Kolthof K A, Voorendonk E M, Van Minnen A, De Jongh A
Psychotrauma Expertise Centre (PSYTREC), Bilthoven, Netherlands.
Sinai Centrum, Amersfoort, Netherlands.
Eur J Psychotraumatol. 2022 Dec;13(2):2143076. doi: 10.1080/20008066.2022.2143076. Epub 2022 Nov 23.
Research indicates that intensive trauma-focused therapy can be effective in alleviating symptoms of post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). However, these studies have relied on self-report of BPD symptoms and follow-up data are scarce. The purpose of this feasibility study was to determine the effects of an intensive trauma-focused treatment programme on the severity of PTSD and BPD symptoms and the diagnostic status up to a 12-month follow-up. A total of 45 (60% female) individuals meeting the diagnostic criteria of both PTSD and BPD participated in an intensive eight-day trauma-focused treatment programme which combined prolonged exposure and EMDR therapy in an inpatient treatment setting. Severity of PTSD and BPD symptoms were assessed at pre-treatment, post-treatment, 6 months, and 12 months after treatment (CAPS-5, BPDSI-IV). Diagnostic status was determined using clinical interviews (CAPS-5 and SCID-5-P) at pre-treatment and 12-month follow-up. Of all participants, 93.3% had been exposed to physical abuse, and 71.1% to sexual abuse prior to the age of 12 years. PTSD and BPD symptom severity significantly decreased from pre- to post-treatment (Cohen's : 1.58 and 0.98, respectively), and these results were maintained at 6- (: 1.20 and 1.01) and 12-month follow-up (: 1.53 and 1.36). Based upon CAPS-5, 69.2% no longer met the diagnostic criteria of PTSD at 12-month follow-up, while according to the SCID-5-P 73.1% no longer fulfilled the diagnostic criteria of BPD at that time. No significant worsening of symptoms occurred. The findings of this study, which is the first to examine the effects of psychotherapeutic treatment of PTSD on the presence of a borderline personality disorder one year after treatment, add support to the notion that a brief intensive trauma-focused treatment can be a valuable option for individuals suffering from both PTSD and BPD.
研究表明,强化的创伤聚焦疗法在减轻创伤后应激障碍(PTSD)和边缘型人格障碍(BPD)的症状方面可能有效。然而,这些研究依赖于BPD症状的自我报告,且随访数据稀少。本可行性研究的目的是确定强化的创伤聚焦治疗方案对PTSD和BPD症状严重程度以及长达12个月随访期内诊断状态的影响。共有45名(60%为女性)同时符合PTSD和BPD诊断标准的个体参加了为期八天的强化创伤聚焦治疗方案,该方案在住院治疗环境中结合了延长暴露疗法和眼动脱敏再处理疗法(EMDR)。在治疗前、治疗后、治疗后6个月和12个月评估PTSD和BPD症状的严重程度(CAPS-5,BPDSI-IV)。在治疗前和12个月随访时通过临床访谈(CAPS-5和SCID-5-P)确定诊断状态。在所有参与者中,93.3%在12岁之前遭受过身体虐待,71.1%遭受过性虐待。PTSD和BPD症状严重程度从治疗前到治疗后显著降低(科恩d值:分别为1.58和0.98),这些结果在6个月随访时(d值:1.20和1.01)和12个月随访时(d值:1.53和1.36)得以维持。根据CAPS-5,在12个月随访时69.2%的人不再符合PTSD的诊断标准,而根据SCID-5-P,此时73.1%的人不再满足BPD的诊断标准。症状未出现明显恶化。本研究首次考察了PTSD心理治疗对治疗一年后边缘型人格障碍存在情况的影响,其结果支持了以下观点:对于同时患有PTSD和BPD的个体,简短的强化创伤聚焦治疗可能是一种有价值的选择。