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在边缘型人格障碍治疗开始时添加眼动脱敏再处理疗法治疗创伤后应激障碍:一项初步研究。

Adding EMDR for PTSD at the onset of treatment of borderline personality disorder: A pilot study.

作者信息

Wilhelmus Bobbie, Marissen Marlies A E, van den Berg David, Driessen Annemieke, Deen Mathijs L, Slotema Karin

机构信息

Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands.

Erasmus School of Social and Behavioural Sciences, Burg. Oudlaan 50, 3062, PA, Rotterdam, the Netherlands.

出版信息

J Behav Ther Exp Psychiatry. 2023 Jun;79:101834. doi: 10.1016/j.jbtep.2023.101834. Epub 2023 Jan 11.

Abstract

BACKGROUND AND OBJECTIVES

Eye movement desensitization and reprocessing (EMDR) is an effective treatment for individuals suffering from posttraumatic stress disorder (PTSD). However, EMDR is not typically offered to people with PTSD who also meet the criteria for borderline personality disorder (BPD). This study examines the feasibility and clinical benefits of EMDR for PTSD delivered in addition to the onset of treatment as usual (TAU) for BPD.

METHODS

In a non-concurrent, multiple baseline design, 12 patients with BPD and PTSD received fifteen weekly 45-min sessions of TAU. During this period, eight weekly 90-min EMDR sessions were added. Outcome measures were obtained weekly for self-reported PTSD symptoms (PTSD checklist for DSM-5), levels of psychopathology (Brief Symptom Checklist), and the effect of psychopathology on different areas of life (Sheehan Disability Scale).

RESULTS

9 participants completed the treatment protocol. In the EMDR phase, PTSD severity scores decreased significantly between sessions, while no between-session drop in scores occurred during the TAU only phase. Similar results were obtained for general symptoms and disability. No adverse events were reported.

LIMITATIONS

Results on the efficacy and safety of EMDR in patients with BPD and PTSD need to be replicated in larger samples and in RCTs before they can be generalized to the entire population.

CONCLUSIONS

The results of our study suggest that EMDR may be feasible and effective in reducing PTSD symptoms in patients concurrently receiving BPD treatment. EMDR appears to be a promising intervention for patients with BPD and comorbid PTSD.

摘要

背景与目的

眼动脱敏再处理疗法(EMDR)是治疗创伤后应激障碍(PTSD)患者的一种有效方法。然而,对于同时符合边缘型人格障碍(BPD)标准的PTSD患者,通常不采用EMDR疗法。本研究探讨了在针对BPD的常规治疗(TAU)基础上增加EMDR治疗PTSD的可行性及临床益处。

方法

采用非同期多基线设计,12例患有BPD和PTSD的患者接受了为期15周、每周一次、每次45分钟的TAU治疗。在此期间,增加了每周一次、每次90分钟的EMDR治疗,共8次。每周收集自我报告的PTSD症状(DSM-5的PTSD检查表)、精神病理学水平(简明症状检查表)以及精神病理学对生活不同领域的影响(希恩残疾量表)等结果指标。

结果

9名参与者完成了治疗方案。在EMDR治疗阶段,各疗程之间PTSD严重程度评分显著下降,而仅在TAU治疗阶段各疗程之间评分未下降。一般症状和残疾情况也得到了类似结果。未报告不良事件。

局限性

在EMDR对BPD和PTSD患者的疗效和安全性结果能够推广至整个人群之前,需要在更大样本和随机对照试验中进行重复验证。

结论

我们的研究结果表明,对于同时接受BPD治疗的患者,EMDR在减轻PTSD症状方面可能是可行且有效的。EMDR似乎是一种有前景的针对BPD合并PTSD患者的干预措施。

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