Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study
IntroductionChildhood traumatization can result in physical and mental health problems in adulthood, such as post-traumatic stress disorder (PTSD), which negatively influences quality of life and social functioning. Although evidence based trauma treatments benefit clients with PTSD after childhood...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Psychiatry |
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| author | Annemieke C. Kamstra Annemieke C. Kamstra Sybolt O. de Vries Maarten F. Brilman Petty Vasilev Manna A. Alma Antoinette D. I. van Asselt Antoinette D. I. van Asselt Mia De Wolf Robert A. Schoevers Frederike Jörg |
| author_facet | Annemieke C. Kamstra Annemieke C. Kamstra Sybolt O. de Vries Maarten F. Brilman Petty Vasilev Manna A. Alma Antoinette D. I. van Asselt Antoinette D. I. van Asselt Mia De Wolf Robert A. Schoevers Frederike Jörg |
| author_sort | Annemieke C. Kamstra |
| collection | DOAJ |
| description | IntroductionChildhood traumatization can result in physical and mental health problems in adulthood, such as post-traumatic stress disorder (PTSD), which negatively influences quality of life and social functioning. Although evidence based trauma treatments benefit clients with PTSD after childhood abuse and comorbid personality disorders, they are less effective than in clients who were traumatized in adulthood, and drop-out is substantial. The current study aims to assess the effects of inpatient dialectical behavior therapy combined with prolonged exposure (DBT-PTSD) on severity of PTSD, dissociation, parasuicidal behavior and borderline personality disorder (BPD) in clients with severe PTSD and comorbid psychiatric disorders. Secondary outcomes are social functioning, quality of life, borderline and cluster C personality disorder symptoms as treatment predictors, treatment trajectories, clients’ experiences and health economic consequences.MethodsThe naturalistic, longitudinal Trauma Therapy Study is conducted from January 2019 until May 2025 in a mental healthcare center in the Netherlands. Clients with severe PTSD and comorbid conditions who are referred to inpatient DBT-PTSD are included into the study. Based on power analyses a total sample size of N=56 is needed. Measurements take place before the waiting list period, at pre- and posttreatment and at six- and twelve-months follow-up. Clients fill in a daily DBT-PTSD diary, which gives insight into individual symptom trajectories.ResultsStatistical analyses include two-sided paired samples t-tests, linear mixed model analyses and cost-effectiveness analyses. Qualitative interviews are conducted within two years posttreatment and analyzed using a phenomenological approach. We correct for chance capitalization by using a conservative α-level of.01. Multiple imputation is used to handle missing data.DiscussionResearch on the effects of integrated treatment programs for clients with severe PTSD and co-morbid conditions is scarce. This study extends current knowledge on the effects of inpatient DBT-PTSD on PTSD and BPD symptoms, clients’ social functioning and quality of life. In addition, it provides insight into individual symptom trajectories and experiences, inspiring future treatment improvements for clients with severe psychopathology.Trial registrationMedical Ethical Committee approval (NL669060018, RTPO1044/01.10.2018). Preregistration: Dutch registration database Centrale Commissie Mensgebonden Onderzoek and International Clinical Trials Registry Platform (NL-OMON46167/01.10.2018/https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON46167). |
| format | Article |
| id | doaj-art-d0beacb94d9d4814a34544ca9fcf9bbf |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-02-01 |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-d0beacb94d9d4814a34544ca9fcf9bbf2025-02-05T07:32:58ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-02-011610.3389/fpsyt.2025.15382671538267Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy studyAnnemieke C. Kamstra0Annemieke C. Kamstra1Sybolt O. de Vries2Maarten F. Brilman3Petty Vasilev4Manna A. Alma5Antoinette D. I. van Asselt6Antoinette D. I. van Asselt7Mia De Wolf8Robert A. Schoevers9Frederike Jörg10Research Department, GGZ Friesland, Leeuwarden, NetherlandsDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsResearch Department, GGZ Friesland, Leeuwarden, NetherlandsDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsResearch Department, GGZ Friesland, Leeuwarden, NetherlandsDepartment of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsDepartment of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsResearch Department, GGZ Friesland, Leeuwarden, NetherlandsDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsIntroductionChildhood traumatization can result in physical and mental health problems in adulthood, such as post-traumatic stress disorder (PTSD), which negatively influences quality of life and social functioning. Although evidence based trauma treatments benefit clients with PTSD after childhood abuse and comorbid personality disorders, they are less effective than in clients who were traumatized in adulthood, and drop-out is substantial. The current study aims to assess the effects of inpatient dialectical behavior therapy combined with prolonged exposure (DBT-PTSD) on severity of PTSD, dissociation, parasuicidal behavior and borderline personality disorder (BPD) in clients with severe PTSD and comorbid psychiatric disorders. Secondary outcomes are social functioning, quality of life, borderline and cluster C personality disorder symptoms as treatment predictors, treatment trajectories, clients’ experiences and health economic consequences.MethodsThe naturalistic, longitudinal Trauma Therapy Study is conducted from January 2019 until May 2025 in a mental healthcare center in the Netherlands. Clients with severe PTSD and comorbid conditions who are referred to inpatient DBT-PTSD are included into the study. Based on power analyses a total sample size of N=56 is needed. Measurements take place before the waiting list period, at pre- and posttreatment and at six- and twelve-months follow-up. Clients fill in a daily DBT-PTSD diary, which gives insight into individual symptom trajectories.ResultsStatistical analyses include two-sided paired samples t-tests, linear mixed model analyses and cost-effectiveness analyses. Qualitative interviews are conducted within two years posttreatment and analyzed using a phenomenological approach. We correct for chance capitalization by using a conservative α-level of.01. Multiple imputation is used to handle missing data.DiscussionResearch on the effects of integrated treatment programs for clients with severe PTSD and co-morbid conditions is scarce. This study extends current knowledge on the effects of inpatient DBT-PTSD on PTSD and BPD symptoms, clients’ social functioning and quality of life. In addition, it provides insight into individual symptom trajectories and experiences, inspiring future treatment improvements for clients with severe psychopathology.Trial registrationMedical Ethical Committee approval (NL669060018, RTPO1044/01.10.2018). Preregistration: Dutch registration database Centrale Commissie Mensgebonden Onderzoek and International Clinical Trials Registry Platform (NL-OMON46167/01.10.2018/https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON46167).https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1538267/fullDBT-PTSDstudy protocoldialectical behavior therapypost-traumatic stress disorderparasuicidal behaviorborderline personality disorder |
| spellingShingle | Annemieke C. Kamstra Annemieke C. Kamstra Sybolt O. de Vries Maarten F. Brilman Petty Vasilev Manna A. Alma Antoinette D. I. van Asselt Antoinette D. I. van Asselt Mia De Wolf Robert A. Schoevers Frederike Jörg Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study Frontiers in Psychiatry DBT-PTSD study protocol dialectical behavior therapy post-traumatic stress disorder parasuicidal behavior borderline personality disorder |
| title | Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study |
| title_full | Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study |
| title_fullStr | Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study |
| title_full_unstemmed | Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study |
| title_short | Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: study design of the naturalistic trauma therapy study |
| title_sort | inpatient dialectical behavior therapy combined with trauma focused therapy for ptsd and borderline personality disorder symptoms study design of the naturalistic trauma therapy study |
| topic | DBT-PTSD study protocol dialectical behavior therapy post-traumatic stress disorder parasuicidal behavior borderline personality disorder |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1538267/full |
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