Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study
Open accessAbstract
BACKGROUND: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. OBJECTIVE: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. METHOD: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis. RESULTS: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles "withdrawn" and "aggressive," were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. CONCLUSIONS: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.
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Cites
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“The 38 patients were distributed as follows: adaptive (n 14; 37%), non-adaptive (n 24; 63%), withdrawn (n 4; 17%); alienated (n 1; 5%); suffering (n 9; 37%); and aggressive (n 10; 41%).”
BackgroundTreatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.
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Self-citationDorrepaal, E., Thomaes, K., Smit, J. H., van Balkom, A. J. L. M., Veltman, D. J., Hoogendoorn, A. W., & Draijer, N. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000335044 · Cited by 82 · see citing works
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Meta-analysis of dropout from cognitive behavioral therapy: Magnitude, timing, and moderators.
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“We do not have a sufficient understanding of the efficacy of current therapies for those with a diagnosis of ICD11 complex PTSD (Dorrepaal et al., 2013, 2014; Karatzias et al., 2019).”
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- Authors
- Dorrepaal, E., Thomaes, K., Smit, J. H., Veltman, D. J., Hoogendoorn, A. W., van Balkom, A. J. L. M., & Draijer, N.
- Affiliations
- Parnassia Groep (NL)
- GGZ inGeest (NL)
- Amsterdam Public Health (NL)
- GGZ inGeest, Amsterdam, The Netherlands
- Corresponding author
- Dorrepaal, Ethy
- Thomaes, Kathleen
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2013-11-06
- Volume
- 4
- Issue
- 1
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC3820917
- OpenAlex
- W2131457150
- Cited by
- 36
- References
- 9
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 2 · 2020: 3 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 11 · 2014: 1
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- complex PTSD, personality disorders, medication adherence, treatment discontinuation, cognitive behavioral therapy, child abuse, personality profiles, symptom relief, emotion regulation, interpersonal problems
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