Borderline-Störungen mit komorbider posttraumatischer Belastungsstörung

Zusammenfassung

Im klinischen Alltag zeigt sich, dass Patientinnen mit einer Borderline-Persönlichkeitsstörung (BPS) und einer posttraumatischen Belastungsstörung (PTBS) aufgrund der Komplexität und Interaktion der beiden Störungsbilder einen besonders hohen Leidensdruck haben, was häufig zu einer hochfrequenten und langjährigen Inanspruchnahme psychiatrischer, psychologischer und sozialpädagogischer Dienste führt. Entsprechend bedarf es eines sowohl störungsspezifischen als auch umfassenden Therapieangebotes für diese Personengruppe. Während für die BPS Behandlungskonzepte bestehen, ist für die Behandlung der BPS mit PTBS im deutschsprachigen Raum nur ein Therapieansatz für eine stationäre Behandlung bekannt. Im Folgenden wird gezeigt, dass mit der narrativen Expositionstherapie (NET) als Kurzzeitintervention zur Behandlung von komplex traumatisierten Personen, ein wissenschaftlich fundierter Behandlungsansatz existiert, der bei der Behandlung von Borderline-Störungen mit PTBS sowohl im stationären als auch ambulanten Rahmen durchführbar ist und in Bezug auf die Symptomatik zu Erfolgen führen kann.

Summary

Clinical experience has shown that patients with borderline personality disorder (BPD) and complex posttraumatic stress disorder (PTSD) have a high degree of psychological stress because of the complexity and interaction of these mental disorders. This in turn may lead to a high frequency and longterm use of psychiatric, psychological and socioeducational services. Accordingly these patients require a comprehensive treatment approach. Whereas there are established concepts in treating BPD, to date only one approach in the German speaking area targets the treatment of comorbid BPD and PTSD. The current investigations demonstrate the feasibility of a treatment which includes narrative exposure therapy (NET) in patients with BPD and comorbid PTSD. NET is an evidence-based therapy with a focus on the full range of traumatic stress experiences. It is specifically suitable for victims of complex traumatization. Our results indicate that narrative exposure therapy may reduced PTSD symptoms in BPD patients with comorbid PTSD. Furthermore, preliminary results derived from clinical impressions point to higher affective responsiveness of participants.

Schlüsselwörter

Borderline-Persönlichkeitsstörung - posttraumatische Belastungsstörung - komplexe Traumatisierung - narrative Expositionstherapie - Trauma - traumafokussierte Verfahren

Keywords

Borderline personality disorder - posttraumatic stress disorder - complex traumatisation - narrative exposure therapy - trauma - trauma-focused

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