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[用于复杂性创伤后应激障碍的辩证行为疗法(DBT-PTSD):一个基于证据的针对特定障碍的治疗方案]

[Dialectical behavioral therapy for complex posttraumatic stress disorder (DBT-PTSD): an evidence-based disorder-specific treatment program].

作者信息

Bohus Martin, Vonderlin Ruben

机构信息

Klinik für Psychosomatik und Psychotherapeutische Medizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland.

McLean Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Nervenarzt. 2024 Jul;95(7):630-638. doi: 10.1007/s00115-024-01680-y. Epub 2024 Jun 14.


DOI:10.1007/s00115-024-01680-y
PMID:38874612
Abstract

Dialectical behavioral therapy for complex posttraumatic stress disorders (DBT-PTSD) is a modular treatment program that was developed at the Central Institute for Mental Health at the University of Heidelberg, Germany in 2005-2021. DBT-PTSD is designed to meet the needs of patients with complex PTSD related to sexual or physical trauma in childhood and adolescence. It is specifically designed for patients suffering from severe emotional dysregulation, persistent self-injury, chronic suicidal ideation, severe dissociative symptoms and a markedly negative self-concept with a high level of guilt, shame, self-loathing and interpersonal problems. To address these different core symptoms, DBT-PTSD combines evidence-based therapeutic strategies: principles, rules, and skills of DBT, trauma-specific cognitive and exposure-based techniques, imaginative interventions and procedures for behavioral change. The treatment program is designed to be carried out in an outpatient (45 weeks) or residential (12 weeks) setting. The results from two randomized controlled trials showed large effect sizes across very different symptom domains and a significant superiority of DBT-PTSD over Cognitive Processing Therapy (CPT). Based on these results, DBT-PTSD is currently a promising evidence-based treatment program for all features of a complex PTSD after sexual abuse in childhood and adolescence.

摘要

用于复杂性创伤后应激障碍的辩证行为疗法(DBT-PTSD)是一种模块化治疗方案,于2005年至2021年在德国海德堡大学中央精神卫生研究所开发。DBT-PTSD旨在满足与童年和青少年期性创伤或身体创伤相关的复杂性创伤后应激障碍患者的需求。它专为患有严重情绪失调、持续性自我伤害、慢性自杀意念、严重解离症状以及具有高度内疚、羞耻、自我厌恶和人际问题的明显负面自我概念的患者设计。为解决这些不同的核心症状,DBT-PTSD结合了循证治疗策略:DBT的原则、规则和技能、创伤特异性认知和暴露技术、想象性干预以及行为改变程序。该治疗方案设计为在门诊(45周)或住院(12周)环境中实施。两项随机对照试验的结果显示,在非常不同的症状领域均有较大效应量,且DBT-PTSD显著优于认知加工疗法(CPT)。基于这些结果,DBT-PTSD目前是一种有前景的循证治疗方案,适用于童年和青少年期性虐待后复杂性创伤后应激障碍的所有特征。

相似文献

[1]
[Dialectical behavioral therapy for complex posttraumatic stress disorder (DBT-PTSD): an evidence-based disorder-specific treatment program].

Nervenarzt. 2024-7

[2]
Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial.

JAMA Psychiatry. 2020-12-1

[3]
Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination.

Eur J Psychotraumatol. 2024

[4]
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

[5]
Changes in Trauma-Related Emotions Following Treatment With Dialectical Behavior Therapy for Posttraumatic Stress Disorder After Childhood Abuse.

J Trauma Stress. 2019-9-2

[6]
A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse.

Borderline Personal Disord Emot Dysregul. 2019-3-5

[7]
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

[8]
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

[9]
Dialectical behaviour therapy for posttraumatic stress disorder (DBT-PTSD): transportability to everyday clinical care in a residential mental health centre.

Eur J Psychotraumatol. 2023

[10]
Identifying Change Targets for Posttraumatic Stress Disorder Among Suicidal and Self-Injuring Women With Borderline Personality Disorder.

J Trauma Stress. 2020-8

本文引用的文献

[1]
Factors Associated with Revictimization in Intimate Partner Violence: A Systematic Review and Meta-Analysis.

Behav Sci (Basel). 2024-1-30

[2]
Factors associated with delayed disclosure of child sexual abuse: A focus on the victim's having been led to perform sexual acts on the perpetrator.

Child Abuse Negl. 2024-1

[3]
Obsessive-Compulsive Symptoms and Daily Experiences of Posttraumatic Stress and Mental Contamination Following Sexual Trauma.

J Obsessive Compuls Relat Disord. 2023-1

[4]
What are the predictive variables that increase the risk of developing a complex trauma? A meta-analysis.

J Affect Disord. 2023-12-15

[5]
Trauma-Related Shame and Guilt as Prospective Predictors of Daily Mental Contamination and PTSD Symptoms in Survivors of Sexual Trauma.

J Interpers Violence. 2023-10

[6]
Complex post-traumatic stress disorder.

Lancet. 2022-7-2

[7]
Optimizing exposure therapy with an inhibitory retrieval approach and the OptEx Nexus.

Behav Res Ther. 2022-5

[8]
Rejection sensitivity and vulnerable attachment: associations with social support and PTSD symptoms in trauma survivors.

Eur J Psychotraumatol. 2022

[9]
Predictors of Skeptical Responses to Disclosures of Childhood Sexual Abuse.

Violence Vict. 2021-12-1

[10]
Treating adults with a dual diagnosis of borderline personality disorder and posttraumatic stress disorder related to childhood abuse: Results from a randomized clinical trial.

J Consult Clin Psychol. 2021-11

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