Narrative Exposure Therapy in Women With Borderline Personality Disorder and Posttraumatic Stress Disorder
Condition: Borderline Personality Disorder; Stress Disorders, Post-Traumatic
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Personality Disorders; Borderline Personality Disorder
Study type: Interventional

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).
    


Intervention name(s): Narrative Exposure Therapy; Dialectical Behavior Therapy; Standard Inpatient Care; Waiting List
Intervention type(s): Behavioral; Behavioral; Behavioral; Other
Intervention description(s): 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.; 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.; Unspecific group therapy that is identical in both groups (music therapy etc.); Treatment as usual in the community (no DBT, no exposure of trauma memories)
Other intervention name(s): NET; DBT; SIC
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Borderline Personality Disorder; comorbid Posttraumatic Stress Disorder; Narrative Exposure Therapy; Dialectical-Behavioral Therapy