Clinical trial NCT00269139: Outcome of Crisis Intervention for Subjects With Borderline Personality Disorder or Post-Traumatic Stress Disorder
Official title: Study of Outcome With an Intervention From the Cape Cod Model of Psychotherapy for Subjects in a Behavioral Crisis and With the Diagnosis of Borderline Personality Disorder (BPD) or Post-Traumatic Stress Disorder (PTSD)
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
Conditions: Borderline Personality Disorder
Post-Traumatic Stress Disorders
Keywords: Behavioral crisis
Perception of social crisis
Repetition compulsion
Intrusive mental events
Uncontrollable urges
Lead sponsor: Laddis, Andreas, M.D.
Sponsor class: INDIV
First posted: 2005-12-23
Enrollment: 40
Sex: ALL
Minimum age (years): 19
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Dr. Laddis will test a hypothesis about the nature and the management of behavioral crises in patients with borderline personality disorder (BPD) or post-traumatic stress disorder (PTSD). The term "behavioral crisis" is used strictly for periods of uncontrollable urges to repeat mental or outward activity, e.g., flashbacks, cutting, binging on food, drugs or sex, with no intervals to rethink one's priorities or to consider others' direction.

The clinical hypothesis states, in two steps, that:

1. the perception of a life crisis precedes and then underlies every behavioral crisis;
2. the behavioral crisis resolves promptly and all symptoms end if the clinicians engage the patient about his management of the life crisis that underlies the symptoms.

Detailed description: Subjects in the experimental group will be treated by Dr. Laddis after their admission to a crisis stabilization unit (CSU) or to an inpatient unit (IPU) for a behavioral crisis. Subjects will be included at random, as assigned to Dr. Laddis according to his routine duties at those units.

Subjects in the control group will receive treatment for behavioral crisis according to the preference of the clinical staff at other comparable units. That treatment will constitute "treatment as usual". Clinicians in the control settings will not be informed about the experimental hypothesis, the clinical intervention and the contingent outcomes.

The subjects will be tested for the results of treatment 12-24 hours after composition of a treatment plan. The testing will be done with the Brief Psychiatric Rating Scale (BPRS), as well as with a set of criteria devised by Dr. Laddis to measure the outward behavior and the mental events during behavioral crisis. The patients and the attending frontline staff will be interviewed also about their beliefs in regard to what, among the clinicians' interventions, made a difference for the course of the behavioral crisis, for better or for worse. The raters will be trained for interrater reliability and they will not be informed about the hypothesis.

Eligibility criteria: Inclusion Criteria:

* Diagnosed with BPD or PTSD, with a structured interview according to the current diagnostic manual
* In behavioral crisis

Exclusion Criteria:

* Brain damage
* Currently intoxicated with alcohol or drugs or in withdrawal

Primary outcomes:
measure: Brief Psychiatric Rating Scale (BPRS) scores
measure: Scores on Client Observation and Client Interview, tools designed for this study
Secondary outcomes:
measure: Patient interview and ratings for the value of the clinicians' interventions
measure: Staff interview and ratings for their own interventions
Other outcomes:
Locations:
city: Pocasset
country: United States
facility: Cape Cod and Islands Community Mental Health Center
state: Massachusetts
Study officials:
affiliation: Cape Cod and Islands Community Mental Health Center
name: Andreas Laddis, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Laddis A. Outcome of crisis intervention for borderline personality disorder and post traumatic stress disorder: a model for modification of the mechanism of disorder in complex post traumatic syndromes. Ann Gen Psychiatry. 2010 Apr 27;9:19. doi: 10.1186/1744-859X-9-19.