Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study
Creators: name: Lampe, A.
name: Riedl, D.
name: Kampling, H.
name: Nolte, T.
name: Kirchhoff, C.
name: Grote, V.
name: Fischer, M. J.
name: Kruse, J.
Publisher: name: Taylor & Francis
Year: 2024
Subjects: Medicine
Neuroscience
Biological Sciences not elsewhere classified
Cancer
Science Policy
Mental Health

description: <b>Background:</b> Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. <b>Methods:</b> In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (<i>T1</i>) and at the end of treatment (<i>T2</i>). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. <b>Results:</b> A total of <i>n</i> = 50 patients with CPTSD were included in the study, of whom <i>n</i> = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; <i>p</i> &lt; .001; <i>η</i><sup>2 </sup>= .36), as well as a significant reduction of psychological distress (<i>p</i> &lt; .001; <i>η</i><sup>2 </sup>= .55) and functional impairment (<i>p</i> &lt; .001; <i>η</i><sup>2 </sup>= .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (<i>β</i> = –.34, <i>p</i> = .026) and decreased epistemic credulity (<i>β</i> = .37, <i>p</i> = .017), which together with lower age (<i>β</i> = .43, <i>p</i> = .012) and lower depression levels at baseline (<i>β</i> = .35, <i>p</i> = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. <b>Discussion:</b> In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process. Complex post-traumatic stress disorder (CPTSD) is a condition often found in individuals who have experienced severe trauma, such as childhood abuse or torture.A study involving 50 patients with CPTSD showed significant improvements in symptoms and overall quality of life after undergoing a 6-week integrative multimodal psychodynamic inpatient rehabilitation treatment.The study also highlighted that improvement in epistemic trust could be a potential mechanism of change contributing to the positive therapeutic outcomes. Complex post-traumatic stress disorder (CPTSD) is a condition often found in individuals who have experienced severe trauma, such as childhood abuse or torture. A study involving 50 patients with CPTSD showed significant improvements in symptoms and overall quality of life after undergoing a 6-week integrative multimodal psychodynamic inpatient rehabilitation treatment. The study also highlighted that improvement in epistemic trust could be a potential mechanism of change contributing to the positive therapeutic outcomes.