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Yeates S, Korner A, McLean L. A Systematic Review and Narrative Analysis of the Evidence for Individual Psychodynamically Informed Psychotherapy in the Treatment of Dissociative Identity Disorder in Adults. J Trauma Dissociation 2024; 25:248-278. [PMID: 38146918 DOI: 10.1080/15299732.2023.2293802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/30/2023] [Indexed: 12/27/2023]
Abstract
Dissociative Identity Disorder (DID) is a highly disabling diagnosis, characterized by the presence of two or more personality states which impacts global functioning, with a substantial risk of suicide. The International Society for the Study of Trauma and Dissociation (ISSTD) published guidelines for treating DID in 2011 that noted individual Psychodynamically Informed Psychotherapy (PDIP) was a cornerstone of treatment. This paper systematically reviews the evidence base for PDIP in the treatment of adults with DID according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-five articles were located and reviewed: seven prospective longitudinal publications, 13 case series and 15 case studies. Results suggested that PDIP has been widely deployed in DID to reported good effect with a range of treatment protocols and using multiple theoretical models. Despite the positive findings observed, the evidence base remains at the level of observational-descriptive design. Creative approaches in recent years have been developed, which add empirical weight to the use of PDIP as an effective treatment. The elevation to observational-analytic designs in the Evidence-Based Medicine hierarchy has yet to take place. Bearing in mind the challenges of research in PDIP, suggestions are offered for how the evidence base might develop.
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Affiliation(s)
- Steven Yeates
- Psychotherapy Educator Westmead/Cumberland Hospitals, Faculty Westmead Psychotherapy Program for Complex Traumatic Disorders, Cumberland Hospital, North Parramatta, Australia
| | - Anthony Korner
- Westmead Psychotherapy Program for Complex Traumatic Disorders, University of Sydney, North Parramatta, Australia
| | - Loyola McLean
- Cumberland Hospital, Westmead Psychotherapy Program for Complex Traumatic Disorders, Course Co-Coordinator, Brain and Mind Centre, Discipline of Psychiatry, The University of Sydney, Research Psychiatrist (HMO) Consultation-Liaison Psychiatry, RNSH, Camperdown, Australia
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Bever-Philipps A, Silbermann A, Morawa E, Schäflein E, Stemmler M, Erim Y. Long-term follow-up of a multimodal day clinic, group-based treatment program for patients with very high risk for complex posttraumatic stress disorder, and for patients with non-complex trauma-related disorders. Front Psychiatry 2023; 14:1152486. [PMID: 37398576 PMCID: PMC10311064 DOI: 10.3389/fpsyt.2023.1152486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Objective The present study examined the follow-up of a multimodal day clinic group-based therapy program for patients with trauma-related disorders and investigated potential differences for patients with classic PTSD versus cPTSD. Method Sixty-six patients were contacted 6 and 12 months after discharge of our 8-week program and completed various questionnaires (Essen Trauma Inventory (ETI), Beck Depression Inventory-Revised (BDI-II), Screening scale of complex PTSD (SkPTBS), Patient Health Questionnaire (PHQ)-Somatization, as well as single items to therapy utilization and life events in the interim period). Due to organizational reasons a control group could not be included. Statistical analyses included repeated-measures ANOVA with cPTSD as between-subject factor. Results The reduction of depressive symptoms at discharge was persistent at 6 and 12 months follow-up. Somatization symptoms were increased at discharge, but were leveled out at 6 months follow-up. The same effect was found for cPTSD symptoms in those patients with non-complex trauma-related disorders: Their increase of cPTSD symptoms was flattened at 6 months follow-up. Patients with a very high risk for cPTSD showed a strong linear reduction of cPTSD symptoms from admission to discharge and 6 months follow-up. cPTSD patients had a higher symptom load compared to patients without cPTSD on all time points and scales. Conclusion Multimodal, day clinic trauma-focused treatment is associated with positive changes even after 6 and 12 months. Positive therapy outcomes (reduced depression, reduced cPTSD symptoms for patients with a very high risk for cPTSD) could be maintained. However, PTSD symptomatology was not significantly reduced. Increases in somatoform symptoms were leveled out and can therefore be regarded as side effects of treatment, which may be connected with actualization of trauma in the intensive psychotherapeutic treatment. Further analyses should be applied in larger samples and a control group.
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Affiliation(s)
- Anke Bever-Philipps
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrea Silbermann
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Schäflein
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Mark Stemmler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Kratzer L, Schiepek G, Heinz P, Schöller H, Knefel M, Haselgruber A, Karatzias T. What makes inpatient treatment for PTSD effective? Investigating daily therapy process factors. Psychother Res 2022; 32:847-859. [DOI: 10.1080/10503307.2022.2050830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Leonhard Kratzer
- Department of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany
| | - Günter Schiepek
- Institute for Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria
- University Hospital of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
- Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
| | - Peter Heinz
- Department of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany
| | - Helmut Schöller
- Institute for Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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Hoeboer CM, De Kleine RA, Molendijk ML, Schoorl M, Oprel DAC, Mouthaan J, Van der Does W, Van Minnen A. Impact of dissociation on the effectiveness of psychotherapy for post-traumatic stress disorder: meta-analysis. BJPsych Open 2020; 6:e53. [PMID: 32423501 PMCID: PMC7345665 DOI: 10.1192/bjo.2020.30] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Many patients with post-traumatic stress disorder (PTSD) experience dissociative symptoms. The question of whether these dissociative symptoms negatively influence the effectiveness of psychotherapy for PTSD is unresolved. AIMS To determine the influence of dissociative symptoms on psychotherapy outcome in PTSD. METHOD We conducted a systematic search in Cochrane, Embase, PILOTS, PsycINFO, PubMed and Web of Science for relevant clinical trials. A random-effects meta-analysis examined the impact of dissociation on psychotherapy outcome in PTSD (pre-registered at Prospero CRD42018086575). RESULTS Twenty-one trials (of which nine were randomised controlled trials) with 1714 patients were included. Pre-treatment dissociation was not related to treatment effectiveness in patients with PTSD (Pearson's correlation coefficient 0.04, 95% CI -0.04 to 0.13). Between-study heterogeneity was high but was not explained by moderators such as trauma focus of the psychotherapy or risk of bias score. There was no indication for publication bias. CONCLUSIONS We found no evidence that dissociation moderates the effectiveness of psychotherapy for PTSD. The quality of some of the included studies was relatively low, emphasising the need for high-quality clinical trials in patients with PTSD. The results suggest that pre-treatment dissociation does not determine psychotherapy outcome in PTSD.
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Affiliation(s)
- C M Hoeboer
- Leiden University, Institute of Psychology; and Parnassiagroep, PsyQ, The Hague, the Netherlands
| | - R A De Kleine
- Leiden University, Institute of Psychology, the Netherlands
| | - M L Molendijk
- Leiden University, Institute of Psychology, the Netherlands
| | - M Schoorl
- Leiden University, Institute of Psychology; and Parnassiagroep, PsyQ, The Hague, the Netherlands
| | - D A C Oprel
- Leiden University, Institute of Psychology; and Parnassiagroep, PsyQ, The Hague, the Netherlands
| | - J Mouthaan
- Leiden University, Institute of Psychology, the Netherlands
| | - W Van der Does
- Leiden University, Institute of Psychology; Parnassiagroep, PsyQ The Hague, the Netherlands; and Department of Psychiatry, Leiden University Medical Center, the Netherlands
| | - A Van Minnen
- PSYTREC, Bilthoven; and Radboud University, Behavioural Science Institute, the Netherlands
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Philipps A, Silbermann A, Morawa E, Stemmler M, Erim Y. Effectiveness of a Multimodal, Day Clinic Group-Based Treatment Program for Trauma-Related Disorders: Differential Therapy Outcome for Complex PTSD vs. Non-Complex Trauma-Related Disorders. Front Psychiatry 2019; 10:800. [PMID: 31787906 PMCID: PMC6853865 DOI: 10.3389/fpsyt.2019.00800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/07/2019] [Indexed: 01/07/2023] Open
Abstract
Background: The effectiveness of the psychotherapeutic treatment of posttraumatic stress disorder is evidence-based and generally considered proven. However, the effectiveness of multimodal, group-based day clinic treatment programs has rarely been investigated. Moreover, there is no consensus in the literature concerning the question whether psychotherapeutic approaches for trauma-related disorders are also applicable for patients with complex PTSD (cPTSD). The aim of the study was to evaluate our multimodal group-based treatment program regarding a change of psychiatric burden, a change of protective factors, and possible differences in therapy outcome for patients with or without cPTSD. Methods: The group-based treatment for patients with trauma-related disorders was examined in 66 patients who filled out the following questionnaires in the first and in the last week of treatment: Essen Trauma Inventory (ETI), Screening for complex PTSD (SkPTBS), Patient Health Questionnaire-somatization module (PHQ-15), Beck Depression Inventory-Revised (BDI-II), Posttraumatic Growth Inventory (PTGI), and Questionnaire on social support (F-SozU). Results: The treatment was shown to significantly reduce depressive symptoms (p < 0.001, d = -0.536) and increase posttraumatic growth (New Possibilities: p = 0.004, d = 0.405; Personal Strength: p = 0.005, d = 0.414). For patients with cPTSD, depressive (p = 0.010, d = -0.63) as well as cPTSD symptoms (p = 0.020, d = -0.796) were significantly reduced; perceived social support was increased after day clinic treatment (p = 0.003, d = 0.61). Contrary to our expectations, somatoform symptoms were increased after therapy. Conclusions: The present work expands previous research by demonstrating that multimodal group-based, day clinic treatment is effective in the treatment of trauma-related disorders, also in their complex form.
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Affiliation(s)
- Anke Philipps
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrea Silbermann
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Mark Stemmler
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Paintain E, Cassidy S. First-line therapy for post-traumatic stress disorder: A systematic review of cognitive behavioural therapy and psychodynamic approaches. COUNSELLING & PSYCHOTHERAPY RESEARCH 2018; 18:237-250. [PMID: 30147450 PMCID: PMC6099301 DOI: 10.1002/capr.12174] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite evidence supporting cognitive behavioural therapy (CBT)-based interventions as the most effective approach for treating post-traumatic stress disorder (PTSD) in randomised control trials, alternative treatment interventions are often used in clinical practice. Psychodynamic (PDT)-based interventions are one example of such preferred approaches, this is despite comparatively limited available evidence supporting their effectiveness for treating PTSD. AIMS Existing research exploring effective therapeutic interventions for PTSD includes trauma-focused CBT involving exposure techniques. The present review sought to establish the treatment efficacy of CBT and PDT approaches and considers the potential impact of selecting PDT-based techniques over CBT-based techniques for the treatment of PTSD. RESULTS The evidence reviewed provided examples supporting PDT-based therapy as an effective treatment for PTSD, but confirmed CBT as more effective in the treatment of this particular disorder. Comparable dropout rates were reported for both treatment approaches, suggesting that relative dropout rate should not be a pivotal factor in the selection of a PDT approach over CBT for treatment of PTSD. CONCLUSION/IMPLICATIONS The need to routinely observe evidence-based recommendations for effective treatment of PTSD is highlighted and factors undermining practitioner engagement with CBT-based interventions for the treatment of PTSD are identified.
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Measuring Self-Soothing Ability in Patients with Childhood Trauma - Psychometric Evaluation of the Self-Soothing Scale in a Clinical Sample. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2017; 63:405-416. [PMID: 29214948 DOI: 10.13109/zptm.2017.63.4.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The regulation of strong emotions is an essential skill for traumatized patients. The present instrument was developed for the measurement of the self-soothing ability in traumatized patients. METHODS The psychometric properties of the SBS were investigated in a clinical sample of patients with childhood trauma (N = 143). In addition, the study explored the factorial structure, internal consistency, retest reliability, convergent validity, and responsiveness of the instrument. RESULTS Results of an exploratory factor analysis indicated a two-factor structure: 'self-soothing' and 'impulse control', explaining 55% of the variance. The total score showed a good internal consistency (α = .83) and re-test reliability (rtt = .87) as well as good validity and responsiveness. CONCLUSIONS The 7-item SBS is a suitable instrument for the measurement of self-soothing ability in traumatized patients.
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Swart S, Wildschut M, Draijer N, Langeland W, Smit JH. The clinical course of trauma-related disorders and personality disorders: study protocol of two-year follow-up based on structured interviews. BMC Psychiatry 2017; 17:173. [PMID: 28486966 PMCID: PMC5424424 DOI: 10.1186/s12888-017-1339-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/30/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Trauma-related disorders and personality disorders are prevalent in survivors of chronic childhood trauma and neglect. Both conditions have serious consequences for patients, their families, society and public health and a high risk of development of chronicity. However, information on the long term course trajectories is lacking and predictors of course outcome in survivors of chronic childhood traumatization are unknown. The first aim of the current study is to identify two-year course trajectories of pathology in patients with trauma-related disorders and personality disorders. The second aim is to examine predictors of the course, including demographics, clinical characteristics and comorbidities. METHODS/DESIGN The study is a naturalistic two-year follow-up of 150 patients consecutively admitted to the trauma treatment program and the personality disorder treatment program respectively at GGZ Friesland, a regular Dutch mental health care center. The only exclusion criterion is insufficient mastery of the Dutch language. Participants will be assessed after 2 years of treatment through measures that have been completed at baseline, including structured clinical interviews to measure childhood histories of trauma and neglect, (symptoms of) trauma-related disorders and personality disorders, and psychological questionnaire measures (e.g., general psychopathology, depressive symptoms and personality features). In addition, participants will complete an evaluation questionnaire to assess medication prescribed and treatment (s) received outside GGZ Friesland between baseline and follow-up. Information about (psychological and pharmacological) treatment received at GGZ Friesland during the follow-up period will be collected from patient files. DISCUSSION This study provides insight in the two-year course of (comorbid) trauma-related disorders and personality disorders. Identifying predictors of the course of trauma-related and personality disorders will allow to differentiate clinical profiles and will offer indicators for treatment.
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Affiliation(s)
- Sanne Swart
- GGZ Friesland, Borniastraat 34b, Leeuwarden, 8934 AD the Netherlands
| | - Marleen Wildschut
- GGZ Friesland, Borniastraat 34b, Leeuwarden, 8934 AD the Netherlands
| | - Nel Draijer
- Department of Psychiatry and EMGO Institute, Vrije University Medical Center/GGZinGeest, Amsterdam, the Netherlands
- Department of Research, GGZinGeest, Amsterdam, the Netherlands
| | | | - Jan H. Smit
- Department of Psychiatry and EMGO Institute, Vrije University Medical Center/GGZinGeest, Amsterdam, the Netherlands
- Department of Research, GGZinGeest, Amsterdam, the Netherlands
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Steinert C, Bumke PJ, Hollekamp RL, Larisch A, Leichsenring F, Mattheß H, Sek S, Sodemann U, Stingl M, Ret T, Vojtová H, Wöller W, Kruse J. Resource activation for treating post-traumatic stress disorder, co-morbid symptoms and impaired functioning: a randomized controlled trial in Cambodia. Psychol Med 2017; 47:553-564. [PMID: 27804900 DOI: 10.1017/s0033291716002592] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mental health morbidity in post-conflict settings is high. Nevertheless, randomized controlled trials of psychotherapy on site are rare. Our aim was to integrate rigorous research procedures into a humanitarian programme and test the efficacy of resource activation (ROTATE) in treating post-traumatic stress disorder (PTSD), co-morbid symptoms and impaired functioning in Cambodia. METHOD A total of 86 out-patients with PTSD were randomly assigned to five sessions of ROTATE (n = 53) or a 5-week waiting-list control (WLC) condition (n = 33). Treatment was provided by six Cambodian psychologists who had received extensive training in ROTATE. Masked assessments were made before and after therapy. RESULTS PTSD remission rates according to the DSM-IV algorithm of the Harvard Trauma Questionnaire were 95.9% in ROTATE and 24.1% in the WLC condition. Thus, patients receiving ROTATE had a significantly higher likelihood of PTSD remission (odds ratio 0.012, 95% confidence interval 0.002-0.071, p < 0.00001). Additionally, levels of anxiety, depression and impaired functioning were significantly reduced compared with the WLC condition (p < 0.00001, between-group effect sizes d = 2.41, 2.26 and 2.54, respectively). No harms were reported. CONCLUSIONS ROTATE was efficacious in treating Cambodian patients with high symptom levels of PTSD, emotional distress and impaired functioning. ROTATE is a brief, culturally adaptable intervention focusing on stabilization and strengthening resources rather than trauma confrontation. It can be taught to local professionals and paraprofessionals and enhance access to mental health care for patients in need.
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Affiliation(s)
- C Steinert
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Ludwigstrasse 76,Giessen,Germany
| | - P J Bumke
- Trauma Aid Germany,Schillerstrasse 6,Berlin,Germany
| | - R L Hollekamp
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Ludwigstrasse 76,Giessen,Germany
| | - A Larisch
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Friedrichstrasse 33,Giessen,Germany
| | - F Leichsenring
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Ludwigstrasse 76,Giessen,Germany
| | - H Mattheß
- Psychotraumatology Institute Europe,Großenbaumer Allee 35a,Duisburg,Germany
| | - S Sek
- Department of Psychology,The Royal University of Phnom Penh,Russian Federation Boulevard,Toul Kork,Phnom Penh,Cambodia
| | - U Sodemann
- Trauma Aid Germany,In den Floragärten 41,Berlin,Germany
| | - M Stingl
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Ludwigstrasse 76,Giessen,Germany
| | - T Ret
- Department of Psychology,The Royal University of Phnom Penh,Russian Federation Boulevard,Toul Kork,Phnom Penh,Cambodia
| | - H Vojtová
- Slovak Institute for Psychotraumatology and EMDR,Legionarska 29, Trencin,Slovakia
| | - W Wöller
- Rhein-Klinik, Hospital for Psychsomatic Medicine and Psychotherapy,Luisenstrasse 3, Bad Honnef,Germany
| | - J Kruse
- University of Giessen,Clinic for Psychosomatic Medicine and Psychotherapy,Friedrichstrasse 33,Giessen,Germany
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Myrick AC, Webermann AR, Loewenstein RJ, Lanius R, Putnam FW, Brand BL. Six-year follow-up of the treatment of patients with dissociative disorders study. Eur J Psychotraumatol 2017; 8:1344080. [PMID: 28680542 PMCID: PMC5492082 DOI: 10.1080/20008198.2017.1344080] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/11/2017] [Indexed: 11/01/2022] Open
Abstract
Objective: Literature on the treatment of dissociative disorders (DDs) suggests that these individuals require long-term and specialized treatment to achieve stabilization and functionality. There is considerable empirical support for specialized phasic, dissociation-focused treatment in reducing a myriad of psychological symptoms and self-harm in this population. However, until recently, there has been a paucity of longitudinal treatment research on DD patients. Method: In the present six-year follow-up study, 61 therapists who participated in the initial phase of the Treatment of Patients with Dissociative Disorders (TOP DD) study answered questionnaires about their study patient's stressors, quality of life, global functioning, victimization, and safety. These results provided a view of patients' progress six years since the beginning of the TOP DD study. Results: Longitudinal analyses demonstrated patients had significantly fewer stressors (Χ2 (6) = 18.76, p < .01, canonical r = .48, N = 76), instances of sexual revictimization (X2(1) = 107.05, p < .001) and psychiatric hospitalizations (t(54) = 2.57, p < .05, Cohen's d = .43), as well as higher global functioning (Χ2 (2) = 59.27, p < .001, canonical r = .65, N = 111). Conclusions: These findings continue to support the initial results of the TOP DD study that, despite marked initial difficulties and functional impairment, DD patients benefit from specialized treatment.
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Affiliation(s)
| | | | | | - Ruth Lanius
- University of Western Ontario, London, ON, Canada
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[Psychotherapie - still alive!]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2014; 60:217-8. [PMID: 25331919 DOI: 10.13109/zptm.2014.60.3.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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