Narrative Exposure Therapy in Women With Borderline Personality Disorder and Posttraumatic Stress Disorder

Summary

Narrative Exposure Therapy (NET) is an evidence-based trauma-focussed treatment, suitable for survivors of prolonged and repeated exposure to traumatic stress and childhood adversity. Patients with Borderline Personality Disorder (BPD) often suffer from a comorbid Posttraumatic Stress Disorder (PTSD) caused by multiple traumatic events. Therapeutic aims are the reduction of PTSD-Symptoms in these patients via activation of associative neural networks related to traumatic experiences and habituation of fear and the placement of traumatic experiences in a reconstructed, detailed and consistent autobiography. This practice enables the processing of and coping with painful memories and the construction of clear contingencies of dangerous and safe conditions, generally leading to significant emotional recovery. The investigators assume that using NET the reduction of PTSD symptom severity is greater compared to treatment by Dialectical-Behavioral Therapy (DBT).

Conditions

• Borderline Personality Disorder
• Stress Disorders, Post-Traumatic

Interventions

BEHAVIORAL

Narrative Exposure Therapy

Narrative Exposure Therapy (NET) is based on Testimony Therapy in combination with cognitive behavioural exposure techniques and elements of client-centered counselling. The clients can restore their autobiographic memories about their traumatic experiences. In this way fragmentary memories are transformed into a coherent narrative structure. This practice enables the processing of painful emotions and the construction of clear contingencies of dangerous and safe conditions, generally leading to significant emotional recovery. Therapeutic aims are the reduction of PTSD-Symptomload via activation of fear-network and habituation of fear and the placement of traumatic experiences in a reconstructed, detailed and consistent autobiography. NET will be applied in eight sessions (90-120min/session) in a standardized, manualized manner.

BEHAVIORAL

Dialectical Behavior Therapy

Dialectical behavior therapy is a cognitive behavioral treatment program developed by Marsha Linehan to treat suicidal clients meeting criteria for BPD. It directly targets suicidal behavior, behaviors that interfere with treatment delivery, and other dangerous, severe, or destabilizing behaviors. Via standard DBT patients improve behavioral capabilities, motivation for skillful behavior, generalization of gains to the natural environment, structuring the treatment environment so that it reinforces functional rather than dysfunctional behaviors. It also targets the therapist capabilities and motivation to treat patients effectively. Patients get weekly individual psychotherapy (1 h/wk), group skills training (3.75 h/wk), a weekly therapist consultation team meetings.

BEHAVIORAL

Standard Inpatient Care

Unspecific group therapy that is identical in both groups (music therapy etc.)

OTHER

Waiting List

Treatment as usual in the community (no DBT, no exposure of trauma memories)

Sponsors & Collaborators

• Evangelisches Krankenhaus Bielefeld gGmbH

  lead OTHER

Principal Investigators

• Carolin Steuwe, M.Sc. · Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

• Martin Driessen, Prof. Dr. med. · Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

FACTORIAL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-04-30

Primary Completion

2020-01-31

Completion

2020-01-31

Countries

• Germany

Study Locations