Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “a modified dialectical behavior therapy (DBT) regimen is effective in reducing PTSD symptom severity in adult women with comorbid PTSD and BPD?”

STUDY DESIGN: Review of two randomized controlled trials (RCTs) and one case study published in English between 2013-2015.

DATA SOURCES: Two RCTs and one case study found via PubMed and Google Scholar evaluated the benefit of a modified dialectical behavior therapy (DBT) in reducing PTSD symptom severity in patients with comorbid PTSD and BPD.

OUTCOMES MEASURED: PTSD Symptom severity was measured via the Clinician- Administered PTSD Scale (CAPS), PTSD Symptom Scale – Interview (PSS-I), and PTSD Checklist (PCL).

RESULTS: Both RCT’s performed by Bohus et al. (Psychother Psychosom. 2013;82(4):221223. doi: 10.1159/000348451) and Harned et al. (Behav Res Ther. 2014;55:7-17. doi: 10.1016/j.brat.2 014.01.008) found a statistically significant relationship between a modified DBT regimen, DBT-PTSD or DBT + DBT PE respectively, and a marked reduction in PTSD symptom severity as compared to the control group. Granato et al. (J. Clin. Psychol. 2015;71:805 -815. doi: 10.100 2/jclp/22207) conducted a case study that descriptively revealed the patient’s reduced PTSD symptomatology after completing DBT + DBT PE yet is deficient in its ability to produce significant data due to their lack of sample size.

CONCLUSIONS: The reported evidence in each study supports the efficacy of a modified DBT regimen in the marked reduction of PTSD symptom severity in adult women with co-occurring PTSD and BPD. However, only the two RCTs by Bohus et al and Harned et al. elicited data with statistical significance. Based on the findings from these two trials, it is evident that women who severely suffer from both mental illnesses are capable of reducing their PTSD symptomatology with potential remission from one of the diagnoses after completion of a modified DBT treatment, as compared to traditional DBT that is unable to elicit the same change. These studies prove that it is imperative to simultaneously target both symptomatic manifestations of BPD and PTSD that co-occur and cause significant impairment. Future research should focus on expanding sample sizes and lengthening follow-up measures to assess the treatment’s long-term impact on psychological remission.

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