Dataset Information

Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions.

ABSTRACT: Although functional impairment typically improves during evidence-based psychotherapies (EBPs) for borderline personality disorder (BPD), functional levels often remain suboptimal after treatment. The present pilot study evaluated whether and how integrating PTSD treatment into an EBP for BPD would improve functional outcomes. Participants were 26 women with BPD, PTSD, and recent suicidal and/or self-injurious behavior who were randomized to receive one year of Dialectical Behavior Therapy (DBT) or DBT with the DBT Prolonged Exposure (DBT PE) protocol for PTSD. Five domains of functioning were assessed at 4-month intervals during treatment and at 3-months post-treatment. DBT + DBT PE was superior to DBT in improving global social adjustment, health-related quality of life, and achieving good global functioning, but not interpersonal problems or quality of life. Results of time-lagged mixed effects models indicated that, across both treatments, reductions in PTSD severity significantly predicted subsequent improvement in global social adjustment, global functioning, and health-related quality of life, whereas reductions in post-traumatic cognitions significantly predicted later improvement in all functional outcomes except global social adjustment. These findings provide preliminary evidence supporting the role of change in PTSD severity and trauma-related cognitions as active mechanisms in improving functional outcomes among individuals with BPD and PTSD.

SUBMITTER: Harned MS

PROVIDER: S-EPMC5837954 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions.

Harned Melanie S MS Wilks Chelsey R CR Schmidt Sara C SC Coyle Trevor N TN

Behaviour research and therapy 20180206

Although functional impairment typically improves during evidence-based psychotherapies (EBPs) for borderline personality disorder (BPD), functional levels often remain suboptimal after treatment. The present pilot study evaluated whether and how integrating PTSD treatment into an EBP for BPD would improve functional outcomes. Participants were 26 women with BPD, PTSD, and recent suicidal and/or self-injurious behavior who were randomized to receive one year of Dialectical Behavior Therapy (DBT) ...[more]

PMID: 29448136

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Project description:Contemporary symptom-based diagnosis of post-traumatic stress disorder (PTSD) largely overlooks related neurobehavioral mechanisms and relies entirely on subjective interpersonal reporting. Previous studies associating biomarkers with PTSD have mostly used symptom-based diagnosis as the main outcome measure, disregarding the wide variability and richness of PTSD phenotypical features. Here, we aimed to computationally derive potential biomarkers that could efficiently differentiate PTSD subtypes among recent trauma survivors. A three-staged semi-unsupervised method ("3C") was used to firstly categorize individuals by current PTSD symptom severity, then derive clusters based on clinical features related to PTSD (e.g. anxiety and depression), and finally to classify participants' cluster membership using objective multi-domain features. A total of 256 features were extracted from psychometrics, cognitive functioning, and both structural and functional MRI data, obtained from 101 adult civilians (age = 34.80 ± 11.95; 51 females) evaluated within 1 month of trauma exposure. The features that best differentiated cluster membership were assessed by importance analysis, classification tree, and ANOVA. Results revealed that entorhinal and rostral anterior cingulate cortices volumes (structural MRI domain), in-task amygdala's functional connectivity with the insula and thalamus (functional MRI domain), executive function and cognitive flexibility (cognitive testing domain) best differentiated between two clusters associated with PTSD severity. Cross-validation established the results' robustness and consistency within this sample. The neural and cognitive potential biomarkers revealed by the 3C analytics offer objective classifiers of post-traumatic morbidity shortly following trauma. They also map onto previously documented neurobehavioral mechanisms associated with PTSD and demonstrate the usefulness of standardized and objective measurements as differentiating clinical sub-classes shortly after trauma.

Dataset Information

Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions.

Publications

Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions.

Similar Datasets

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