Sven Cornelisse1, Miriam Biermann2, Frank Enning2,3, Christian Schmahl3, Nikolaus Kleindienst2. 1. Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland. sven.cornelisse@zi-mannheim.de. 2. Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland. 3. Klinik für Psychosomatik und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland.
Abstract
BACKGROUND: Recent meta-analyses have shown that posttraumatic stress disorder (PTSD) in adolescents and young adults can be effectively treated; however, there is a lack of studies that investigated the efficacy of psychotherapy in the clinically important group of adolescents with PTSD related to childhood sexual and/or physical abuse and co-occurring symptoms of borderline personality disorder (BPD). OBJECTIVE: The aim of this study was a first evaluation of the efficacy of a specifically developed trauma-focused treatment (DBT-PTSD-EA) for adolescent patients with PTSD and BPD symptoms after interpersonal violence in childhood and adolescence. METHODS: Validated questionnaires including the Davidson trauma scale (DTS), the borderline symptom list (BSL-23) and the Beck depression inventory (BDI-II) were used to assess treatment-related changes in psychopathology in 39 treatment-seeking adolescents with a diagnosis of PTSD and symptoms of BPD after childhood sexual and/or physical abuse. The diagnoses were established from standardized clinical interviews. The analyses were primarily based on pre-to-post comparisons of all patients who were included (intent to treat analyses, ITT). RESULTS AND DISCUSSION: Significant improvements were observed in all questionnaires including PTSD severity, intrusive re-experiencing, hyperarousal, PTSD-related avoidance, severity of BPD and depressive symptoms. The pre-post effect sizes were large for the DTS total score (Cohen's d = 1.24) and medium to large for both the BSL-23 (d = 0.69) and the BDI-II (d = 0.72). While these results are very promising, the validity is limited by the lack of a control group.
BACKGROUND: Recent meta-analyses have shown that posttraumatic stress disorder (PTSD) in adolescents and young adults can be effectively treated; however, there is a lack of studies that investigated the efficacy of psychotherapy in the clinically important group of adolescents with PTSD related to childhood sexual and/or physical abuse and co-occurring symptoms of borderline personality disorder (BPD). OBJECTIVE: The aim of this study was a first evaluation of the efficacy of a specifically developed trauma-focused treatment (DBT-PTSD-EA) for adolescent patients with PTSD and BPD symptoms after interpersonal violence in childhood and adolescence. METHODS: Validated questionnaires including the Davidson trauma scale (DTS), the borderline symptom list (BSL-23) and the Beck depression inventory (BDI-II) were used to assess treatment-related changes in psychopathology in 39 treatment-seeking adolescents with a diagnosis of PTSD and symptoms of BPD after childhood sexual and/or physical abuse. The diagnoses were established from standardized clinical interviews. The analyses were primarily based on pre-to-post comparisons of all patients who were included (intent to treat analyses, ITT). RESULTS AND DISCUSSION: Significant improvements were observed in all questionnaires including PTSD severity, intrusive re-experiencing, hyperarousal, PTSD-related avoidance, severity of BPD and depressive symptoms. The pre-post effect sizes were large for the DTS total score (Cohen's d = 1.24) and medium to large for both the BSL-23 (d = 0.69) and the BDI-II (d = 0.72). While these results are very promising, the validity is limited by the lack of a control group.