Narrative Exposure Therapy in Women With Borderline Personality Disorder and Posttraumatic Stress Disorder

October 7, 2021 updated by: Prof. Dr. med. Martin Driessen, Evangelisches Krankenhaus Bielefeld gGmbH

A Randomized Controlled Clinical Trial (RCCT) to Test the Effectiveness of Narrative Exposure Therapy (NET) Versus Dialectical-Behavioral Therapy in Reducing Trauma Related Symptoms in Women Suffering From Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD)

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).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

67

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Germany
      • Bielefeld, Germany, 33617
        • Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • age ≥ 18 years
  • DSM-IV-TR diagnoses of BPD and PTSD
  • legal competence
  • none or stable medication
  • illegal drug abstinence for at least the last 6 months
  • capacity to consent and contract

Exclusion Criteria:

  • other severe mental disorders (e.g., bipolar disorder, acute psychosis)
  • simultaneous consumption of drugs
  • simultaneous participation in other treatment-studies
  • pregnancy or breastfeeding
  • lack of capability to negotiate a no-suicide agreement
  • suicide attempt or attempts during the 8 weeks prior to start of treatment
  • perpetrator-contact
  • Body Mass Index (BMI) < 16

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: SIC + NET
Waiting List + Standard Inpatient Care + Narrative Exposure Therapy
Behavioral: Narrative Exposure Therapy

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.

Other Names:
  • NET
Behavioral: Standard Inpatient Care
Unspecific group therapy that is identical in both groups (music therapy etc.)
Other Names:
  • SIC
Other: Waiting List
Treatment as usual in the community (no DBT, no exposure of trauma memories)
Active Comparator: SIC + DBT
Waiting List + Standard Inpatient Care + Dialectical Behavior Therapy
Behavioral: Standard Inpatient Care
Unspecific group therapy that is identical in both groups (music therapy etc.)
Other Names:
  • SIC
Other: Waiting List
Treatment as usual in the community (no DBT, no exposure of trauma memories)
Behavioral: Dialectical Behavior Therapy

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.

Other Names:
  • DBT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Change from first investigation in Posttraumatic Symptom Severity at 18 months (Clinician-Administered PTSD Scale; CAPS)
Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (3 months, t1), 1 year after therapy (15 months, t3)
first investigation (t1), after waiting list (3 months, t2), directly after therapy (3 months, t1), 1 year after therapy (15 months, t3)

Secondary Outcome Measures

Outcome Measure
Time Frame
Change from first investigation in Borderline Symptome Severity at 18 months(Borderline Symptom Liste; BSL)
Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
Change from first investigation in Severity of Dissociative Symptoms at 18 months (Fragebogen zu Dissoziativen Symptome ;FDS)
Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
Change from first investigation in Severity of Depressive Symptoms at 18 months (Becks Depressions Inventar II, BDI-II)
Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
Change from first investigation in Quality of Life at 12 months (WHO-Qualitiy of Life; WHOQOL)
Time Frame: first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)
first investigation (t1), after waiting list (3 months, t2), directly after therapy (6 months, t3), 1 year after therapy (18 months, t4)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Evangelisches Krankenhaus Bielefeld gGmbH

Investigators

  • Study Director: Carolin Steuwe, M.Sc., Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld
  • Principal Investigator: Martin Driessen, Prof. Dr. med., Clinic of Psychiatry, Evangelisches Krankenhaus Bielefeld

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2014

Primary Completion (Actual)

January 31, 2020

Study Completion (Actual)

January 31, 2020

Study Registration Dates

First Submitted

January 6, 2014

First Submitted That Met QC Criteria

August 4, 2015

First Posted (Estimate)

August 7, 2015

Study Record Updates

Last Update Posted (Actual)

October 8, 2021

Last Update Submitted That Met QC Criteria

October 7, 2021

Last Verified

October 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NET_BPS+PTBS

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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