Dealing with the consequences of severe interpersonal trauma through inpatient DBT-PTSD
Dealing with the consequences of severe interpersonal trauma through inpatient DBT-PTSD
Clients with post‑traumatic stress disorder (PTSD) benefit from evidence‑based treatments, but outcomes are less favorable after repeated interpersonal or sexual trauma and when comorbidity is present, such as personality disorders or suicidality.
The aim of this dissertation of Annemieke Kamstra was to increase knowledge about the short‑ and long‑term effects of clinical dialectical behavior therapy for PTSD (DBT‑PTSD) in clients with severe PTSD following (childhood) interpersonal trauma. We conducted a naturalistic, longitudinal study with five assessment points, a qualitative study on clients’ experiences, and a diary study during the twelve‑week treatment program.
The severity of PTSD decreased after treatment, and the change remained stable. Dissociative experiences improved to a lesser extent, and somatoform dissociation did not change. Borderline personality symptoms had slightly decreased at the follow‑up assessments. Although social functioning improved directly after discharge, this effect became even stronger at six and twelve months after treatment. The improvement in health‑related quality of life was not statistically significant.
Participants described the treatment program as intensive and demanding, but helpful. Individual exposure sessions were often mentioned as crucial for experiencing improvement. A few participants reported little reduction in PTSD symptoms, yet still experienced positive changes due to treatment.
Finally, the diary data indicated that PTSD intrusions appear to increase initially and decrease during the second half of treatment. Intrusions also seem to play a more central role in the sequence in which various symptoms (suicidality, self‑harm, emotion dysregulation, and sleep) change.