Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Bohus, Martin; Dyer, Anne S.; Priebe, Kathlen; Krüger, Antje; Kleindienst, Nikolaus; Schmahl, Christian; Niedtfeld, Inga; Steil, Regina

doi:10.1159/000348451

Cited by 344Personality Disorders and PsychopathologyPosttraumatic Stress Disorder ResearchChild Abuse and Trauma

Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Bohus, Martin, Dyer, Anne S., Priebe, Kathlen, Krüger, Antje, Kleindienst, Nikolaus, Schmahl, Christian, Niedtfeld, Inga, Steil, Regina·2013·Psychotherapy and Psychosomatics

DOI 10.1159/000348451

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Abstract

BACKGROUND: Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. METHODS: Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. RESULTS: Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. CONCLUSION: DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.

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Combined personality disorder and post-traumatic stress disorder treatment may lead to larger improvements in post-traumatic stress disorder and borderline personality disorder than a personality disorder treatment alone.
“and may lead to larger improvements in PTSD and BPD than a PD treatment alone.”
From Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial (2023) · cites this paper as [6]
Combined personality disorder and post-traumatic stress disorder treatment is feasible, acceptable, and safe to administer.
“These studies found a relationship that combined treatment is feasible, acceptable, and safe to administer”
From Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial (2023) · cites this paper as [6]
Specific trauma-focused dialectical behavior therapy and mentalization-based treatment programs have been developed for borderline personality disorder patients with comorbid post-traumatic stress disorder.
“Only more recently, specific trauma-focused DBT and MBT programs have been developed for BPD patients with comorbid PTSD, underscoring the importance of trauma processing in the treatment of patients with PTSD and BPD (6–8).”
From Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial (2023) · cites this paper as [6]
An RCT found DBT-PTSD superior to a treatment-as-usual waitlist for PTSD, depression, and global functioning, but not for borderline personality disorder severity or dissociation.
“Results indicated that DBT-PTSD was superior to TAU-WL in improving PTSD, depression, and global functioning, but not BPD severity or dissociation”
From A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD (2014) · cites this paper as Bohus et al., 2013
In that RCT, outcomes did not differ between patients with and without borderline personality disorder.
“and results did not differ between patients with and without BPD (Bohus et al., 2013).”
From A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD (2014) · cites this paper as Bohus et al., 2013

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“…for PTSD (Gersons, Carlier, Lamberts, & Van der Kolk, 2000), STAIR narrative therapy (Cloitre et al., 2010), and dialectical behavior therapy (Bohus et al., 2013), which have begun to receive empirical support for the treatment of PTSD, explicitly address enhancing interpersonal…”
Background
Ayahuasca: pharmacology, neuroscience and therapeutic potential
Domínguez-Clavé, E., Soler, J., Elices, M., Pascual, J. C., Álvarez, E., de la Fuente Revenga, M., Friedlander, P., Feilding, A., & Riba, J. (2016) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2016.03.002 · Cited by 226 · see citing works
“…mechanisms suggest its potential to treat trauma-related conditions and other disorders like borderline personality disorder (Bohus et al., 2011, Bohus et al., 2013, Harner and Burgess, 2011; Harner et al, 2015), obsessive-compulsive disorder (OCD), and phobias, in a structured, safe and…”
Background
What Works in the Treatment of Borderline Personality Disorder
Choi-Kain, L., Finch, E. F., Masland, S., Jenkins, J., & Unruh, B. (2017) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-017-0103-z · Cited by 148 · see citing works
A review of the long‐term impact of child maltreatment on posttraumatic stress disorder and its comorbidities: An emotion dysregulation perspective.
Messman‐Moore, T. L., & Bhuptani, P. H. (2017) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12193 · Cited by 209 · see citing works
“DBT has also been combined with trauma-focused interventions in a 12-week residential program for women with histories of CSA (Bohus et al., 2013).”
The “one size fits all” approach to trauma treatment: should we be satisfied?
Cloître, M. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.27344 · Cited by 200 · see citing works
“…individual therapy indicated that four were sequenced, multicomponent (Cloitre, Koenen, Cohen, & Han, 2002; Chard, 2005; Cloitre et al., 2010; Bohus et al., 2013) and four were purely trauma-focused treatments (McDonagh et al., 2005; Resick et al., 2008, which included three active…”
Background
The Relationship of Psychological Trauma and Dissociative and Posttraumatic Stress Disorders to Nonsuicidal Self-Injury and Suicidality: A Review
Ford, J. D., & Gómez, J. M. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2015.989563 · Cited by 199 · see citing works
“Adaptations of these interventions specifically for adolescents and adults with PTSD have shown promise (Bohus et al., 2013; Cloitre, Koenen, Cohen, & Han, 2002; Harned, Jackson, Comtois, & Linehan, 2010; Harned, Korslund, & Linehan, 2014).”
Background
Complex PTSD, affect dysregulation, and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-9 · Cited by 182 · see citing works
“A recent randomized controlled trial study tested the efficacy of a similar combination of trauma processing therapy and DBT (DBT-PTSD) with 74 women diagnosed with PTSD related to childhood sexual abuse [211].”
Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis
Oud, M., Arntz, A., Hermens, M., Verhoef, R. E. J., & Kendall, T. (2018) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867418791257 · Cited by 128 · see citing works
“Our review included some relevant studies (Bohus et al., 2013; Clarkin et al., 2007; Feigenbaum et al., 2012; Giesen-Bloo et al., 2006; Harned et al., 2014; Linehan et al., 2015; Nadort et al., 2009; Steil et al., 2011) that were missing in the meta-analysis of Cristea et al.”
BackgroundMethodResultInfluential
Emotion regulation in schema therapy and dialectical behavior therapy.
Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01373 · Cited by 163 · see citing works
“These negative experiences have led to unprocessed psychological traumas and fear of emotions and result in attempts to avoid emotions and dysfunctional meta-cognitive schemas about the meaning of emotions.”
Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis
Stoffers-Winterling, J. M., Storebø, O. J., Kongerslev, M. T., Faltinsen, E., Todorovac, A., Sedoc Jørgensen, M., Sales, C. P., Edemann Callesen, H., Pereira Ribeiro, J., Völlm, B. A., et al. (2022) · The British Journal of Psychiatry · doi:10.1192/bjp.2021.204 · Cited by 156 · see citing works
Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts
Hendriks, L., Kleine, R. A. D., Broekman, T. G., Hendriks, G.-J., & Minnen, A. V. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1425574 · Cited by 121 · see citing works
Randomized Clinical Trial of Dialectical Behavior Therapy for Preadolescent Children With Disruptive Mood Dysregulation Disorder: Feasibility and Outcomes.
Perepletchikova, F., Nathanson, D., Axelrod, S., Merrill, C. R. S., Walker, A., Grossman, M., Rebeta, J., Scahill, L., Kaufman, J., Flye, B., et al. (2017) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1016/j.jaac.2017.07.789 · Cited by 111 · see citing works
The centrality of affective instability and identity in Borderline Personality Disorder: Evidence from network analysis
Richetin, J., Preti, E., Costantini, G., & Panfilis, C. D. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186695 · Cited by 121 · see citing works
Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review
Frías, Á., & Palma, C. (2015) · Psychopathology · doi:10.1159/000363145 · Cited by 114 · see citing works
Barriers and solutions to implementing dialectical behavior therapy in a public behavioral health system
Carmel, A., Rose, M. L., & Fruzzetti, A. E. (2014) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-013-0504-6 · Cited by 112 · see citing works
“Eleven controlled trials of DBT have shown to be efficacious in reducing suicidal behavior, inpatient admissions, and other key outcomes (Bohus et al. 2013; Koons et al. 2001; Linehan et al. 1991, 2006, 2002; Lynch et al. 2003; Telch et al. 2001; Verheul et al. 2003).”
Background
Gender difference in outcomes following trauma-focused interventions for posttraumatic stress disorder: systematic review and meta-analysis
Wade, D., Varker, T., Kartal, D., Hetrick, S., O'Donnell, M., & Forbes, D. (2016) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/tra0000110 · Cited by 111 · see citing works
“Seven of 38 studies (Başoğlu et al., 2005; Beck et al., 2009; Bohus et al., 2013; J. A. Jensen, 1994; Litz et al., 2007; Rothbaum, 1997; Schnurr et al., 2003) were excluded from an analysis restricted to trials that evaluated an intervention likely to be provided in routine practice.”
Background
State dissociation moderates response to dialectical behavior therapy for posttraumatic stress disorder in women with and without borderline personality disorder
Kleindienst, N., Priebe, K., Görg, N., Dyer, A., Steil, R., Lyssenko, L., Winter, D., Schmahl, C., & Bohus, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.30375 · Cited by 105 · see citing works
“The present paper presents a post hoc analysis of a randomized controlled trial that compared DBT-PTSD and a treatment-as-usual wait-list (TAU WL) in patients with PTSD after CSA (Bohus et al., 2013).”
BackgroundMethodSelf-citation
Effects of Motive-Oriented Therapeutic Relationship in a Ten-Session General Psychiatric Treatment of Borderline Personality Disorder: A Randomized Controlled Trial
Kramer, U., Kolly, S., Berthoud, L., Keller, S., Preisig, M., Caspar, F., Berger, T., de Roten, Y., Marquet, P. P., & Despland, J. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000358528 · Cited by 101 · see citing works
Effect of Developmentally Adapted Cognitive Processing Therapy for Youth With Symptoms of Posttraumatic Stress Disorder After Childhood Sexual and Physical Abuse: A Randomized Clinical Trial
Rosner, R., Rimane, E., Frick, U., Gutermann, J., Hagl, M., Renneberg, B., Schreiber, F., Vogel, A., & Steil, R. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.4349 · Cited by 102 · see citing works
Self-citation
Cognitive behavioral therapy: Current status and future research directions
McMain, S., Newman, M. G., Segal, Z. V., & DeRubeis, R. J. (2015) · Psychotherapy Research · doi:10.1080/10503307.2014.1002440 · Cited by 100 · see citing works
“This PE-enhanced DBT was tested in an inpatient DBT context in Germany (Bohus et al., 2013) and an outpatient context in the US (Harned, Korlsund, Foa, & Linehan, 2012).”
Method
Societal cost-of-illness in patients with borderline personality disorder one year before, during and after dialectical behavior therapy in routine outpatient care
Wagner, T., Fydrich, T., Stiglmayr, C., Marschall, P., Salize, H.-J., Renneberg, B., Fleßa, S., & Roepke, S. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.004 · Cited by 92 · see citing works
“During follow-up, only one patient took part in an inpatient DBT-program to treat comorbid posttraumatic stress disorder (DBT-PTSD; Bohus et al., 2013).”
Background
A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse
Bohus, M., Schmahl, C. G., Fydrich, T., Steil, R., Müller‐Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., & Priebe, K. (2019) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-019-0099-y · Cited by 92 · see citing works
Self-citation
A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials
Dixon, L. J., & Linardon, J. (2020) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2019.1620324 · Cited by 86 · see citing works
A systematic review of negative parenting practices predicting borderline personality disorder: Are we measuring biosocial theory's ‘invalidating environment’?
Musser, N., Zalewski, M., Stepp, S. D., & Lewis, J. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.06.003 · Cited by 85 · see citing works
Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study
Matulis, S., Resick, P. A., Rosner, R., & Steil, R. (2013) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-013-0156-9 · Cited by 85 · see citing works
“These sessions are based on emotion regulation interventions as described in DBT-PTSD (Steil et al. 2011; Bohus et al. 2013).”
Self-citation
Understanding and Responding to the Needs of Commercially Sexually Exploited Youth
Ijadi‐Maghsoodi, R., Cook, M. C., Barnert, E. S., Gaboian, S., & Bath, E. P. J. (2015) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2015.08.007 · Cited by 80 · see citing works
Prediction of treatment discontinuation and recovery from Borderline Personality Disorder: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy.
Arntz, A., Stupar-Rutenfrans, S., Bloo, J., van Dyck, R., & Spinhoven, P. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.09.002 · Cited by 73 · see citing works
“Note however that another (smaller) study did not ﬁ nd evidence for dissociation predicting less treat-ment response of inpatient DBT (Braakmann et al., 2007).”
Influential
The effect of trauma-focused therapy on the altered T cell distribution in individuals with PTSD: Evidence from a randomized controlled trial
Morath, J., Gola, H., Sommershof, A., Hamuni, G., Kolassa, S., Catani, C., Adenauer, H., Ruf‐Leuschner, M., Schauer, M., Elbert, T. R., et al. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.03.016 · Cited by 72 · see citing works
Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature
Cotter, J., Kaess, M., & Yung, A. R. (2014) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2014.74 · Cited by 70 · see citing works
“A newly developed modular treatment programme that combines principles of the widely used Dialectical Behaviour Therapy (Linehan, 1993) and trauma-focused interventions has recently been found to be effective in women with borderline personality disorder who had experienced sexual abuse (Bohus et al. 2013).”
BackgroundMethod
A systematic review and meta-analysis of group treatments for adults with symptoms associated with complex post-traumatic stress disorder
Mahoney, A., Karatzias, T., & Hutton, P. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.09.059 · Cited by 69 · see citing works
Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study
Bemmouna, D., Coutelle, R., Weibel, S., & Weiner, L. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05317-w · Cited by 64 · see citing works
Psychometric Properties and Factor Structure of the German Version of the Clinician-Administered PTSD Scale for DSM-5
Müller‐Engelmann, M., Schnyder, U., Dittmann, C., Priebe, K., Bohus, M., Thome, J., Fydrich, T., Pfaltz, M. C., & Steil, R. (2018) · Assessment · doi:10.1177/1073191118774840 · Cited by 66 · see citing works
Self-citation
Imagery Rescripting as a stand-alone treatment for posttraumatic stress disorder related to childhood abuse: A randomized controlled trial
Raabe, S., Ehring, T., Marquenie, L., Arntz, A., & Kindt, M. (2022) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2022.101769 · Cited by 64 · see citing works
“Sequential treatments have indeed shown to be effective for CA-related PTSD, e.g. DBT-PTSD (Bohus et al., 2013; Steil, Dyer, Priebe, Kleindienst, & Bohus, 2011), and STAIR-MPE (Cloitre et al., 2010; Cloitre, Koenen, Cohen, & Han, 2002).”
Self-compassion in PTSD
Braehler, C., & Neff, K. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00020-x · Cited by 38 · see citing works
Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis
Yung, A. R., Cotter, J., Wood, S. J., McGorry, P. D., Thompson, A. D., Nelson, B., & Lin, A. P. (2015) · Psychological Medicine · doi:10.1017/s003329171500135x · Cited by 57 · see citing works
“…1993) and trauma-focused interventions seems to be effective in women with borderline personality disorder with a history of childhood sexual abuse (Bohus et al. 2013) and eye movement desensitization and reprocessing (EMDR) may be helpful for people with psychotic disorder and post-traumatic…”
Background
The impact of brief intensive trauma-focused treatment for PTSD on symptoms of borderline personality disorder
de Jongh, A., Groenland, G. N., Sanches, S. A., Bongaerts, H., Voorendonk, E. M., & van Minnen, A. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1721142 · Cited by 56 · see citing works
“Most of these treatment programmes include patients with BPD and integrate trauma-focused treatment (prolonged exposure) within Dialectical Behaviour Therapy (DBT; Bohus et al., 2013; Harned et al., 2014).”
Background
Defining the index trauma in post-traumatic stress disorder patients with multiple trauma exposure: impact on severity scores and treatment effects of using worst single incident versus multiple traumatic events
Priebe, K., Kleindienst, N., Schropp, A., Dyer, A., Krüger-Gottschalk, A., Schmahl, C. G., Steil, R., & Bohus, M. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1486124 · Cited by 53 · see citing works
Self-citation
Post-Traumatic Stress Disorder
Frommberger, U., Angenendt, J., & Berger, T. (2014) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2014.0059 · Cited by 51 · see citing works
Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting
Steil, R., Dittmann, C., Müller‐Engelmann, M., Dyer, A., Maasch, A.-M., & Priebe, K. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1423832 · Cited by 51 · see citing works
“Neither a diagnosis of BPD nor BPD symptom severity was significantly related to treatment outcome (Bohus et al., 2013).”
BackgroundMethodInfluentialSelf-citation
Frequency of intrusions and flashbacks in patients with posttraumatic stress disorder related to childhood sexual abuse: An electronic diary study.
Priebe, K., Kleindienst, N., Zimmer, J., Koudela-Hamila, S., Ebner‐Priemer, U., & Bohus, M. (2013) · Psychological Assessment · doi:10.1037/a0033816 · Cited by 46 · see citing works
Self-citation
Attachment-Related Regulatory Processes Moderate the Impact of Adverse Childhood Experiences on Stress Reaction in Borderline Personality Disorder
Ehrenthal, J. C., Levy, K. N., Scott, L. N., & Granger, D. A. (2018) · Journal of Personality Disorders · doi:10.1521/pedi.2018.32.supp.93 · Cited by 48 · see citing works
“Here DBT has already started to combine its core program with features of other trauma-related interventions (Bohus et al., 2013; Harned, 2014).”
Background
Sexual Functioning After Childhood Abuse: The Influence of Post-Traumatic Stress Disorder and Trauma Exposure
Bornefeld‐Ettmann, P., Steil, R., Lieberz, K. A., Bohus, M., Rausch, S., Herzog, J., Priebe, K., Fydrich, T., & Müller‐Engelmann, M. (2018) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2018.02.016 · Cited by 46 · see citing works
Self-citation
The integrated treatment of eating disorders, posttraumatic stress disorder, and psychiatric comorbidity: a commentary on the evolution of principles and guidelines
Brewerton, T. D. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1149433 · Cited by 46 · see citing works
Outcomes of trauma‐informed care on the psychological health of women experiencing intimate partner violence: A systematic review and meta‐analysis
Chu, Y., Wang, H., Chou, F., Hsu, Y., & Liao, K. (2023) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12976 · Cited by 51 · see citing works
Effectiveness and feasibility of Narrative Exposure Therapy (NET) in patients with borderline personality disorder and posttraumatic stress disorder – a pilot study
Steuwe, C., Rullkötter, N., Ertl, V., Berg, M., Neuner, F., Beblo, T., & Drießen, M. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0969-4 · Cited by 44 · see citing works
“[18] compared DBT with trauma-focused cognitive-behavioral treatment (TF-CBT) in PTSD patients with and without BPD and a wait-list control group.”
Background
Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial
Rosner, R., König, H., Neuner, F., Schmidt, U., & Steil, R. (2014) · Trials · doi:10.1186/1745-6215-15-195 · Cited by 44 · see citing works
“As survivors of childhood abuse often experience difficulties in emotion regulation, behavior and emotion management techniques, as used within Dialectical Behavior Therapy for PTSD (DBT-PTSD [27,28]), were also integrated in D-CPT.”
MethodSelf-citation
Dissociation, trauma, and borderline personality disorder
Krause-Utz, A. (2022) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-022-00184-y · Cited by 50 · see citing works
Between Childhood Maltreatment and Shame
Talmon, A., & Ginzburg, K. (2017) · Psychology of Women Quarterly · doi:10.1177/0361684317702503 · Cited by 43 · see citing works
“Dialectical behavioral therapy (DBT) may be particularly relevant because it attends to emotional and bodily experiences in an integrative and coherent manner; DBT has been specifically applied to trauma (Wagner & Linehan, 2006) and has shown efficacy in reducing psychological distress associated with childhood sexual…”
BackgroundMethod
Psychotherapy for posttraumatic stress disorder in patients with borderline personality disorder: a systematic review and meta-analysis of its efficacy and safety
Slotema, C. W., Wilhelmus, B., Arends, L. R., & Franken, I. H. A. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1796188 · Cited by 43 · see citing works
Change in Identity Diffusion and Psychopathology in a Specialized Inpatient Treatment for Borderline Personality Disorder.
Sollberger, D., Gremaud-Heitz, D. J., Riemenschneider, A., Agarwalla, P., Benecke, C., Schwald, O., Küchenhoff, J., Walter, M., & Dammann, G. (2015) · Clinical Psychology and Psychotherapy · doi:10.1002/cpp.1915 · Cited by 39 · see citing works
“Regarding the current state of research, it is striking that only a few studies have been published on inpatient treatments (Bartak et al., 2011; Bohus et al., 2013) with even fewer investigating the combination of different and specific therapeutic approaches in the treatment of BPD patients.”
Background
Interventions for adults with a history of complex traumatic events: the INCiTE mixed-methods systematic review
Melton, H., Meader, N., Dale, H. E., Wright, K. E., Jones-Diette, J. S., Temple, M., Shah, I., Lovell, K., McMillan, D., Churchill, R. C., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24430 · Cited by 44 · see citing works
Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design
Boterhoven de Haan, K. L., Lee, C. W., Fassbinder, E., Voncken, M. J., Meewisse, M., Van Es, S. M., Menninga, S., Kousemaker, M., & Arntz, A. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1330-2 · Cited by 41 · see citing works
“Secondly, there is the phase-based approach which incorporates skill building with trauma reprocessing techniques such as prolonged exposure [10, 11].”
Background
Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study
Slotema, C. W., van den Berg, D. P. G., Driessen, A., Wilhelmus, B., & Franken, I. H. A. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1614822 · Cited by 42 · see citing works
“Our findings concerning the reduction of dissociative symptoms are consistent with some reports on trauma-focused psychotherapy in BPD (Harned et al., 2012, 2014; Pabst et al., 2012; Steuwe et al., 2016), although others have not observed this change (Bohus et al., 2013).”
BackgroundMethodResultInfluential
Applying an International Perspective in Defining PTSD and Related Disorders: Comment on Friedman (2013)
Maercker, A. R. A., & Perkonigg, A. (2013) · Journal of Traumatic Stress · doi:10.1002/jts.21852 · Cited by 41 · see citing works
“In addition, Bohus et al. (2013) developed a more explicitly applied-skills training intervention taken from dialectic behavior therapy in a 12-week residential intensive treatment program that led to stable improvements.”
Background
Addressing co‐occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence‐based psychotherapies for adults: A systematic review
Rozek, D. C., Baker, S. N., Rugo, K. F., Steigerwald, V. L., Sippel, L. M., Holliday, R. P., Roberge, E. M., Held, P., Mota, N. P., & Smith, N. B. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22774 · Cited by 43 · see citing works
Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions
Harned, M. S., Wilks, C. R., Schmidt, S. C., & Coyle, T. N. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.02.002 · Cited by 39 · see citing works
“In addition, a 12-week residential adaptation of DBT for PTSD related to childhood sexual abuse found a PTSD remission rate of 41.2% among those participants with BPD (Bohus et al., 2013).”
BackgroundInfluential
Effectiveness of a Transdiagnostic guided internet-delivered protocol for emotional disorders versus treatment as usual in specialized care: randomized controlled trial
González-Robles, A., Díaz-García, A., García-Palacios, A., Roca, P., Ramos-Quiroga, J. A., & Botella, C. (2020) · Journal of Medical Internet Research · doi:10.2196/18220 · Cited by 40 · see citing works
“More recently, DBT skills have been adapted and successfully applied to several anxiety and depressive disorders [47,48], which suggests that they could be used in a transdiagnostic manner to improve the symptomatology of these disorders.”
Background
Komplexe posttraumatische Belastungsstörung nach ICD-11
Hecker, T., & Maercker, A. R. A. (2015) · Psychotherapeut · doi:10.1007/s00278-015-0066-z · Cited by 37 · see citing works
“Diese Phase kann allerdings sehr kurz sein, wenn eine intensive Behandlung erfolgt, wie es anhand des stationären 12-wöchigen Konzepts der Dialektisch-Behavioralen Therapie (DBT) bei PTBS [23] gezeigt wurde.”
Sexuality‐related issues in borderline personality disorder: A comprehensive review
Frías, Á., Palma, C., Farriols, N., & González, L. (2016) · Personality and Mental Health · doi:10.1002/pmh.1330 · Cited by 37 · see citing works
Posttraumatic Stress Disorder in Patients With Borderline Personality Disorder: Treatment Outcomes and Mediators.
Barnicot, K., & Crawford, M. J. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22340 · Cited by 30 · see citing works
Evaluation of Narrative Exposure Therapy (NET) for Borderline Personality Disorder with Comorbid Posttraumatic Stress Disorder
Pabst, A., Schauer, M., Bernhardt, K., Ruf‐Leuschner, M., Göder, R., Elbert, T. R., Rosentreager, R., Robjant, K., Aldenhoff, J. B., & Seeck-Hirschner, M. (2014) · KOPS (University of Konstanz) · Cited by 36 · see citing works
Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation
Thome, J., Koppe, G., Hauschild, S., Liebke, L., Schmahl, C. G., Lis, S., & Bohus, M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0161044 · Cited by 34 · see citing works
“In recent years, exposure-based techniques have been combined with reappraisal and multimodal sensory stimulation to diminish the influence of dissociative symptoms, which often hamper learning in this clinical group (see skills-assisted exposure [44]).”
BackgroundInfluentialSelf-citation
Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse
Görg, N., Priebe, K., Boehnke, J. R., Steil, R., Dyer, A., & Kleindienst, N. (2017) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-017-0065-5 · Cited by 36 · see citing works
“To increase the external validity these comorbidities were included in the original RCT. Exclusion criteria were: medical contraindications for exposure treatment (e.g., severe cardiovascular disorders; body mass index <16.5), life-threatening behavior within 4 months prior to study entry, intellectual disability, a l…”
BackgroundMethodInfluentialSelf-citation
No evidence for differential dose effects of hydrocortisone on intrusive memories in female patients with complex post-traumatic stress disorder – A randomized, double-blind, placebo-controlled, crossover study
Ludäscher, P., Schmahl, C., Feldmann, R. E., Kleindienst, N., Schneider, M., & Bohus, M. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115592339 · Cited by 35 · see citing works
“Twenty-four subjects were inpatients during the trial at the PTSD unit of the clinic (Bohus et al., 2013).”
BackgroundSelf-citation
A randomized controlled trial comparing the clinical efficacy and cost-effectiveness of eye movement desensitization and reprocessing (EMDR) and integrated EMDR-Dialectical Behavioural Therapy (DBT) in the treatment of patients with post-traumatic stress disorder and comorbid (Sub)clinical borderline personality disorder: study design
Snoek, A., Beekman, A. T. F., Dekker, J., Aarts, I., van Grootheest, G., Blankers, M., Vriend, C., van den Heuvel, O., & Thomaes, K. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02713-x · Cited by 44 · see citing works
“compared to waiting-list [25], much remains to be”
Background
Trauma-informed care and practice for eating disorders: personal and professional perspectives of lived experiences
Brewerton, T. D., Alexander, J. G., & Schaefer, J. (2018) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-018-0628-5 · Cited by 36 · see citing works
Impact of comorbid personality disorders on psychotherapy for post-traumatic stress disorder: systematic review and meta-analysis
Snoek, A., Nederstigt, J., Čihařová, M., Sijbrandij, M., Lok, A., Cuijpers, P. J., & Thomaes, K. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1929753 · Cited by 34 · see citing works
“, 2012), a combination of exposurebased techniques and skills training (Bohus et al., 2013) and a combination of CPT and skills training (Walter et al.”
BackgroundMethod
Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder
Elices, M., Pascual, J. C., Carmona, C., Martín‐Blanco, A., Feliu‐Soler, A., Ruiz, E., Gomà‐i‐Freixanet, M., Pérez, V., & Soler, J. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0573-z · Cited by 34 · see citing works
“In any case, the association between mindfulness facets and sexual abuse highlights the relevance of addressing mindfulness deficits during the treatment of BPD patients with traumatic histories [13, 14, 43].”
Background
PRO*BPD: effectiveness of outpatient treatment programs for borderline personality disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for a randomized trial
Fassbinder, E., Assmann, N., Schaich, A., Heinecke, K., Wagner, T., Sipos, V., Jauch-Chara, K., Hüppe, M., Arntz, A., & Schweiger, U. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1905-6 · Cited by 33 · see citing works
How to Assess Recovery in Borderline Personality Disorder: Psychosocial Functioning and Satisfaction With Life in a Sample of Former DBT Study Patients
Zeitler, M.-L., Bohus, M., Kleindienst, N., Knies, R., Ostermann, M., Schmahl, C. G., & Lyssenko, L. (2018) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_394 · Cited by 33 · see citing works
Self-citation
Biased Attention to Facial Expressions of Ambiguous Emotions in Borderline Personality Disorder: An Eye-Tracking Study
Kaiser, D., Jacob, G. A., van Zutphen, L., Siep, N., Sprenger, A., Tuschen‐Caffier, B., Senft, A., Arntz, A. R., & Domes, G. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_363 · Cited by 32 · see citing works
Optimizing treatment for comorbid borderline personality disorder and posttraumatic stress disorder: A systematic review of psychotherapeutic approaches and treatment efficacy
Zeifman, R. J., Landy, M. S. H., Liebman, R. E., Fitzpatrick, S., & Monson, C. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102030 · Cited by 32 · see citing works
Krankheitskosten der Borderline Persönlichkeitsstörung aus gesellschaftlicher Perspektive
Wagner, T., Roepke, S., Marschall, P., Stiglmayr, C., Renneberg, B., Gieb, D., Dambacher, C., Matthies, S., Salbach-Andrae, H., Fleßa, S., et al. (2013) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000227 · Cited by 35 · see citing works
“comorbid posttraumatic stress disorder (DBT-PTSD; Bohus et al., 2013).”
Background
Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse
Krüger, A., Ehring, T. W., Priebe, K., Dyer, A., Steil, R., & Bohus, M. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.24470 · Cited by 32 · see citing works
“The treatment group received dialectical behaviour therapy for PTSD in a residential setting (DBT-PTSD; Bohus et al., 2013).”
MethodInfluentialSelf-citation
Negative Affect Instability Among Individuals With Comorbid Borderline Personality Disorder and Posttraumatic Stress Disorder
Scheiderer, E. M., Wang, T., Tomko, R. L., Wood, P. K., & Trull, T. J. (2015) · Clinical Psychological Science · doi:10.1177/2167702615573214 · Cited by 31 · see citing works
“…modular, or “phase-based,” inpatient variant of DBT designed for individuals with PTSD subsequent to CSA that has been found to be efficacious (that is, improving CSA-related PTSD and global functioning, though not BPD symptoms) in adult women with and without cooccurring BPD (Bohus et al., 2013).”
Background
Phase-based psychological interventions for complex post-traumatic stress disorder: A systematic review
Darby, R. J., Taylor, E. P., & Cadavid, M. S. (2023) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2023.100628 · Cited by 32 · see citing works
Mindfulness-Based Stress Reduction (MBSR) as a Standalone Intervention for Posttraumatic Stress Disorder after Mixed Traumatic Events: A Mixed-Methods Feasibility Study
Müller-Engelmann, M., Wünsch, S., Volk, M., & Steil, R. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01407 · Cited by 30 · see citing works
“The idea that mindfulness-based interventions are helpful to reduce PTSD symptoms is supported by promising experiences with approaches that include mindfulness and acceptance exercises in PTSD treatment, such as dialectical behavior therapy for PTSD (Steil et al., 2011; Bohus et al., 2013) and acceptance and commitme…”
BackgroundSelf-citation
General invalidation and trauma-specific invalidation as predictors of personality and subclinical psychopathology
Hong, P. Y., & Lishner, D. A. (2016) · Personality and Individual Differences · doi:10.1016/j.paid.2015.10.016 · Cited by 32 · see citing works
Preventing mental health symptoms in adolescents using dialectical behaviour therapy skills group: a feasibility study
Burckhardt, R., Manicavasagar, V., Shaw, F., Fogarty, A., Batterham, P. J., Dobinson, K., & Karpin, I. (2018) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2017.1292927 · Cited by 26 · see citing works
“…et al., 2016), attention-deficit/hyperactivity disorder (Hirvikoski et al., 2011), binge eating (Safer, Robinson, & Jo, 2010; Telch, Agras, & Linehan, 2001), bulimia (Safer, Telch, & Agras, 2001), depression (Lynch, Morse, & Robins, 2003) and post-traumatic stress disorder (Bohus et al., 2013).”
Patient and Therapist Perspectives on Treatment for Adults with PTSD from Childhood Trauma
de Haan, K. B., Lee, C. W., Correia, H., Menninga, S., Faßbinder, E., Köhne, S., & Arntz, A. R. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10050954 · Cited by 27 · see citing works
“To date, predominant research focus has been on trauma-focused cognitive behaviour therapies, particularly prolonged exposure approaches, or phase-based treatments [2,3].”
Background
A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT)
Liljedahl, S., Helleman, M., Daukantaité, D., Westrin, Å., & Westling, S. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1371-6 · Cited by 27 · see citing works
Evaluating the effectiveness of phase-oriented treatment models for PTSD—A meta-analysis.
Corrigan, J.-P., Fitzpatrick, M., Hanna, D., & Dyer, K. F. W. (2020) · Traumatology An International Journal · doi:10.1037/trm0000261 · Cited by 26 · see citing works
“For example, two of the studies used a sample with a co-occurring diagnosis, including Borderline Personality Disorder (Bohus et al, 2013, Steil et al, 2011), which has noted overlap with the CPTSD classification (Ford & Courtois, 2014).”
MethodInfluential
Non-suicidal self-injury during an exposure-based treatment in patients with posttraumatic stress disorder and borderline features
Krüger, A., Kleindienst, N., Priebe, K., Dyer, A., Steil, R., Schmahl, C. G., & Bohus, M. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.08.003 · Cited by 26 · see citing works
“As reported in the main publication on this study (Bohus et al., 2013), we found a significant symptom reduction in the treatment group in comparison to the treatment-as-usual wait list (TAU-WL) group with large between-group effect sizes.”
BackgroundResultInfluentialSelf-citation
Exploring DBT skills training as a treatment avenue for generalized anxiety disorder
Malivoire, B. L. (2020) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12339 · Cited by 25 · see citing works
Stabilisation and Phase-Orientated Psychological Treatment for Posttraumatic Stress Disorder – A Systematic Review and Meta-Analysis
Willis, N., Dowling, C., & O'Reilly, G. (2022) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2022.100311 · Cited by 23 · see citing works
Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges
Links, P. S., Shah, R., & Eynan, R. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0766-x · Cited by 25 · see citing works
Childhood adversity and borderline personality disorder
Newnham, E. A., & Janča, A. (2013) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000028 · Cited by 25 · see citing works
Sensation seeking, binge-type eating disorders, victimization, and PTSD in the National Women's study
Brewerton, T. D., Cotton, B. D., & Kilpatrick, D. G. (2018) · Eating Behaviors · doi:10.1016/j.eatbeh.2018.07.001 · Cited by 24 · see citing works
Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study
Lampe, A., Riedl, D., Kampling, H., Nolte, T., Kirchhoff, C., Grote, V., Fischer, M. J., & Kruse, J. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2333221 · Cited by 24 · see citing works
“While current treatment guidelines high-light the possible usefulness of different treatment approaches based on developments of cognitive behavioural therapy (McDonagh et al., 2005), such as Dialectical-Behaviour Therapy (DBT) (Bohus et al., 2013) or skills training in affective and interpersonal regulation (STAIRS)…”
Method
Is dissociation predicting the efficacy of psychological therapies for PTSD? Results from a randomized controlled trial comparing Dialectical Behavior Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT)
Kleindienst, N., Steil, R., Priebe, K., Müller‐Engelmann, M., Lindauer, P., Krause-Utz, A., Friedmann, F., Schmahl, C. G., Enning, F., & Bohus, M. (2025) · Psychological Medicine · doi:10.1017/s0033291724003453 · Cited by 24 · see citing works
“DBT-PTSD has been found to be efficacious in treating women with a history of CA and complex presentations of PTSD (Bohus et al., 2013; Bohus et al., 2020; Kleindienst et al., 2021).”
Self-citation
Traumatic invalidation in the Jewish community after October 7
Bar-Halpern, M., & Wolfman, J. (2025) · Journal of Human Behavior in the Social Environment · doi:10.1080/10911359.2025.2503441 · Cited by 24 · see citing works
“According to Bohus et al. (2013), traumatic invalidation is a social trauma that can create an existential crisis, since human beings cannot survive without our group.”
Severity of borderline personality disorder symptoms as a moderator of the association between the use of dialectical behaviour therapy skills and treatment outcomes
Seow, L. L., Page, A. C., & Hooke, G. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1720931 · Cited by 21 · see citing works
“Similarly, studies have also shown that both 12-week and 20-week adaptations of DBT that consist of skills training interventions as a standalone treatment may be effective in reducing internalizing and externalizing symptoms (Bohus et al., 2013; Eisner et al., 2017; Gibson, Booth, Davenport, Keogh, & Owens, 2014; McM…”
Background

Dialectical Behavioral Therapy for Patients with Borderline Features and Posttraumatic Stress Disorder After Childhood Sexual Abuse (DBT-P)
Bohus, M., Priebe, K., Dyer, A., & Steil, R. (2009) · European Psychiatry · doi:10.1016/s0924-9338(09)70324-4 · Cited by 5 · see citing works
Self-citation
An examination of the role of PTSD and childhood trauma on treatment outcomes for individuals with borderline personality disorder in dialectical behavior therapy
Christensen, K. E., McMain, S., Chapman, A. L., & Kuo, J. R. (2025) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-025-00322-2
Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting
Steil, R., Dittmann, C., Müller‐Engelmann, M., Dyer, A., Maasch, A.-M., & Priebe, K. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1423832 · Cited by 51 · see citing works
Self-citation
Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial
Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., et al. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.2148 · Cited by 265 · see citing works
Self-citation
Dialectical behavior therapy for posttraumatic stress disorder related to childhood sexual abuse: A pilot study of an intensive residential treatment program
Steil, R., Dyer, A., Priebe, K., Kleindienst, N., & Bohus, M. (2011) · Journal of Traumatic Stress · doi:10.1002/jts.20617 · Cited by 205 · see citing works
Self-citation

Authors: Bohus, M., Dyer, A. S., Priebe, K., Krüger, A., Kleindienst, N., Schmahl, C., Niedtfeld, I., & Steil, R.
Affiliations: Heidelberg University (DE)
Goethe University Frankfurt (DE)
ORCID: Bohus, Martin
Dyer, Anne S.
Priebe, Kathlen
Krüger, Antje
Kleindienst, Nikolaus
Schmahl, Christian
Niedtfeld, Inga
Steil, Regina
Venue: Psychotherapy and Psychosomatics
Publisher: S. Karger AG
Published: 2013
Volume: 82
Issue: 4
Pages: 221-233
ISSN: 0033-3190 (ISSN-L)
1423-0348
DOI: 10.1159/000348451
OpenAlex: W2103127241
Cited by: 344
References: 60
Citations by year: 2026: 18 · 2025: 25 · 2024: 24 · 2023: 23 · 2022: 28 · 2021: 30 · 2020: 34 · 2019: 24 · 2018: 29 · 2017: 29 · 2016: 20 · 2015: 24 · 2014: 24 · 2013: 10 · 2012: 1
FWCI: 28.90
Type: journal article
Language: en
Open access: closed
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Psychotherapy and Psychosomatics (publishedVersion)
PubMed (publishedVersion)
Funders: Department of Biotechnology, Ministry of Science and Technology, India
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: dialectical behavior therapy, post-traumatic stress disorder, child sexual abuse, borderline personality disorder, trauma-focused interventions, residential treatment, treatment efficacy, co-occurring psychopathology, self-harm, women
MeSH terms: Adolescent, Adult, Aged, Behavior Therapy, Borderline Personality Disorder, Child, Child Abuse, Sexual, Child, Preschool, Female, Humans, Middle Aged, Stress Disorders, Post-Traumatic, Comorbidity, Treatment Outcome, Young Adult

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Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

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