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

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ClinicalTrials.gov Identifier: NCT02517723
Recruitment Status : Active, not recruiting
First Posted : August 7, 2015
Last Update Posted : February 8, 2019
Sponsor:
Information provided by (Responsible Party):
Prof. Dr. med. Martin Driessen, Evangelisches Krankenhaus Bielefeld gGmbH

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).

Condition or disease Intervention/treatment Phase
Borderline Personality Disorder Stress Disorders, Post-Traumatic Behavioral: Narrative Exposure Therapy Behavioral: Dialectical Behavior Therapy Behavioral: Standard Inpatient Care Other: Waiting List Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized Controlled Clinical Trial (RCCT) to Test the Effectiveness of Narrative Exposure Therapy (NET) Versus Dialectical-Behavioral Therapy in Reducing Trauma Related Symptoms in Women Suffering From Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD)
Actual Study Start Date : April 2014
Estimated Primary Completion Date : November 2019
Estimated Study Completion Date : November 2019

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: SIC + NET
Waiting List + Standard Inpatient Care + Narrative Exposure Therapy
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.

Other Name: NET

Behavioral: Standard Inpatient Care
Unspecific group therapy that is identical in both groups (music therapy etc.)
Other Name: SIC

Other: Waiting List
Treatment as usual in the community (no DBT, no exposure of trauma memories)

Active Comparator: SIC + DBT
Waiting List + Standard Inpatient Care + Dialectical Behavior Therapy
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.

Other Name: DBT

Behavioral: Standard Inpatient Care
Unspecific group therapy that is identical in both groups (music therapy etc.)
Other Name: SIC

Other: Waiting List
Treatment as usual in the community (no DBT, no exposure of trauma memories)




Primary Outcome Measures :
  1. Change from first investigation in Posttraumatic Symptom Severity at 18 months (Clinician-Administered PTSD Scale; CAPS) [ Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (3 months, t1), 1 year after therapy (15 months, t3) ]

Secondary Outcome Measures :
  1. Change from first investigation in Borderline Symptome Severity at 18 months(Borderline Symptom Liste; BSL) [ Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4) ]
  2. Change from first investigation in Severity of Dissociative Symptoms at 18 months (Fragebogen zu Dissoziativen Symptome ;FDS) [ Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4) ]
  3. Change from first investigation in Severity of Depressive Symptoms at 18 months (Becks Depressions Inventar II, BDI-II) [ Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4) ]
  4. Change from first investigation in Quality of Life at 12 months (WHO-Qualitiy of Life; WHOQOL) [ Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4) ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 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

Exclusion Criteria:

  • 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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02517723


Locations
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Germany
Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld
Bielefeld, Germany, 33617
Sponsors and Collaborators
Evangelisches Krankenhaus Bielefeld gGmbH
Investigators
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Study Director: Carolin Steuwe, M.Sc. Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld
Principal Investigator: Martin Driessen, Prof. Dr. med. Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Prof. Dr. med. Martin Driessen, Martin Driessen, Prof. Dr. med., Evangelisches Krankenhaus Bielefeld gGmbH
ClinicalTrials.gov Identifier: NCT02517723     History of Changes
Other Study ID Numbers: NET_BPS+PTBS
First Posted: August 7, 2015    Key Record Dates
Last Update Posted: February 8, 2019
Last Verified: February 2019

Keywords provided by Prof. Dr. med. Martin Driessen, Evangelisches Krankenhaus Bielefeld gGmbH:
Borderline Personality Disorder
comorbid Posttraumatic Stress Disorder
Narrative Exposure Therapy
Dialectical-Behavioral Therapy

Additional relevant MeSH terms:
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Disease
Stress Disorders, Traumatic
Stress Disorders, Post-Traumatic
Personality Disorders
Borderline Personality Disorder
Pathologic Processes
Trauma and Stressor Related Disorders
Mental Disorders