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

Psychotherapy and Psychosomatics

Volumn 82, Issue 4, 2013, Pages 221-233

  Bohus, Martin ^a   Dyer, Anne S ^a   Priebe, Kathlen ^a   Krüger, Antje ^a   Kleindienst, Nikolaus ^a   Schmahl, Christian ^a   Niedtfeld, Inga ^a   Steil, Regina ^b  

^a UNIVERSITY OF HEIDELBERG   (Germany)

^b GOETHE UNIVERSITY   (Germany)

Author keywords

Borderline personality disorder; Childhood sexual abuse; Cognitive behaviour therapy; Dialectical behaviour therapy; Modular treatment; Post traumatic stress disorder; Psychotherapy outcome research; Randomised controlled trial; Trauma

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; ASSESSMENT OF HUMANS; BEHAVIOR THERAPY; BORDERLINE STATE; CHILD SEXUAL ABUSE; CLINICIAN ADMINISTERED PTSD SCALE; CONTROLLED STUDY; DIALECTICAL BEHAVIOR THERAPY; DSM-IV; EFFECT SIZE; FEMALE; HEALTH PROGRAM; HUMAN; MAJOR CLINICAL STUDY; POSTTRAUMATIC STRESS DIAGNOSTIC SCALE; POSTTRAUMATIC STRESS DISORDER; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SAFETY; STATISTICAL MODEL; TREATMENT DURATION; TREATMENT OUTCOME;

EID: 84878074951     PISSN: 00333190     EISSN: 14230348     Source Type: Journal    
DOI: 10.1159/000348451     Document Type: Article

References (65)

1. Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S: Burden and consequences of child maltreatment in high-income countries. Lancet 2009; 373: 68-81.
2. Cutajar MC, Mullen PE, Ogloff JR, Thomas SD, Wells DL, Spataro J: Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse Negl 2010; 34: 813-822.
3. Harned MS, Rizvi SL, Linehan MM: Impact of co-occurring posttraumatic stress disorder on suicidal women with borderline personality disorder. Am J Psychiatry 2010; 167: 1210-1217.
4. Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR: Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. Am J Psychiatry 2004; 161: 2108-2114.
5. Zlotnick C, Johnson DM, Yen S, Battle CL, Sanislow CA, Skodol AE, Grilo CM, Mc-Glashan TH, Gunderson JG, Bender DS, Zanarini MC, Shea MT: Clinical features and impairment in women with borderline personality disorder (BPD) with posttraumatic stress disorder (PTSD), BPD without PTSD, and other personality disorders with PTSD. J Nerv Ment Dis 2003; 191: 706-713.
6. Harned M, Korslund KE, Foa EB, Linehan MM: Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behav Res Ther 2012; 50: 381-386.
7. Pabst A, Schauer M, Bernhardt K, Ruf M, Goder R, Rosentraeger R, Elbert T, Aldenhoff J, Seeck-Hirschner M: Treatment of patients with borderline personality disorder and comorbid posttraumatic stress disorder using narrative exposure therapy: a feasibility study. Psychother Psychosom 2012; 81: 61-63.
8. Steil R, Dyer A, Priebe K, Kleindienst N, Bohus M: 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; 24: 102-106.
9. Rizvi SL, Steffel LM, Carson-Wong A: An overview of dialectical behavior therapy for professional psychologists. Prof Psychol Res Pr 2012, DOI: 10.1037/a0029808.
10. Harned MS, Chapman AL, Dexter-Mazza ET, Murray A, Comtois KA, Linehan MM: Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts. J Consult Clin Psychol 2008; 76: 1068-1075.
11. Feigenbaum JD, Fonagy P, Pilling S, Jones A, Wildgoose A, Bebbington PE: A real-world study of the effectiveness of DBT in the UK National Health Service. Br J Clin Psychol 2012; 51: 121-124.
12. Bradley R, Greene J, Russ E, Dutra L, Westen W: A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatry 2005; 162: 214-227.
13. Bisson J, Andrew M: Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2007:CD003388.
14. Foa EB, Keane TM, Friedman MJ, Cohen JA: Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York, Guilford, 2009.
15. Institute of Medicine (IOM): Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, National Academies Press, 2008.
16. National Collaborating Centre for Mental Health: Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline Number 26. London, Gaskell and the British Psychological Society, 2005.
17. Ursano RJ, Bell C, Spencer E, Friedman M, Norwood A, Pfefferbaum B, Pynoos RS, Zatzick DF, Benedek DM: Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am J Psychiatry 2004; 161: 3-33.
18. Schnyder U: Why new psychotherapies for posttraumatic stress disorder? Psychother Psychosom 2005; 74: 199-201.
19. Harvey ST, Taylor JE: A meta-analysis of the effects of psychotherapy with sexually abused children and adolescents. Clin Psychol Rev 2010; 30: 517-535.
20. Chard KM: An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. J Consult Clin Psychol 2005; 73: 965-971.
21. McDonagh A, Friedman M, McHugo G, Ford J, Sengupta A, Mueser K, Demment CC, Fournier D, Schnurr PP, Descamps M: Randomized trial of cognitive-behavioral therapy for chronic posttraumatic stress disorder in adult female survivors of childhood sexual abuse. J Consult Clin Psychol 2005; 73: 515-524.
22. Zlotnick C, Shea TM, Rosen K, Simpson E, Mulrenin K, Begin A, Pearlstein T: An affectmanagement group for women with posttraumatic stress disorder and histories of childhood sexual abuse. J Trauma Stress 1997; 10: 425-436.
23. Cloitre M, Koenen KC, Cohen LR, Han H: Skills training in affective and interpersonal regulation followed by exposure: a phasebased treatment for PTSD related to childhood abuse. J Consult Clin Psychol 2002; 70: 1067-1074.
24. Cloitre M, Stovall-McClough KC, Nooner K, Zorbas P, Cherry S, Jackson CL, Gan W, Petkova E: Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry 2010; 167: 915-924.
25. Dorrepaal E, Thomaes K, Smit JH, van Balkom AJ, Veltman DJ, Hoogendoorn AW, Draijer N: Stabilizing group treatment for complex posttraumatic stress disorder related to child abuse based on psychoeducation and cognitive behavioural therapy: a multisite randomized controlled trial. Psychother Psychosom 2012; 81: 217-225.
26. Krakow B, Hollifield M, Johnston L, Koss M, Schrader R, Warner TD, Tandberg D, Lauriello J, McBride L, Cutchen L, Cheng D, Emmons S, Germain A, Melendrez D, Sandoval D, Prince H: Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA 2001; 286: 537-545.
27. Resick PA, Galovski TE, O'Brien Uhlmansiek M, Scher CD, Clum GA, Young-Xu Y: A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. J Consult Clin Psychol 2008; 76: 243-258.
28. Albach F, Everaerd W: Posttraumatic stress symptoms in victims of childhood incest. Psychother Psychosom 1992; 57: 143-151.
29. Amir M, Kaplan Z, Efroni R, Kotler M: Suicide risk and coping styles in posttraumatic stress disorder patients. Psychother Psychosom 1999; 68: 76-81.
30. Foa EB, Hembree E, Rothbaum BO: Prolonged exposure therapy for PTSD. New York, Oxford University Press, 2007.
31. Linehan M: Cognitive-behavioral treatment of borderline personality disorder. New York, Guilford Press, 1993.
32. Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL: Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices. J Trauma Stress 2011; 24: 615-627.
33. Ebner-Priemer UW, Mauchnik J, Kleindienst N, Schmahl C, Peper M, Rosenthal Z, Flor H, Bohus M: Emotional learning during dissociative states in borderline personality disorder. J Psychiatry Neurosci 2009; 34: 214-222.
34. Kleindienst N, Bohus M, Ludaescher P, Limberger MF, Kuenkele K, Ebner-Priemer UW, Chapman AL, Reicherzer M, Stieglitz RD, Schmahl C: Motives for non-suicidal self-injury among women with borderline personality disorder. J Nerv Ment Dis 2008; 196: 230-236.
35. Schauer M, Elbert T: Dissociation following traumatic stress: etiology and treatment. J Psychol 2010; 218: 109-127.
36. Rüsch N, Corrigan PW, Bohus M, Kühler T, Jacob GA, Lieb K: The impact of posttraumatic stress disorder on dysfunctional implicit and explicit emotions among women with borderline personality disorder. J Nerv Ment Dis 2007; 195: 537-539.
37. Rüsch N, Schulz D, Valerius G, Steil R, Bohus M, Schmahl C: Disgust and implicit self-concept in women with borderline personality disorder and posttraumatic stress disorder. Eur Arch Psychiatry Clin Neurosci 2011; 261: 369-376.
38. Steil R, Jung K, Stangier U: Efficacy of a twosession program of cognitive restructuring and imagery modification to reduce the feeling of being contaminated in adult survivors of childhood sexual abuse: a pilot study. J Behav Ther Exp Psychiatry 2011; 42: 325-329.
39. Jung K, Steil R: The feeling of being contaminated in adult survivors of childhood sexual abuse and its treatment via a two-session program of cognitive restructuring and imagery modification: a case study. Behav Modif 2012; 36: 67-86.
40. Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK, Daleiden EL, Ugueto AM, Ho A, Martin J, Gray J, Alleyne A, Langer DA, Southam-Gerow MA, Gibbons RD, The Research Network on Youth Mental Health: Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry 2012; 69: 274-282.
41. Bohus M, Haaf B, Simms T, Limberger MF, Schmahl C, Unckel C, Lieb K, Linehan MM: Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial. Behav Res Ther 2004; 42: 487-499.
42. Ehlers A, Clark DM: A cognitive model of posttraumatic stress disorder. Behav Res Ther 2000; 38: 319-345.
43. Bartak A, Spreeuwenberg MD, Andrea H, Holleman L, Rijnierse P, Rossum BV, Hamers EF, Meerman AM, Aerts J, Busschbach JJ, Verheul R, Stijnen T, Emmelkamp PM: Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: results of a large prospective multicentre study. Psychother Psychosom 2010; 79: 20-30.
44. Bartak A, Andrea H, Spreeuwenberg MD, Thunnissen M, Ziegler UM, Dekker J, Bouvy F, Hamers EF, Meerman AM, Busschbach JJ, Verheul R, Stijnen T, Emmelkamp PM: Patients with cluster a personality disorders in psychotherapy: an effectiveness study. Psychother Psychosom 2011; 80: 88-99.
45. Bartak A, Andrea H, Spreeuwenberg MD, Ziegler UM, Dekker J, Rossum BV, Hamers EF, Scholte W, Aerts J, Busschbach JJ, Verheul R, Stijnen T, Emmelkamp PM: Effectiveness of outpatient, day hospital, and inpatient psychotherapeutic treatment for patients with cluster B personality disorders. Psychother Psychosom 2011; 80: 28-38.
46. Ogrodniczuk JS: New directions in treatment research for personality disorders: effectiveness of different levels of care. Psychother Psychosom 2010; 89: 65-69.
47. Ehlers A, Clark DM, Hackmann A, Grey N, Liness S, Wild J, Manley J, Waddington L, McManus F: Intensive cognitive therapy for PTSD: a feasibility study. Behav Cogn Psychother 2010; 38: 383-398.
48. Hendriks L, de Kleine R, van Rees M, Bult C, van Minnen A: Feasibility of brief intensive exposure therapy for PTSD patients with childhood sexual abuse: a brief clinical report. Eur J Psychotraumatol 2010, DOI: 10.3402/ejpt.v1i0.5626.
49. First MB, Spitzer RL, Gibbon M, Williams JBW, Benjamin LS: User's Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I)-Clinical Version. Washington, American Psychiatric Press, 1997.
50. Bohus M, Borgmann E: Borderline-Persönlichkeitsstörungen; In Meinlschmidt G, Schneider S, Margraf J. (eds.): Lehrbuch der Verhaltenstherapie. Materialien für die Psychotherapie. Berlin, Springer, 2012, pp 271-277.
51. Loranger AW, Sartorius N, Andreoli A, Berger P, Buchheim P, Channabasavanna SM, Coid B, Dahl A, Diekstra RFW, Ferguson B, Jacobsberg LB, Mombour W, Pull C, Ono Y, Regier DA: The International Personality Disorder Examination, IPDE. The WHO/ADAMHA international pilot study of personality disorders. Arch Gen Psychiatry 1994; 51: 215-224.
52. Wechsler D: Wechsler Adult Intelligence Scale, ed 3. San Antonio, Pearson, 1997.
53. Blake DD, Weathers FW, Nagy LM, Kaloupek D, Klauminzer G, Charney DS, Keane TM, Buckley TC: Clinician-Administered PTSD Scale (CAPS) Instruction Manual. Boston, National Center for PTSD, 2000.
54. Griesel D, Wessa M, Flor H: Psychometric qualities of the German version of the Posttraumatic Diagnostic Scale (PDS). Psychol Assess 2006; 18: 262-268.
55. Bohus M, Limberger MF, Frank U, Chapman AL, Kuehler T, Stieglitz RD: Psychometric properties of the Borderline Symptom List (BSL). Psychopathology 2007; 40: 126-132.
56. Spitzer C, Mestel R, Klingelhoefer J, Gaensicke M, Freyberger HJ: Screening and measurement of change of dissociative psychopathology: psychometric properties of the short version of the 'Fragebogen zu Dissoziativen Symptomen' (FDS-20). Psychother Psychosom Med Psychol 2004; 54: 165-172.
57. Beck A, Steer R, Brown G: Beck Depression Inventory-II Manual, ed 2. San Antonio, Psychological Corporation, 1996.
58. Endicott J, Spitzer RL, Fleiss JL, Cohen J: The global assessment scale: a procedure for measuring overall severity of psychiatric disorders. Arch Gen Psychiatry 1976; 33: 766-771.
59. Derogatis L: SCL-90-R, Administration, Scoring and Procedures Manual-II for the Revised Version and Other Instruments of the Psychopathology Rating Scale Series. Towson, Clinical Psychometric Research, 1992.
60. Hien DA, Wells EA, Jiang H, Suarez-Morales L, Campbell AN, Cohen LR, Miele GM, Killeen T, Brigham GS, Zhang Y, Hansen C, Hodgkins C, Hatch-Maillette M, Brown C, Kulaga A, Kristman-Valente A, Chu M, Sage R, Robinson JA, Liu D, Nunes EV: Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders. J Consult Clin Psychol 2009; 77: 607-619.
61. Hedecker D, Gibbons RD: Application of random-effects pattern-mixture models for missing data in longitudinal studies. Psychol Methods 1997; 2: 64-78.
62. Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149-1160.
63. Lampe A, Mitmansgruber H, Gast U, Schüssler G, Reddemann L: Treatment outcome of psychodynamic trauma therapy in an inpatient setting (in German). Neuropsychiatr 2008; 22: 189-197.
64. Sachsse U, Vogel C, Leichsenring F: Results of psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). Bull Menninger Clin 2006; 70: 125-144.
65. Stalker CA, Palmer SE, Wright DC, Gebotys R: Specialized inpatient trauma treatment for adults abused as children: a follow-up study. Am J Psychiatry 2005; 162: 552-559.