DBT Skills Plus EMDR for BPD and Trauma

Study Overview
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Brief Summary
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Borderline Personality Disorder (BPD) is a severe disorder that frequently co-occurs with post-traumatic stress disorder (PTSD). The comorbidity of BPD and PTSD is more disabling, predicting lower rates of BPD remission. Dialectical behavioral skills training (DBT-ST), is a group-delivered training that covers four types of skills: emotion regulation, mindfulness, interpersonal effectiveness and distress tolerance. As a stand-alone treatment, research suggest that DBT-ST is an efficacious treatment for BPD. In parallel, EMDR has emerged in last years as an efficacious approach to adult trauma. However, so far, the efficacy of EMDR to treat trauma in populations with BPD diagnosis has not been tested. The present pilot randomized-controlled clinical trial aims to test whether a combination of DBT-ST plus EMDR could be efficacious to treat trauma in individuals with BPD. 40 participants will be recruited from the BPD Unit at the Hospital de la Santa Creu I Sant Pau (Barcelona, Spain) and will be randomized (1:1) to DBT-ST + EMDR or DBT-ST alone. The primary outcome will be the reduction of PTSD symptoms. In addition, symptom-related variables will be collected before and after the interventions. This will be the first study to test the combination of DBT-ST and EMDR.

Official Title
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A Pilot Randomized-controlled Study of Dialectical Behavioral Skills Training Plus EMDR for Borderline Personality Disorder and Trauma

Conditions
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Borderline Personality Disorder, Trauma

Intervention / Treatment
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* Behavioral: Dialectical Behavioral Therapy Skills Training
* Behavioral: EMDR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: men and women between 18 and 60 years old having had adverse childhood experiences and/or current PTSD symptoms signed informed consent Exclusion Criteria: lifetime diagnosis of schizophrenia, drug-induced psychosis, organic brain syndrome, bipolar disorder, or mental retardation. participation in any psychotherapy during the study or having received DBT or EMDR in the past

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: DBT Skills Training<br>This intervention will consist of a 6-month-group DBT-skills training continuation, in which participants will be trained in mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. | Behavioral: Dialectical Behavioral Therapy Skills Training<br>* DBT skills training consists of a 6 months training in mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.<br>* Other names: DBT-ST;|
| Active Comparator: Eye Movement Desensitization and Reprocessing (EMDR)<br>EMDR will consist of individual therapy sessions that will be focused on processing traumatic memories. Participants will receive up to 16 individual EMDR sessions, of 60 min each. | Behavioral: EMDR<br>* EMDR sessions will be conducted to reprocess trauma-related memories.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Borderline Symptom List 23 (BSL-23) | The scores range from a 0 to 4, with higher scores indicating a worse outcome. | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of Events Scale Revised | The scores range from a 0 to 25, with higher scores indicating a higher impact of the traumatic event (worse outcome) | 1 week | 
| Patient Health Questionnaire (PHQ-9) | The scores range from a 0 to 27, with higher scores indicating a worse outcome. | 2 weeks | 
| DISSOCIATIVE EXPERIENCES SCALE (DES) | The scores range from 0 to 100, with higher scores representing a worse outcome. | 1 month |