Steil Regina, Dittmann Clara, Müller-Engelmann Meike, Dyer Anne, Maasch Anne-Marie, Priebe Kathlen
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.
Eur J Psychotraumatol. 2018 Jan 19;9(1):1423832. doi: 10.1080/20008198.2018.1423832. eCollection 2018.
: 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.
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。
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