Evaluation of Narrative Exposure Therapy (NET) for Borderline Personality Disorder with Comorbid Posttraumatic Stress Disorder

Abstract

Objective: frequently patients with borderline personality disorder (BPD) report a history of exposure to traumatic stressors and, as a consequence, symptoms of Posttraumatic Stress Disorder (PTSD). BPD and PTSD combined exacerbate suffering beyond a simple additive effect. To assist these complex cases, we have tested the efficacy of Narrative Exposure Therapy (NET), an evidence-based treatment for survivors of different, multiple or continued traumatic stressors and compared the outcome with the one from a standard Treatment by Experts for Borderline Personality Disorder (TBE)Method: in both an inpatient and outpatient setting, patients with BPD and comorbid PTSD (N=22) were assigned to NET or a TBE They received either weekly sessions of NET(on average 17) or TBE (on average 14). Changes in symptoms were evaluated prior to therapy, at 6 months and 1 year post-therapy.Results: both treatment forms reduced all of the symptoms (PTSD, borderline, depression and dissociation) substantially. The decrease continued throughout the 12 months follow-up period producing large effects. Greatest effect sizes with Hedge’s g =1.6; CI 0.6 – 2.5 was obtained for the reduction of PTSD symptoms by NET (g=1.1; CI 0.2 – 2.0 for TBE) and depression (g=1.4 for NET and g=0.7 TBE).Conclusions: the results of this evaluation study showed a considerable reduction for the whole spectrum of symptoms in patient with BPD and PTSD and indicate that Narrative Exposure Therapy (NEt) warrants further testing as an effective tool to assist borderline patients suffering from trauma symptoms in both, a hospital setting as well as on an outpatient basis.