Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions

Autor: Melanie S. Harned, Chelsey R. Wilks, Trevor N. Coyle, Sara C. Schmidt
Rok vydání: 2018
Předmět:
Adult
050103 clinical psychology
Social adjustment
Adolescent
medicine.medical_treatment
Implosive Therapy
Pilot Projects
Experimental and Cognitive Psychology
Dialectical Behavior Therapy
behavioral disciplines and activities
Article
Suicidal Ideation
Stress Disorders
Post-Traumatic
Young Adult
03 medical and health sciences
Interpersonal relationship
0302 clinical medicine
Quality of life (healthcare)
Behavior Therapy
Borderline Personality Disorder
mental disorders
Humans
Medicine
0501 psychology and cognitive sciences
Borderline personality disorder
business.industry
05 social sciences
Cognition
Middle Aged
medicine.disease
Dialectical behavior therapy
030227 psychiatry
Psychiatry and Mental health
Clinical Psychology
Treatment Outcome
Ptsd treatment
Mixed effects
Female
business
Social Adjustment
Clinical psychology
Zdroj: Behaviour Research and Therapy. 103:53-61
ISSN: 0005-7967
DOI: 10.1016/j.brat.2018.02.002
Popis: Although functional impairment typically improves during evidence-based psychotherapies (EBPs) for borderline personality disorder (BPD), functional levels often remain suboptimal after treatment. The present pilot study evaluated whether and how integrating PTSD treatment into an EBP for BPD would improve functional outcomes. Participants were 26 women with BPD, PTSD, and recent suicidal and/or self-injurious behavior who were randomized to receive one year of Dialectical Behavior Therapy (DBT) or DBT with the DBT Prolonged Exposure (DBT PE) protocol for PTSD. Five domains of functioning were assessed at 4-month intervals during treatment and at 3-months post-treatment. DBT + DBT PE was superior to DBT in improving global social adjustment, health-related quality of life, and achieving good global functioning, but not interpersonal problems or quality of life. Results of time-lagged mixed effects models indicated that, across both treatments, reductions in PTSD severity significantly predicted subsequent improvement in global social adjustment, global functioning, and health-related quality of life, whereas reductions in post-traumatic cognitions significantly predicted later improvement in all functional outcomes except global social adjustment. These findings provide preliminary evidence supporting the role of change in PTSD severity and trauma-related cognitions as active mechanisms in improving functional outcomes among individuals with BPD and PTSD.
Databáze: OpenAIRE
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