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

NCT02517723 | Completed

• 1 other identifier: NET_BPS+PTBS
• Study Type: interventional
• Target: 67
• Locations: 1 country
• Sites: 1

Brief 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

Keywords

Borderline Personality Disorder; comorbid Posttraumatic Stress Disorder; Narrative Exposure Therapy; Dialectical-Behavioral Therapy

Outcome Measures

Primary Outcomes (1)

• Change from first investigation in Posttraumatic Symptom Severity at 18 months (Clinician-Administered PTSD Scale; CAPS)

  first investigation (t1), after waiting list (3 months, t2), directly after therapy (3 months, t1), 1 year after therapy (15 months, t3)

Secondary Outcomes (4)

• Change from first investigation in Borderline Symptome Severity at 18 months(Borderline Symptom Liste; BSL)

  first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)

• Change from first investigation in Severity of Dissociative Symptoms at 18 months (Fragebogen zu Dissoziativen Symptome ;FDS)

  first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)

• Change from first investigation in Severity of Depressive Symptoms at 18 months (Becks Depressions Inventar II, BDI-II)

  first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)

• Change from first investigation in Quality of Life at 12 months (WHO-Qualitiy of Life; WHOQOL)

  first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)

Study Arms (2)

SIC + NET

EXPERIMENTAL

Waiting List + Standard Inpatient Care + Narrative Exposure Therapy

Behavioral: Narrative Exposure Therapy; Behavioral: Standard Inpatient Care; Other: Waiting List

SIC + DBT

ACTIVE COMPARATOR

Waiting List + Standard Inpatient Care + Dialectical Behavior Therapy

Behavioral: Dialectical Behavior Therapy; Behavioral: Standard Inpatient Care; Other: Waiting List

Interventions

Narrative Exposure Therapy BEHAVIORAL

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.

Also known as: NET

SIC + NET

Dialectical Behavior Therapy BEHAVIORAL

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.

Also known as: DBT

SIC + DBT

Standard Inpatient Care BEHAVIORAL

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

Also known as: SIC

SIC + DBT; SIC + NET

Waiting List OTHER

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

SIC + DBT; SIC + NET

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age ≥ 18 years
• DSM-IV-TR diagnoses of BPD and PTSD
• legal competence
• none or stable medication
• illegal drug abstinence for at least the last 6 months
• capacity to consent and contract

You may not qualify if:

• other severe mental disorders (e.g., bipolar disorder, acute psychosis)
• simultaneous consumption of drugs
• simultaneous participation in other treatment-studies
• pregnancy or breastfeeding
• lack of capability to negotiate a no-suicide agreement
• suicide attempt or attempts during the 8 weeks prior to start of treatment
• perpetrator-contact
• Body Mass Index (BMI) \< 16

Sponsors & Collaborators

• Evangelisches Krankenhaus Bielefeld gGmbH: lead

Study Sites (1)

Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

Bielefeld, 33617, Germany

Location

Related Publications (3)

• Steuwe C, Berg M, Beblo T, Driessen M. Narrative Exposure Therapy in Patients With Posttraumatic Stress Disorder and Borderline Personality Disorder in a Naturalistic Residential Setting: A Randomized Controlled Trial. Front Psychiatry. 2021 Nov 26;12:765348. doi: 10.3389/fpsyt.2021.765348. eCollection 2021.

  PMID: 34899426 DERIVED

• Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2.

  PMID: 32368793 DERIVED

• Steuwe C, Rullkotter N, Ertl V, Berg M, Neuner F, Beblo T, Driessen M. Effectiveness and feasibility of Narrative Exposure Therapy (NET) in patients with borderline personality disorder and posttraumatic stress disorder - a pilot study. BMC Psychiatry. 2016 Jul 20;16:254. doi: 10.1186/s12888-016-0969-4.

  PMID: 27439618 DERIVED

MeSH Terms

Conditions

Borderline Personality Disorder; Stress Disorders, Post-Traumatic

Interventions

Dialectical Behavior Therapy; Waiting Lists

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities; Appointments and Schedules; Organization and Administration; Health Services Administration

Study Officials

• Carolin Steuwe, M.Sc.

  Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

  STUDY DIRECTOR

• Martin Driessen, Prof. Dr. med.

  Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Martin Driessen, Prof. Dr. med.

Study Record Dates

• First Submitted: January 6, 2014
• First Posted: August 7, 2015
• Study Start: April 1, 2014
• Primary Completion: January 31, 2020
• Study Completion: January 31, 2020
• Last Updated: October 8, 2021

Record last verified: 2021-10

Locations

DE (1)