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Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment with exposure-based components in adolescent and young adult PTSD patients


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Fischer, Anne ; Rosner, Rita ; Renneberg, Babette ; Steil, Regina:
Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment with exposure-based components in adolescent and young adult PTSD patients.
In: Borderline Personality Disorder and Emotion Dysregulation : the official journal of the National Education Alliance for Borderline Personality Disorder (NEA.BPD) and Dachverband Dialektisch Behaviorale Therapie (DDBT). 9 (2022): 1.
ISSN 2051-6673


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Multiple traumata such as child sexual and/or physical abuse often result in complex psychopathologies and a range of associated dysfunctional behaviors. Although evidence-based interventions exist, some therapists are concerned that trauma-focused psychotherapy with exposure-based elements may lead to the deterioration of associated dysfunctional behaviors in adolescents and young adults. Therefore, we examined the course of suicidal ideation, self-injury, aggressive behavior and substance use in a group of abuse-related posttraumatic stress disorder (PTSD) patients during phase-based, trauma-focused PTSD treatment.

Daily assessments from a randomized controlled trial (RCT) of Developmentally adapted Cognitive Processing Therapy (D-CPT) were analyzed to test for differences in the stated dysfunctional behaviors between the four treatment phases. We conducted multilevel modeling and repeated measure ANOVAs.

We did not find any significant differences between the treatment phases concerning the stated dysfunctional behaviors, either at the level of urge or at the level of actual actions. On the contrary, in some primary outcomes (self-injury, aggressive behavior), as well as secondary outcomes (distress caused by trauma, joy), we observed significant improvements.

Overall, during D-CPT, adolescents and young adults showed no deterioration in dysfunctional behaviors, while even showing improvements in some, suggesting that trauma-focused treatment preceded by skills building was not deleterious to this population. Hence, the dissemination of effective interventions such as D-CPT should be fostered, whilst the concerns of the therapists regarding exposure-based components need to be addressed during appropriate training. Nevertheless, further studies with momentary assessment, extended measurement methods, a control group and larger sample sizes are needed to confirm our preliminary findings.

Weitere Angaben

Schlagwörter:Child abuse; Adolescents; Self-injury; Aggression; Substance use; Suicidality; Daily diary; Exposure
Sprache des Eintrags:Englisch
Institutionen der Universität:Philosophisch-Pädagogische Fakultät > Psychologie > Lehrstuhl für Klinische und Biologische Psychologie
DOI / URN / ID:10.1186/s40479-021-00172-8
Open Access: Freie Zugänglichkeit des Volltexts?:Ja
Verlag:Springer Nature
Die Zeitschrift ist nachgewiesen in:
Titel an der KU entstanden:Ja
Eingestellt am: 17. Jul 2023 13:29
Letzte Änderung: 26. Jul 2023 09:10
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