Experiences Of Abuse Research Articles

Development and validation of a brief questionnaire for the joint assessment of early maltreatment and early caring experiences.

Development and validation of a brief questionnaire for the joint assessment of early maltreatment and early caring experiences.

Exploring the impact of child maltreatment on adult suicidal ideation and suicide attempts.

Exploring the impact of child maltreatment on adult suicidal ideation and suicide attempts.

Addressing domestic abuse in cancer care: Developing and piloting a specialized intervention for healthcare professionals.

e13549 Background: Over 20% of people in England and Wales have lifetime experience of domestic abuse (DA)—i.e. family violence. Healthcare-based DA interventions increase professionals’ identification rate of DA among patients, yet no cancer-care based DA interventions exist. DA is linked to a higher likelihood of cancer diagnosis, later diagnosis stage, higher depression, stress, poorer quality of life and physical, social, and emotional functioning. We aimed to enhance the cancer workforce response to DA. Methods: We developed and administered a national survey and follow-up interviews to professionals and survivors (who had a cancer diagnosis or experienced DA from someone with the diagnosis) to explore experiences of the cancer-DA intersection. We used findings to adapt a generic hospital-based DA coordinator role to a cancer-specific setting and pilot an intervention. The core intervention component was the coordinators’ training and monitoring process. We used an explanatory sequential design, comprising a survey pre-training, immediately post-training, and 6 months post-training, with follow-up interviews, to assess pre-training preparedness to identify and respond to DA explore changes post-training. Results: Survey respondents were 20 DA survivors and 334 professionals mostly from acute/community healthcare. DA often worsened after a cancer diagnosis. Abuse affected cancer treatment, surgery, and recovery. Most professionals expressed a responsibility to identify and respond to DA. They and survivors felt that the cancer setting was a unique opportunity to identify and respond to DA response to due frequent contact, appointment length, continuity of care, and holistic approaches. Lack of confidence and knowledge were barriers. Professionals were eager to improve their response and wanted specialist training. Two coordinators were hired in two cancer centres. Coordinators trained 1080 staff (17% of staff across two sites). Survey 1 (Time 1 & 2) response rate was 44.9% (n = 485) and survey 2 8.8% (n = 95) (Time 3). All confidence scores significantly increased from pre- (Time 1) to post-training (Time 2). Time 3 also saw significant gains. There were also highly significant decreases in the perception of most barriers to asking about and responding to domestic abuse post-training. Site 1’s identification rate increased. Qualitative findings shed light on key moderators between intervention components and outcomes, and additional components needed to change practice. Conclusions: Our evaluation shows a need for a DA response in the cancer setting. We showed it is possible to adapt a generic role for the cancer context, train staff, improve confidence and identification rates with specialised training. Our outputs are a training package and toolkit for good practice (available online). Our next steps are to develop trauma-informed cancer treatment for patients.

The Relationship Between Parent-Adolescent Relationships and Emotional Abuse.

This study aimed to evaluate the relationship between parent-adolescent relationships and emotional abuse. The research was conducted with 400 adolescents between 25.11.2023 and 25.03.2024. Adolescents in one school were included in the study by simple random sampling method. Data were collected with AMFRI and EAQ and a questionnaire regarding the demographic structure of adolescents. ANOVA, t-test and correlation analysis were used to analyze the data of the study. The average score of the adolescents from the Emotional Abuse Questionnaire was 30.43 ± 23.11 and the total average score received from the Adolescent-Mother, Father Relationship Inventory was 126.22 ± 24.57 for their mothers and 133.38 ± 32.36 for their fathers. It was determined that there was a moderate negative relationship between EAQ and its sub-scales and AMFRI (mother) score averages. It was determined that there was a weak negative relationship between EAQ and its sub-scales and AMFRI (father) score averages. Emotional abuse scores of adolescents were found to be high and parental relationships were evaluated as inadequate. Adolescents' experiences of emotional abuse and parental relationships were found to be related to each other.

The effects of sexual orientation and adverse childhood experiences on short sleep duration: Evidence from the behavioral risk factor surveillance system (BRFSS).

The effects of sexual orientation and adverse childhood experiences on short sleep duration: Evidence from the behavioral risk factor surveillance system (BRFSS).

How do people with a history of sexual abuse experience talking therapies for sexual trauma? A systematic review of qualitative findings.

This systematic review investigated the qualitative experiences of sexual abuse survivors in talking therapy treatments with respect to the helpful and hindering aspects of therapy. Searches were conducted on five databases; PubMed, Web of Science, PyscInfo, PsycArticles and PsycExtra and through searching reference lists. Papers were included where they provided qualitative primary data of client experiences of therapy, did not involve specialist clinical populations and were written in English. Papers were included irrespective of whether study participants had experienced sexual abuse in childhood, adulthood or both. Studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Meta-study was used to analyse the results. Four themes were generated: (1) helpful therapy relies on choice, autonomy, and the freedom to choose when to speak and what to speak on, (2) engagement relies on considerations of the complexity of recovery from sexual abuse, (3) feeling cared for and connected with the therapist is important and (4) a sensitive and thoughtful end of therapy can bring positive holistic emotional and lifestyle changes. This study provides clinical insights into the helpful aspects of therapy, facilitating a safe therapeutic engagement, and managing an effective and sensitive transition into recovery. These themes are considered in relation to understanding supportive factors in therapy.

Sexual problems among a representative sample of Australian men who have experienced physical and emotional intimate partner abuse

Abstract Background The experiences of being emotionally and physically abused by a romantic partner are associated with several deleterious outcomes including poor mental health, being sexually assaulted, and partner homicide. Aim To explore the roles of emotional and physical abuse in relation to men’s sexual functioning. Methods The sample comprised 5642 Australian men (Mage = 45.87 years, SD = 12.36) who completed Wave 4 (2022) of the Australian Longitudinal Study on Male Health: Ten to Men (T2M). As part of the T2M survey, participants completed questions relating to physical and emotional intimate partner abuse, and the National Survey of Sexual Attitudes and Lifestyles – Sexual Function subscale (Natsal-SF). Hierarchical binary logistic regression analyses were conducted to explore whether experiences of abuse in romantic relationships predicted the likelihood of sexual dysfunction in Australian men. Outcomes The variance in sexual dysfunction explained by men’s experiences of physical and emotional abuse over and above the variance explained by relevant covariates. Results The analyses showed that, after controlling for several covariates, physical abuse was not associated with any physio-psychological aspects of sexual dysfunction. However, emotional abuse was significantly associated with all aspects of physio-psychological functioning except for reaching climax more quickly than the man would have liked and experiencing pain as a result of sex. Clinical Implications The results have important implications for relationship therapy and intimacy counselling, with greater awareness of how emotional abuse impacts sexual functioning providing valuable insight for men and their partners. Strengths and Limitations The study used data from the Australian Longitudinal Study on Male Health, which sourced data from a nationally representative sample of Australian men. A potential limitation is that individual Natsal-SF items were used in lieu of the total score, and thus the same variance may be explained in multiple analyses. Conclusion The results suggest that emotional abuse is more damaging to male sexual functioning than physical abuse.

Childhood Maltreatment Experiences in Mothers’ and Fathers’ Parental Burnout: The Mediating Role of Epistemic Stances

The present study investigated the impact of childhood maltreatment experiences on parental burnout, while also examining the mediating roles of epistemic trust, mistrust, and credulity, and exploring potential differences between mothers and fathers. Utilizing a cross-sectional design, data were collected from a community sample of 948 cisgender heterosexual parents residing in Italy ( M age = 41.95, SD = 7.51; 78.90% mothers), each with at least one biological child aged 0 to 18 years ( M age = 9.38, SD = 5.37), through online self-report questionnaires. Structural equation modeling revealed that parents with higher levels of childhood maltreatment reported greater levels of parental burnout, with emotional abuse emerging as the strongest indicator of maltreatment experiences. Across the entire sample, heightened maltreatment experiences were associated with reduced epistemic trust and increased epistemic mistrust, both of which significantly contributed to more severe parental burnout. Importantly, while epistemic mistrust served as a significant mediator for both mothers and fathers, epistemic credulity emerged as a significant mediator exclusively for mothers. These findings highlight the intricate pathways through which childhood maltreatment experiences can exacerbate parental burnout. From a clinical perspective, the results underscore the need to address distortions in epistemic trust to mitigate parental burnout among parents with histories of childhood maltreatment. Moreover, these findings underscore the need for awareness campaigns designed to reduce parents’ hesitation to seek assistance—potentially rooted in their own experiences of childhood maltreatment and epistemic stances—and to enhance public understanding of parental burnout.

Perceptions of the impact of military life on relationships and Intimate Partner Violence and Abuse among UK military personnel.

Research suggests that the prevalence of Intimate Partner Violence and Abuse (IPVA) use (i.e., perpetration) and experience (i.e., victimisation) is higher among military compared to civilian populations and that military-related factors, such as deployment and deployment-related trauma, are associated with IPVA. However, the mechanisms underlying the associations between military factors and IPVA use and experience are not well understood. This study explores narratives of how military personnel perceive military life to influence IPVA within relationships. Semi-structured interviews were conducted with 40 UK military serving and ex-serving personnel (29 male, 11 female) and analysed using Framework analysis. Three superordinate themes were derived describing how elements of military life were perceived by personnel and veterans to impact on relationships and contribute to IPVA: Demands of military work; Military cultural spill-over; and Deployment-related difficulties with psychosocial functioning and mental health. The findings highlight risky periods for relationship conflict and IPVA, especially during reintegrations following deployments, but also show the impact of other military factors which provide significant context for IPVA. Our findings emphasise how difficulties with psychosocial functioning and communication, as well as deployment-related traumas and reintegration challenges, can influence relationships and IPVA behaviours among military personnel and veterans. Such experiences are aggravated or perpetuated by occupational demands, military socialization or institutionalisation, and the hypermasculine military environment. Targeted interventions to improve emotion regulation, conflict resolution and mentalizing skills may be especially useful for minimising harm resulting from relationship conflict and preventing IPVA.

The Mediating Role of Early Maladaptive Schemas in the Relationship Between Childhood Abuse and Forgiveness: A Structural Equation Modeling

Backgrounds: Experiencing childhood maltreatment can have different mental health outcomes. This study aimed to explore how childhood abuse and forgiveness are related, considering the mediating influence of early maladaptive schemas (EMSs). Methods: A total of 427 students were selected using random cluster sampling from three different universities in Tehran, Iran. This study utilized three instruments: Self-reported Experience of Childhood Abuse (Nourbakhsh, 2012), The Young Schema Questionnaire (Young, 1998, Young Schema Questionnaire Short Form ), and the Forgiveness Scale (Mauger et al., 1992, J Psychol Christ ., 11, 2, 170-180). Results: Data analysis was conducted using statistical package for the social sciences (SPSS) and PLS software, applying partial least squares structural equation modeling to examine the relationships among variables. Findings yielded a good model fit (standardized root mean square error of approximation [SRMSEA] = 0.08, goodness of fit [GOF] = 0.401, Q2 of EMSs = 0.095, Q2 of forgiveness = 0.088, R 2 of EMSs = 0.187, R 2 of forgiveness = 0.136). Direct path coefficients and indirect path coefficients yielded statistically significant results. Conclusions: This research supports the role of EMSs as a mediator between experiences of childhood abuse and the capacity for forgiveness.

Bipolar Bozukluk ve Sınır Kişilik Özellikleri Gösteren Bir Danışanın BDT Temelli Psikoterapi Süreci: Olgu Sunumu ve Formülasyon

This study presents the Cognitive Behavioral Therapy (CBT) process of a 33-year-old female client exhibiting symptoms of bipolar disorder and borderline personality traits. The client experienced prolonged grief due to the traumatic death of her primary caregivers—her grandparents—during early childhood. Her developmental history includes severe childhood traumas such as attention deficit, emotional neglect, physical abuse, and sexual trauma. In adulthood, she exhibited significant emotional instability, impulse control problems, and difficulties in interpersonal relationships. The client also has a family history of bipolar disorder, suggesting a genetic predisposition. Her early marriage, lack of family support, and emotional abuse by her spouse contributed to the development of low self-esteem and learned helplessness. Furthermore, the sexual trauma experienced at a young age underlies her deep-seated feelings of worthlessness and low self-worth. The therapy process focused on issues such as attention deficits, impulse control problems, low self-esteem, feelings of worthlessness, difficulties in setting boundaries, and unresolved grief. CBT interventions included the use of automatic thought records, cognitive restructuring, emotion regulation strategies, trauma-focused techniques, and the development of healthy boundary-setting skills. The client’s experiences of physical violence, emotional neglect, and sexual abuse in early childhood significantly contributed to her sense of worthlessness, low self-esteem, and learned helplessness. These issues manifested in adulthood as difficulties in social relationships, inability to establish boundaries, heightened anxiety, and inner conflict. In conclusion, the therapeutic process emphasized the resolution of past traumas, reconstruction of self-perception, and development of adaptive coping strategies. The client showed significant improvements in quality of life, gained skills in setting healthy boundaries, and enhanced her social functioning. For future cases with similar presentations, longer-term and integrative therapeutic approaches are recommended. Keywords: Bipolar disorder, borderline personality, cognitive behavioral therapy, trauma, low self-esteem, feelings of worthlessness, learned helplessness, boundary setting.

Why avoidance? The impact of childhood emotional abuse on social avoidance

Childhood is a critical period for the development of social relationships, and experiences of abuse during this time can have long-lasting negative effects on social interactions. This study has explored the relationship between childhood emotional abuse and social avoidance in college students, using the social cognitive model of rejection sensitivity and the model of social support degradation as theoretical frameworks. A total of 422 Chinese university students (285 females and 157 males), aged from 19 to 25 (M = 21.27, SD = 3.47), participated in this study. Data were collected using different tools: Childhood Abuse Questionnaire, the Rejection Sensitivity Scale, the Perceived Social Support Scale, and the Social Avoidance and Distress Scale. Results indicated that: (1) emotional abuse were significantly positively correlated with social avoidance; (2) rejection sensitivity mediated the relationship between childhood emotional abuse and social avoidance; (3) perceived social support also served as mediators in the relationship between childhood emotional abuse and social avoidance in college students. These findings suggest that enhancing individuals' perceived social support or reducing rejection sensitivity may be effective strategies for improving social avoidance.

‘But isn’t that normal?’: Australian foster parent’s experiences of parental abuse by children in their care

Abstract While growing attention has been paid to the abuse of parents by their children, research to date has almost exclusively focused on parents who have birthed and/or conceived their child. Given that the trauma histories that foster children bring with them may result in abusive behaviours, it is vital to focus on the specific experiences of foster parents with regard to parental abuse. The research reported in this article involved interviews with twenty-eight Australian foster parents, with a specific focus on a subset of twenty participants who reported experiences of violence and abuse perpetrated against them by children in their care. Thematic analysis of the interview data resulted in the development of three themes: (1) living with the threat of escalating abuse, (2) minimizing experiences of parental abuse, and (3) understanding triggers in order to mitigate abuse. The article concludes by considering what an understanding of parental abuse as a form of domestic violence might offer in terms of service delivery.

Состояние высших психических функций у юношей и девушек, переживших жестокое обращение в детском и подростковом возрасте (пилотажное исследование)

<p><strong>Context and relevance.</strong> Childhood abuse has a negative impact on physical and mental health, socioeconomic status and quality of life of victims. Child and adolescent abuse leads to disruptions in the structural integrity of various parts of the brain. There is an objective lack of scientific data on the characteristics of cognitive functioning of individuals who were abused in childhood and adolescence. <strong>Objective.</strong> The aim of this study was to identify and describe deviations in the functioning of higher mental functions, potentially caused by structural defects of the brain caused by abuse. <strong>Methods and materials.</strong> The experimental group consisted of 20 young adults (15 women, 5 men, mean age — 20 years) who were abused in childhood and adolescence. Experience of abuse was confirmed using the international questionnaire ICAST-R. The control group included 19 young adults (2 men, 17 women, mean age — 21 years) with no history of abuse. To assess the state of higher mental functions (gnosis, praxis, memory, attention, thinking), a protocol was drawn up from neuropsychological and pathopsychological tests. <strong>Results. </strong>It has been found that individuals who were abused in childhood and adolescence are characterized by disturbances in attentional-mnestic processes, thinking, tactile gnosis, dynamic and spatial praxis. The frontal lobes and subcortical structures of the brain, and the parietal-occipital cortices were predominantly affected. <strong>Conclusions.</strong> Understanding the long-term consequences of childhood abuse on the cognitive functioning of victims will allow us to find more effective approaches to early diagnosis and prevention of disorders of higher mental functions.</p>

The effects of maternal childhood victimization on depression, harsh parenting, and child externalizing problems over 10 years.

Physical and sexual abuse have far-reaching mental and behavioral health consequences, extending across the lifespan and, in some cases, across generations. However, empirical work in this area is limited by cross-sectional study designs, short follow-up durations, and data analytic techniques that fail to capture the nuanced developmental processes through which caregivers and children impact one another. The present study investigated the cross-lagged and bidirectional pathways between maternal childhood victimization, depression, harsh parenting, and their children's externalizing symptoms over a 10-year period. Participants were 818 mother-child dyads prospectively identified as at-risk for family violence when children were four years old. Traditional cross-lagged panel modeling (CLPM) and random-intercept cross-lagged panel modeling (RI-CLPM) documented that maternal depression, harsh parenting, and child externalizing problems - all predicted by mothers' early abuse experiences - exacerbated one another across time. Discrepancies between the CLPM and RI-CLPM highlighted the advantages, disadvantages, and methodological implications of each approach. Findings highlight maternal psychopathology and parenting as key mechanisms in the intergenerational impact of abuse, emphasizing the importance of trauma-informed, parent-mediated interventions for breaking long-term cycles of family dysfunction. The present findings support separating out between-person, trait-like components when interpreting cross-lagged associations, as these may confound within-person effects.

‘I feel so alone… I am nobody, and I am nothing’. A psychosocial autopsy study on adolescent girls’ suicide, with a focus on sexual orientation

This study aimed to understand suicide among LGB or Questioning (LGBQ) and heterosexual adolescent girls in the Netherlands and to examine the role of their sexual orientation to their suicide following the sexual minority stress framework. Narrative interviews with 35 survivors of 18 female adolescents’ suicide cases revealed approximately half of the cases as LGBQ. Thematic analyses of informants perspectives demonstrated three life trajectories: (1) Trauma and stressors in childhood impacting mental health. (2) Onset of decreased mental health in adolescence without major external stressors. (3) Unexpected suicide in girls seemingly doing well. Regarding the minority stress framework, most LGBQ girls had faced some form of sexual minority stressors (LGB bullying, non-affirmation) from peers or family. Nevertheless, the minority stress the girls had been confronted with, had often been preceded by, or interlinked with other trauma, stressful life events, that is, general bullying, the experience of sexual abuse and family problems.

PREVALENCE AND CHARACTERISTICS OF PROBLEMATIC PORNOGRAPHY USE IN SWEDISH ADOLESCENTS

Abstract Objectives Compulsive Sexual Behavior Disorder is a new diagnosis included in the 11th revision of International Classification of Diseases (ICD-11). It is characterized by a persistent preoccupation with sexual behaviors, accompanied by a perceived loss of control and significant distress or impairment in key areas of life. The most common manifestation of CSBD is Problematic Pornography Use (PPU). Many adults seeking help for CSBD report its onset during adolescence. Yet, there is limited knowledge about PPU in adolescents and its predisposing factors. This study aims to explore the prevalence of self-reported PPU among Swedish adolescents and its associated factors. Methods A representative sample of 3016 Swedish third-year high school students participated in a comprehensive survey. Data were collected on sociodemographic variables, health and abusive experiences, as well as sexuality and pornography-related factors. PPU was characterized by difficulties in refraining from watching pornography or stopping once started. To explore the associations between PPU and the collected variables, we employed descriptive statistics and logistic regression analyses. Results PPU was reported by 19% of boys (n = 257) and 4% of girls (n = 67). PPU was associated with more time spent on pornography use and higher exposure to violent or concerning sexual material, such as content involving animals or children. Adolescents with PPU showed higher rates of abusive experiences, mental health problems (ie, emotional dysregulation and trauma symptoms) and risky behaviors compared to the reference group. Specifically, boys exhibited more nonconsensual sexual acts, while girls demonstrated increased substance use and earlier sexual activity. Conclusions Our findings indicate a significant prevalence of PPU among Swedish adolescents, particularly among boys. It is crucial for professionals working with adolescents to address concerns related to pornography use and provide necessary support. The association between PPU and emotional dysregulation, as well as trauma symptoms, underscores the importance of addressing underlying psychological issues in both prevention and treatment efforts. Future research should focus on longitudinal studies and the development of effective intervention and prevention strategies for at-risk adolescents. Conflicts of Interest The authors declare that they have no conflicts of interest.

Attention to facial emotions in adult women varies by type and severity of childhood maltreatment experience and emotion regulation strategy

Little eye-tracking research has been conducted so far on the association of subtypes of childhood maltreatment and habitual emotion regulation with attention to emotions. To address this issue, gaze behavior of one hundred women with experiences of childhood maltreatment was examined in a free-viewing task in which pairs of faces consisting of an emotional (happy, surprised, angry, disgusted, fearful, and sad) and a neutral face were displayed. Participants’ childhood maltreatment experiences, emotion regulation strategies (reappraisal and suppression), anxiety, depression, stress perception, level of alexithymia, and intelligence were assessed. Fixation durations were used to assess attentional bias. A mixed linear model with post-hoc pairwise comparisons was used to investigate research questions. Results indicated that, at high levels of maltreatment severity, attentional preference for positive over other emotional faces was found to be diminished for physical and emotional abuse but not for emotional neglect. At a severe level of emotional abuse, a bias away from disgusted faces was observed. Suppression was linked to reduced and reappraisal was related to heightened attention allocation to facial emotions. Our data indicates that attention to social emotional information in adulthood could depend on the type and severity of childhood trauma and habitual emotion regulation strategy.

“SENSING THE BODY AS A SEXUAL BODY” - EXPLORING PROFESSIONAL DANCERS’ RELATIONSHIP BETWEEN BODY AWARENESS AND SEXUAL PLEASURE

Abstract Objectives Sexual pleasure is acknowledged as vital to sexual health, rights, and well-being. However, the connection between body perception and sexual pleasure remains underexplored. This study addresses this gap by examining how professional contemporary dancers, a population specifically trained to perceive their own and others’ bodies in space, relate their heightened somatic awareness to sexual pleasure. Methods Semi-structured interviews were conducted with 28 European professional dancers, aged 26 to 72. Among them, 21 identified as female (75%), 6 as male (21%), and one as genderless (4%). Participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA-2; Mehling et al., 2018). The question, “How do you think feeling your body and feeling sexual pleasure are related within you?” was posed either in person (36%) or via video call (64%). All responses were transcribed verbatim and analyzed thematically. Presented findings are preliminary. Results Many participants (89%) emphasized a positive correlation between body awareness and sexual pleasure, often describing that an intensified perception of their body led to greater sexual pleasure. Some (21%) viewed body awareness and sexual pleasure as “the same” or deeply intertwined. However, 25% noted instances where these experiences diverged due to factors like shame, stress, overthinking, or specific contextual situations. Challenges such as experiences of sexual abuse, public judgment while performing, and non-conformity to sexual gender roles were mentioned. Relational aspects, including the awareness and communication of desires and needs, through different types of touch and sexual boundary-setting, particularly in dance contexts, were highlighted. For some (18%), dancing with others or sensory experiences in nature paralleled sexual activity. Others (18%) viewed sexual arousal, desire, and pleasure as vital, a choice “to be alive”. Conclusions These preliminary insights underscore the importance of further research on the connection between bodily awareness and sexual pleasure among dancers, as well as in the general population. Sex-positive and embodied approaches could prove valuable within therapeutic and educational settings, potentially enhancing sexual health and overall well-being. Somatic and mindfulness-based interventions are possible applications. Conflicts of Interest The authors declare no conflicts of interest related to this study.

Trauma-focused dialectical behavior therapy: study protocol for a randomized controlled multi-center trial in online and face-to-face formats

BackgroundBorderline Personality Disorder (BPD) is a severe mental health condition that requires intensive psychotherapeutic treatment. Dialectical Behavior Therapy (DBT) is a specialized treatment approach for BPD with broad empirical evidence. However, as with other disorder-specific treatments, the effect sizes of the standard DBT approach are only modest and access to treatment is limited. To enhance the efficacy of DBT, we developed an adaptation called Trauma-Focused DBT (TF-DBT), which is based on the principles, treatment modes, and functions of DBT. The goal was to (i) condense and accelerate the core therapeutic processes of DBT and (ii) expand therapeutic strategies for addressing BPD symptoms beyond Stage I of DBT (i.e., focusing on behavioral dyscontrol). TF-DBT adopts an accelerated experiential approach that is phase-based in its delivery. It emphasizes the processing of maladaptive emotions related to a wide range of developmental relational trauma (i.e., experiences of traumatic invalidation, emotional abuse, bullying, sexual abuse, or neglect in childhood or adolescence).AimThe primary aim of this study is to investigate the efficacy of this novel DBT adaptation (TF-DBT) compared to standard DBT (S-DBT) as developed by M. Linehan. We hypothesize that TF-DBT is superior to S-DBT on all BPD symptom measures. A second aim of the study is to investigate the efficacy of the delivery format of both treatments (i.e., online vs. face-to-face), with the hypothesis that online therapy is non-inferior to face-to-face treatment.MethodsThis study will enroll N = 260 individuals diagnosed with BPD according to DSM-5. Participants will be randomly assigned to 12 months of outpatient TF-DBT or S-DBT in an online or face-to-face format.DiscussionThe expected results might help to improve psychotherapy efficacy for BPD. Additionally, they will improve our understanding of the efficacy of online-delivered DBT treatments which might contribute to facilitating access to treatment.Trial registrationGerman Clinical Trials Register: registration number DRKS00031808, date of registration 04 July 2023. WHO Universal Trial Number: U1111-1273-3381.