Treating Veterans With PTSD and Borderline Personality Symptoms in a 12‐Week Intensive Outpatient Setting: Findings From a Pilot Program

Meyers, Laura L.; Voller, Emily K.; McCallum, Ethan B.; Thuras, Paul; Shallcross, Sandra L.; Velasquez, Tina; Meis, Laura

doi:10.1002/jts.22174

Cited by 36 publications

(24 citation statements)

References 23 publications

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“…The number of trauma-focused psychological interventions that may potentially be helpful for treating PTSD in patients with BPD is increasing. Although conclusive data are lacking, findings from several studies suggest that cognitive behavioural therapy, narrative exposure therapy, prolonged exposure (in combination with dialectical behaviour therapy), trauma-focused dialectical behaviour therapy, and cognitive processing therapy are promising interventions for PTSD in these patients (Bohus et al, 2013;Clarke et al, 2008;Harned et al, 2012Harned et al, , 2014Hembree et al, 2004;Holder et al, 2017;Kredlow et al, 2017;Meyers et al, 2017;Pabst et al, 2012;Steuwe et al, 2016;Walter et al, 2012). There is also some evidence to suggest that trauma-focused psychotherapy can be beneficial for other personality disorders as well (Bovin et al, 2017;Walter et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…PE was also found to be effective in combination with DBT in two small pilot studies. The first of these studies included war veterans with BPD (Meyers et al, 2017). The second study involved patients with BPD, PTSD, and (imminent) serious intentional self-injury, and led to significant reductions in the severity of PTSD (Harned, Korslund, Foa, & Linehan, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study

Slotema

Berg

Driessen

et al. 2019

European Journal of Psychotraumatology

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Background: Trauma and posttraumatic stress disorder (PTSD) are prevalent in patients with personality disorders. Despite the established efficacy of eye movement desensitisation and reprocessing (EMDR) for PTSD, EMDR has barely been examined in patients with comorbid PTSD and personality disorders. Objective: The aim of this study was to explore what changes occur in symptom severity of PTSD, dissociative symptoms, insomnia, non-suicidal self-injurious behaviour and auditory verbal hallucinations in patients with personality disorders during treatment with EMDR. Method: This uncontrolled open feasibility study on EMDR for PTSD was an addition to treatment-as-usual for personality disorders. The outcome measures were the severity of PTSD symptoms, dissociation, insomnia, non-suicidal self-injury, and auditory verbal hallucinations. Results: Forty-seven participants (22 with a borderline personality disorder, 25 with other personality disorders) were included. A significant reduction in the severity of symptoms of PTSD, dissociation and insomnia was observed after EMDR treatment (median of four sessions), and 40% of the participants scored below the threshold for PTSD diagnosis. No differences in efficacy were found between patients with borderline personality disorder and other personality disorders. EMDR treatment was completed by 68% of the participants. Conclusions: The addition of EMDR techniques to treatment, as usual, may be beneficial in the treatment of PTSD in patients with personality disorders in order to reduce symptoms of PTSD, dissociation and insomnia. Although one-third of these patients did not complete the additional EMDR treatment, no severe complications (e.g. suicidal behaviour or hospitalisation) occurred. Controlled studies are needed to further investigate the validity of these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study

Slotema

Berg

Driessen

et al. 2019

European Journal of Psychotraumatology

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“…In the last decade, short and highly intensive traumafocused treatment programmes have been developed (Ehlers et al, 2014;Meyers et al, 2017). These programmes show that it is possible to intensify traumafocused treatment for PTSD patients exposed to a wide variety of multiple traumas, including childhood sexual abuse, and suffering from high rates of comorbidity, dissociative symptoms, and suicidal ideation, while symptom worsening and patient dropout appears to be rare (Hendriks et al, 2018;Van Woudenberg et al, 2018;.…”

mentioning

confidence: 99%

The impact of brief intensive trauma-focused treatment for PTSD on symptoms of borderline personality disorder

Jongh

Groenland

Sanches

et al. 2020

European Journal of Psychotraumatology

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Background: It is generally recommended to exercise caution in applying trauma-focused treatment to individuals with posttraumatic stress disorder (PTSD) and comorbid borderline personality disorder (BPD). Objective: To investigate the effects of a brief, intensive, direct trauma-focused treatment programme for individuals with PTSD on BPD symptom severity. Methods: Individuals (n = 72) with severe PTSD (87.5% had one or more comorbidities; 52.8% fulfilled the criteria for the dissociative subtype of PTSD) due to multiple traumas (e.g. 90.3% sexual abuse) participated in an intensive eight-day trauma-focused treatment programme consisting of eye movement desensitization and reprocessing (EMDR) and prolonged exposure (PE) therapy, physical activity, and psychoeducation. Treatment did not include any form of stabilization (e.g. emotion regulation training) prior to trauma-focused therapy. Assessments took place at pre-and post-treatment (Borderline Symptom List, BSL-23; PTSD symptom severity, Clinician Administered PTSD Scale for DSM-5, CAPS-5), and across the eight treatment days (PTSD Checklist, PCL-5). Results: Treatment resulted in significant decreases of BPD symptoms (Cohen's d = 0.70). Of the 35 patients with a positive screen for BPD at pre-treatment, 32.7% lost their positive screen at post-treatment. No adverse events nor dropouts occurred during the study time frame, and none of the patients experienced symptom deterioration in response to treatment. Conclusion: The results suggest that an intensive trauma-focused treatment is a feasible and safe treatment for PTSD patients with clinically elevated symptoms of BPD, and that BPD symptoms decrease along with the PTSD symptoms.

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“…The primary limitation of this study was that the sample sizes for almost all of the included research articles were low as most studies included less than 10 participants. While many studies examined the role of BA paired with another treatment such as cognitive or dialectical behavior therapy on PTSD symptoms (Meyers et al, ; Nixon & Nearmy, ), very few studies examined the effects of BA as a stand‐alone treatment (Matthieu et al, ; Hershenberg et al, ; Jakupcak et al, ; Wagner et al, ; Jakupcak et al, . ; Rahman et al, ; Luxton et al, ).…”

Section: Discussionmentioning

confidence: 99%

Clinical research on behavioral activation as treatment for post‐traumatic stress disorder: A brief review and meta‐analysis

Flint

Ferrell

Engelman

2020

Behavioral Interventions

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Behavioral activation (BA), an effective treatment for depression, has recently been receiving attention as a possible intervention for PTSD. BA interventions could be particularly useful in treating underserved populations (i.e., individuals with lower socioeconomic status). A literature search was conducted, which identified seven outcome studies that examined the effectiveness of stand-alone BA treatment for individuals with PTSD. All studies identified for this brief review demonstrated clinically significant reductions in PTSD symptoms using BA as an intervention. A meta-analysis of these few studies revealed a nonsignificant effect (Cohen's d = 0.713, p = .512) despite reporting an average symptom reduction of 25.8%. Other studies utilizing BA treatment for PTSD do so in tandem with other interventions and were excluded from analysis. This brief review summarizes the literature on the use of BA as a stand-alone treatment for PTSD and suggests that future research seek to confirm the usefulness of BA as a potential treatment modality for mental health-care providers treating individuals with PTSD. K E Y W O R D S behavioral activation, post-traumatic stress disorder, PTSD

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Treating Veterans With PTSD and Borderline Personality Symptoms in a 12‐Week Intensive Outpatient Setting: Findings From a Pilot Program

Cited by 36 publications

References 23 publications

Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study

Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study

The impact of brief intensive trauma-focused treatment for PTSD on symptoms of borderline personality disorder

Clinical research on behavioral activation as treatment for post‐traumatic stress disorder: A brief review and meta‐analysis

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