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针对童年期性虐待相关创伤后应激障碍的辩证行为疗法:门诊治疗环境中的一项初步研究。

Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting.

作者信息

Steil Regina, Dittmann Clara, Müller-Engelmann Meike, Dyer Anne, Maasch Anne-Marie, Priebe Kathlen

机构信息

Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University, Frankfurt Main, Germany.

Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.

出版信息

Eur J Psychotraumatol. 2018 Jan 19;9(1):1423832. doi: 10.1080/20008198.2018.1423832. eCollection 2018.


DOI:10.1080/20008198.2018.1423832
PMID:29372016
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5774406/
Abstract

: Dialectical behaviour therapy for posttraumatic stress disorder (DBT-PTSD), which is tailored to treat adults with PTSD and co-occurring emotion regulation difficulties, has already demonstrated its efficacy, acceptance and safety in an inpatient treatment setting. It combines elements of DBT with trauma-focused cognitive behavioural interventions. : To investigate the feasibility, acceptance and safety of DBT-PTSD in an outpatient treatment setting by therapists who were novice to the treatment, we treated 21 female patients suffering from PTSD following childhood sexual abuse (CSA) plus difficulties in emotion regulation in an uncontrolled clinical trial. : The Clinician Administered PTSD Symptom Scale (CAPS), the Davidson Trauma Scale (DTS), the Borderline Section of the International Personality Disorder Examination (IPDE) and the Borderline Symptom List (BSL-23) were used as primary outcomes. For secondary outcomes, depression and dissociation were assessed. Assessments were administered at pretreatment, post-treatment and six-week follow-up. : Improvement was significant for PTSD as well as for borderline personality symptomatology, with large pretreatment to follow-up effect sizes for completers based on the CAPS (Cohens  = 1.30), DTS ( = 1.50), IPDE ( = 1.60) and BSL-23 ( = 1.20). : The outcome suggests that outpatient DBT-PTSD can safely be used to reduce PTSD symptoms and comorbid psychopathology in adults who have experienced CSA.

摘要

辩证行为疗法治疗创伤后应激障碍(DBT-PTSD)是专门为治疗患有创伤后应激障碍且同时存在情绪调节困难的成年人而设计的,已在住院治疗环境中证明了其有效性、可接受性和安全性。它将辩证行为疗法的元素与以创伤为重点的认知行为干预相结合。

为了调查由不熟悉该疗法的治疗师在门诊治疗环境中实施DBT-PTSD的可行性、可接受性和安全性,我们在一项非对照临床试验中治疗了21名童年期遭受性虐待(CSA)后患有创伤后应激障碍且存在情绪调节困难的女性患者。

使用临床医生管理的创伤后应激障碍症状量表(CAPS)、戴维森创伤量表(DTS)、国际人格障碍检查表(IPDE)的边缘型人格障碍部分以及边缘型症状清单(BSL-23)作为主要结局指标。对于次要结局指标,评估抑郁和解离情况。在治疗前、治疗后和六周随访时进行评估。

创伤后应激障碍以及边缘型人格症状均有显著改善,基于CAPS(科恩d = 1.30)、DTS(d = 1.50)、IPDE(d = 1.60)和BSL-23(d = 1.20),完成治疗者从治疗前到随访的效应量较大。

结果表明,门诊DBT-PTSD可安全用于减轻经历过CSA的成年人的创伤后应激障碍症状和共病精神病理学症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b922/5774406/09962f1b869a/ZEPT_A_1423832_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b922/5774406/09962f1b869a/ZEPT_A_1423832_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b922/5774406/09962f1b869a/ZEPT_A_1423832_F0001_B.jpg

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[1]
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引用本文的文献

[1]
A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder.

Eur J Psychotraumatol. 2024

[2]
Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation.

Psychol Res Behav Manag. 2024-6-18

[3]
Is adherence to dialectic behaviour therapy for post-traumatic stress disorder (PTSD) and cognitive processing therapy related to treatment outcome in PTSD after childhood abuse?

Eur J Psychotraumatol. 2023

[4]
Does treatment specific-, disorder specific- or general therapeutic competence predict symptom reduction in posttraumatic stress disorder?

Eur J Psychotraumatol. 2023

[5]
Sexual Dysfunctions in Women with Posttraumatic Stress Disorder Following Childhood Sexual Abuse: Prevalence Rates According to DSM-5 and Clinical Correlates.

Arch Sex Behav. 2023-11

[6]
Determinants of Care Pathways for C-PTSD Patients in French Psychotrauma Centers: A Qualitative Study.

Int J Environ Res Public Health. 2023-7-2

[7]
Application of Dialectical Behaviour Therapy in treating common psychiatric disorders: study protocol for a scoping review.

BMJ Open. 2022-9-26

[8]
Current state of the evidence on community treatments for people with complex emotional needs: a scoping review.

BMC Psychiatry. 2022-9-5

[9]
How to Treat Childhood Sexual Abuse Related PTSD Accompanied by Risky Sexual Behavior: A Case Study on the Use of Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD).

J Child Adolesc Trauma. 2021-11-18

[10]
Scales for assessing therapeutic adherence and competence in dialectical behaviour therapy for PTSD: development and analysis of psychometric properties.

Eur J Psychotraumatol. 2022

本文引用的文献

[1]
Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis.

JAMA Psychiatry. 2017-4-1

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Eur J Psychotraumatol. 2014-10-14

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Clin Psychol Rev. 2014-10-24

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Dialectical behaviour therapy for post-traumatic stress disorder after childhood sexual abuse in patients with and without borderline personality disorder: a randomised controlled trial.

Psychother Psychosom. 2013-5-22

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J Consult Clin Psychol. 2013-1-21

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Behav Res Ther. 2012-3-11

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Psychother Psychosom Med Psychol. 2012-1

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Dialectical behavior therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study of an intensive residential treatment program.

J Trauma Stress. 2011-2-4

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