Abstract
BackgroundTrauma-related disorders and personality disorders are prevalent in survivors of chronic childhood trauma and neglect. Both conditions have serious consequences for patients, their families, society and public health and a high risk of development of chronicity. However, information on the long term course trajectories is lacking and predictors of course outcome in survivors of chronic childhood traumatization are unknown. The first aim of the current study is to identify two-year course trajectories of pathology in patients with trauma-related disorders and personality disorders. The second aim is to examine predictors of the course, including demographics, clinical characteristics and comorbidities.Methods/designThe study is a naturalistic two-year follow-up of 150 patients consecutively admitted to the trauma treatment program and the personality disorder treatment program respectively at GGZ Friesland, a regular Dutch mental health care center. The only exclusion criterion is insufficient mastery of the Dutch language. Participants will be assessed after 2 years of treatment through measures that have been completed at baseline, including structured clinical interviews to measure childhood histories of trauma and neglect, (symptoms of) trauma-related disorders and personality disorders, and psychological questionnaire measures (e.g., general psychopathology, depressive symptoms and personality features). In addition, participants will complete an evaluation questionnaire to assess medication prescribed and treatment (s) received outside GGZ Friesland between baseline and follow-up. Information about (psychological and pharmacological) treatment received at GGZ Friesland during the follow-up period will be collected from patient files.DiscussionThis study provides insight in the two-year course of (comorbid) trauma-related disorders and personality disorders. Identifying predictors of the course of trauma-related and personality disorders will allow to differentiate clinical profiles and will offer indicators for treatment.
Highlights
Trauma-related disorders and personality disorders are prevalent in survivors of chronic childhood trauma and neglect
This study provides insight in the two-year course of trauma-related disorders and personality disorders
A recent review concludes that trajectories of posttraumatic stress symptoms or disorder (PTSD) after intentional traumatic experience, i.e. deliberate infliction of harm, show wide variability: among the patients who develop PTSD, one third remit within 3 months, while in nearly 40% of cases PTSD may become chronic
Summary
Trauma-related disorders and personality disorders are prevalent in survivors of chronic childhood trauma and neglect Both conditions have serious consequences for patients, their families, society and public health and a high risk of development of chronicity. One of these studies [3] with a longer (i.e. 5 year) follow-up among patients with anxiety disorders shows that PTSD is a persistent illness Another important result of this study is that trauma in childhood, compared with trauma in adulthood, predicts a longer time to remit from chronic PTSD, especially in case of comorbidity with Borderline Personality Disorder (BPD). Some studies did measure affect dysregulation as a symptom of complex PTSD [10], there are no studies known to report data on the course of affect dysregulation
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