with complex PTSD. Further research should explore its underlying mechanisms, broader applicability and effects.

While body experience is a key focus of treatment in psychomotor therapy (PMT), research has largely overlooked this important topic. In this study we explored three domains of body experience-body satisfaction, body attitude, and interoceptive awareness-in individuals with mental disorders in a clinical sample receiving PMT. We expected these patients to have a more negative body experience than nonclinical controls, with PTSD, mood disorders, personality disorders, and sex negatively affecting all three domains of body experience. The study involved 235 participants aged 18-59 with various mental disorders that were referred to PMT between 2008 and 2017 at a mental health center in the Netherlands. They completed questionnaires on all three of the body experience domains of interest. One sample t-tests revealed that patients had significantly greater negative body satisfaction and body attitude than nonclinical control samples obtained from the literature, with no significant difference in interoceptive awareness. Regression analyses within the patient sample revealed that female patients and patients with mood disorders or PTSD, displayed more negative body satisfaction than patients with other mental disorders. Additionally, female patients and patients with mood disorders displayed more negative body attitude. Although the total patient group and controls had comparable interoceptive awareness, only PTSD had significantly lower interoceptive awareness. Age and personality disorders did not predict differences on any domain of body experience. This research demonstrates that body experience is disturbed in patients with mental disorders who received PMT, and that there are disorder-specific disturbances on domains of body experience domains.

Background: The body is the medium through which humans experience the world, and the body is key to most suffering, healing, and clinical mental diagnoses. Body attitude refers to the affective, cognitive, and behavioural aspects of embodiment, which typically is more negative in clinical samples.Objective: We examine how adult body attitude is associated with self-reported childhood abuse and neglect. We hypothesised that child sexual abuse is associated stronger with a negative adult body attitude than emotional or physical abuse/neglect would. Second, we expected that the association between body attitude and childhood sexual abuse was gender equivalent. Third, we expected a more positive body attitude in men than women after childhood physical abuse/neglect or emotional abuse/neglect.Method: Body attitude was measured with the Dresden Body Image Questionnaire (DBIQ-NL) and the severity and type of childhood trauma with the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in 749 Dutch adults aged 18-77. We fit multiple regression models and focused on childhood abuse and neglect with moderate to severe intensity.Results: Childhood sexual abuse (∼15%), physical neglect (∼14%), emotional abuse (∼20%) and emotional neglect (∼30%) are associated with a more negative body attitude, while childhood physical abuse (moderate/severe, ∼6%) associated with a slightly more positive adult body attitude. Body attitude associations with childhood abuse/neglect were similar for both genders (no moderation).Conclusion: Child maltreatment seems to precede the development of a more negative adult body attitude and more negative body experiences compared to individuals without child maltreatment.

Body satisfaction in eating disorders (EDs) is negatively affected by critical evaluation of aesthetic aspects. A focus on the appreciation for the functioning of the body could create a more positive perspective. The Functional Appreciation Scale (FAS) measures functional appreciation. This is the first study that examines the Dutch version of the FAS in a clinical sample. Psychometric properties and differences in scores are evaluated in an ED and a community sample consisting of women. Factor analysis identified and confirmed a one-dimensional factor structure. Reliability was adequate; convergent and discriminant validity were supported through correlations with the Body Cathexis Scale and the Eating Disorder Examination Questionnaire respectively. Women with EDs scored significantly lower than women from a community sample. Further research regarding the applicability of the FAS for clinical practice is needed because of the ceiling effect and the lack of strong invariance between the clinical and non-clinical group.

BackgroundDomestic violence is a public health concern, impacting the health and well-being of women and children globally. Shelter homes are one of the support services for victims’ recovery, although providing holistic healthcare in this setting remains a struggle. Feel-Own-Move® (FOM) is an evidence-based psychomotor intervention designed to help women who have experienced domestic violence reconnect with their bodies. Hybrid FOM (H-FOM) is a version of FOM that combines in-person with online sessions for both women and children living in shelter homes. To examine the effectiveness and implementation success of H-FOM are the aims of this study.MethodsThis protocol details an effectiveness-implementation type I hybrid study, to be carried out in shelter homes across three European countries. Health outcomes of the participants, and the implementation success within professionals from the shelter homes and the psychomotor therapists responsible for implementing H-FOM will be assessed. Results will be analyzed through a mixed methods approach, following the conceptual model of implementation science and the RE-AIM framework.DiscussionThis effectiveness-implementation study is expected to contribute to understanding H-FOM health-related effects on women and children survivors of violence, as well as to its sustainable implementation, up-scaling and integration into trauma support services and associated healthcare policy. H-FOM is expected to (i) improve the known effects of FOM on women survivors of DV, while ensuring continuity of the therapeutic process following relocation, and promoting the health and well-being of children living in the shelter homes.

Posttraumatic stress disorder (PTSD) is a significant mental health condition that may occur after traumatic events. Given its body- and movement-related features, psychomotor therapy (PMT) may be a valuable treatment option for PTSD. PMT employs body- and movement-oriented activities to reduce psychiatric symptoms, enhance mental health, and improve psychosocial functioning. The potential merits of PMT for individuals with PTSD are reviewed, combining evidence from a systematic literature search and insights from an expert panel. Body-oriented psychotherapy professionals are informed about how PMT can address trauma-related mental health conditions and provide a theoretical background for its implementation. Various interventions tailored to diverse populations within the trauma spectrum are included. Common factors across these interventions, which may underpin PMT's working mechanisms, include developing adaptive interoceptive awareness, regulating arousal, and improving interpersonal functioning. The reviewed literature indicates that PMT may be beneficial in both the diagnosis and treatment of trauma-related conditions.

Background Interoceptive awareness is a multidimensional construct that refers to the sensation, interpretation, and integration of signals within the body. There is increasing evidence that problems with interoceptive awareness form an important component of mental health problems. The Multidimensional Assessment of Interoceptive Awareness 2 (MAIA-2) is presently the most used self-report questionnaire to measure interoceptive awareness. The aim of the present study is to psychometrically evaluate the Dutch version of the MAIA-2. Method The psychometric properties of the MAIA-2-NL were examined in a non-clinical sample of 1054 participants aged between 18 and 83. Internal consistency and test-retest reliability were investigated. Factor structure was examined by exploratory factor analysis (EFA), followed by confirmatory factor analysis (CFA). Results Internal consistency was good, with McDonald’s omega (ω) ranging from 0.67 to 0.89. Test-retest reliability was moderate to good, with intraclass correlation coefficients (ICC) ranging from 0.67 to 0.79. Factor analyses suggested a six-factor structure, combining the original subscales Noticing with Emotional awareness and Self-regulation with Body listening. However, a CFA based on the original eight factors showed a somewhat better fit than the CFA based on six factors. Conclusion The MAIA-2-NL is a reliable and valid instrument to measure interoceptive awareness in healthy Dutch adults. We recommend to maintain the original 37 items.

Specific Phobia (SP), Generalized Anxiety Disorders (GAD), and Social Anxiety Disorder (SAD) are the most prevalent anxiety disorders in children and adolescents. Although anxiety has a major influence on the body, evidence-based treatments mainly focus on cognitive and behavioral aspects of anxiety. Body- and movement-oriented interventions, such as psychomotor therapy (PMT), address the physical aspects. Bodily experience and interoceptive awareness are used to change behavior, cognition, and emotions. This review aimed to provide an overview of the efficacy of PMT for children and adolescents aged 0–18 years with SP, GAD, or SAD.MethodData were collected in PsycINFO, Medline, Embase, ERIC, and Web of Science, from January 2020 until April 2022. Two independent researchers (EV and JM) selected the articles and performed a critical appraisal.ResultsFrom 1,438 articles found, only one article met the inclusion criteria.ConclusionNo consensus-based statement about the efficacy of PMT in children and adolescents with SP, GAD, or SAD can be made due to the gap in the literature. Future research is needed to evaluate the efficacy. The first step may be to design treatment protocols. Subsequently, these protocols may be evaluated concerning efficacy.

Abstract Background Body satisfaction in people with eating disorders (EDs) is negatively affected by their critical evaluation of aesthetic aspects. A focus on body functionality could create a more positive perspective. This study examines psychometric properties of the Dutch version of the Functionality Appreciation Scale (FAS) and differences in scores between women with and without EDs. Method Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate the factor structure in data from a community sample of 669 women and an ED sample of 150 women. Reliability, test-retest scores and correlations with Body Cathexis Scale (BCS) and Eating Disorder Examination Questionnaire (EDE-Q) were investigated. T-tests were used to evaluate differences between samples. Results EFA identified a one-dimensional factor structure, which was confirmed by CFA. Reliability was adequate and convergent and discriminant validity were supported through correlations with BCS and EDE-Q (subscale) scores. FAS-scores were significantly lower for women with EDs compared to women from a community sample. Conclusions Psychometric results of the Dutch version of the FAS are promising and validate its use for clinical and research purposes. The significant difference between FAS scores in the female ED sample and the female community sample indicates that female ED patients obviously have a lower body satisfaction concerning body functionality compared with healthy women. Further research with male ED participants as well as exploration of sensitivity to change are recommended.

BackgroundResearch is lacking on body-related consequences of sexual abuse in adults with mild intellectual disability or borderline intellectual functioning (MID-BIF), although the prevalence of abuse is high and body- and movement-oriented diagnostics and therapeutics seem warranted for this group.MethodBody experience in adults with MID-BIF who were sexually abused (SA) and were not sexually abused (NSA) was compared using a self-report instrument, the Body Experience Questionnaire-mb, and an instrument to observe non-verbal psychomotor behaviour, the PsyMot-mb.ResultsThe SA group showed significantly higher self-reported body awareness and more observed problems with body acceptance than the NSA group. No significant group differences were found for self-reported body satisfaction and body attitude.ConclusionsAdults with MID-BIF who were sexually abused are more aware of their body signals, but less able to adequately attend to, tolerate, and interpret these signals. Therefore, body- and movement-oriented therapies hold promise for this group.

This study is an update of the meta-analysis we published in 2019 on the effectiveness of body- and movement-oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) in decreasing PTSD symptoms and secondary outcomes of depressive symptoms, sleep disturbance, and interoceptive awareness. Search terms for BMOIs and PTSD were combined to identify eligible studies in four bibliographical databases. Articles were selected if they included adult participants with a primary diagnosis of PTSD, included BMOI as one of the investigated therapies, were designed as a comparative outcome trial with any control condition, and involved a standardized outcome measure for PTSD symptom severity. This resulted in the addition of 14 new studies compared to the 2019 study. The meta-analysis, which included 29 studies in total, resulted in a mean Hedges' g effect size of 0.50, 95% CI [0.22, 0.79], in decreasing PTSD symptoms, with very high heterogeneity, I2 = 89%. Meta-analyses of secondary outcomes resulted in Hedges' g effect sizes of 0.37, 95% CI [0.08, 0.66] for depressive symptoms; 0.62, 95% CI [0.42, 0.81] for sleep quality; and -0.10, 95% CI [-0.23, 0.43] for interoceptive awareness. The risk of bias analysis resulted in some concerns or high risk of bias in almost all included studies; only one study had a low risk of bias. We conclude that BMOIs may be valuable for patients with PTSD. There is, however, still a lack of high-quality studies with proper control conditions and long-term follow-up periods from which to draw conclusions.

Individuals with intellectual disability living in a care facility are at high risk of sexual abuse. Formal policies on sexual abuse within these care facilities and their effective implementation are a prerequisite to reducing the risk of sexual abuse in this group. The present study aimed to determine the state of affairs in this regard in the Netherlands and identify areas of improvement regarding both policy formulation and implementation. An online survey was sent to the management boards of 129 Dutch care facilities for individuals with intellectual disability. Sixty-nine managers completed the survey on behalf of their care facility. Descriptive statistics were used to characterize the state of affairs regarding policies on sexual abuse. Areas of improvement reported by the managers were examined qualitatively by thematic analysis. Most care facilities complied with the national legal requirements on sexual abuse, which include the availability of a protocol on sexual abuse and mandatory reporting. It varied across the care facilities to what extent the protocols on sexual abuse are brought to the staff's attention and used in practice. About half of them provided no staff training on the protocol on sexual abuse, while nearly one-third of the care facilities provided no organizational protective factors on sexual abuse, such as a special-task official on sexual abuse, sexuality or sexual abuse department, or cooperation with the vice squad. Most areas of improvement reported by the managers pertained to the need for staff training and the improvement of practical use of policies and protocols on sexual abuse. In conclusion, the availability of policies and protocols on sexual abuse in care facilities for individuals with intellectual disability does not guarantee a caring culture in which these policies and protocols are implemented effectively, and in which sexual abuse is prevented and detected in a timely way.

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE.