title: Non-suicidal self-injury during an exposure-based treatment in patients with posttraumatic stress disorder and borderline features.
abstract: Patients with posttraumatic stress disorder (PTSD) and features of borderline personality disorder (BPD) often show non-suicidal self-injury (NSSI). However, patients with on-going NSSI are mostly excluded from PTSD treatments and NSSI during PTSD treatment has rarely been investigated. The aim of the present study was to evaluate the course of NSSI during an exposure-based PTSD treatment. This study focused on a subset (n = 34) of data from a randomised controlled trial that tested the efficacy of a residential PTSD programme (DBT-PTSD) in comparison to a treatment-as-usual wait-list. In this subset we compared a) NSSI during treatment between participants who had or had not engaged in NSSI pre-treatment and b) NSSI between treatment weeks that included exposure interventions vs. those that did not. We further compared the outcome between participants with vs. without NSSI at pre-treatment. At pre-treatment, 62% participants reported on-going NSSI. During treatment, the percentage of participants carrying out NSSI decreased to 38% (p = 0.003). The rates of NSSI were similar in treatment weeks with exposure compared to weeks without. Similar results were observed for the frequency of NSSI. At the end of treatment, participants showed comparable improvement in PTSD symptoms regardless of whether or not they had exhibited NSSI beforehand.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany; Department of Psychology and Sports Sciences, Institute of Psychology, University of Münster, Germany. Electronic address: antje.krueger@uni-muenster.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Krüger
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kleindienst
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Kathlen
authors.initials: K
authors.lastname: Priebe
authors.affiliation: Department of Psychology and Psychotherapy, School of Social Science, University of Mannheim, Germany.
authors.forename: Anne S
authors.initials: AS
authors.lastname: Dyer
authors.affiliation: Department of Psychology and Sports Sciences, Institute of Psychology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Steil
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmahl
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bohus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001883:Borderline Personality Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000150:complications* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology / Q000628:therapy*; D059020:Suicidal Ideation; D055815:Young Adult
keywords: Dialectical behavioural therapy; Exposure-based treatment; Non-suicidal self-injury; Posttraumatic stress disorder