The research project outlined in this proposal aims to investigate the effectiveness of stabilizing group treatment as an add-on to conventional treatment, for patients with Post Traumatic Stress Disorder (PTSD) or dissociative disorders after childhood abuse. The investigators also aim to study psychophysiological markers associated with complex trauma and treatment, mechanisms of change involved in treatment, and which patient characteristics that predict positive outcome.
Patients with histories of repeated traumatization in childhood often display a wide array of symptoms described as complex traumatic stress disorder. This sequela involves a high degree of comorbid mental and somatic disturbances, and entails tremendous health care costs for society and suffering for the victims. Despite the prevalence and consequences of complex trauma, research on effective treatments is extremely limited. Expert clinicians suggest that initial treatment for these patients should focus on stabilization of symptoms through psychoeducation and skills - training, and some research has supported this advice. Offering such treatment as group therapy can be both cost - effective and give patients additional peer-support. The research project outlined in this proposal aims to investigate the effectiveness of stabilizing group treatment as an add-on to conventional treatment, for patients with PTSD or dissociative disorders after childhood abuse. This will be investigated in a randomized controlled design. The investigators also aim to discover psychophysiological markers associated with treatment, mechanisms of change involved in treatment, and what patient characteristics that predict outcome. The results may contribute to new knowledge about treatment of complex traumatization, as well as new and improved health services for a vulnerable patient group with little specialized treatment today. The main aim of this project is to compare the effectiveness of stabilizing group treatment as an add-on to conventional individual therapy, to conventional individual therapy alone, in a randomized controlled design. This will be tested in two independent diagnostic groups: Patients with PTSD and patients with Dissociative disorders, both groups with reports of childhood abuse. The investigators will further investigate how level of dissociative symptoms influence treatment, how group climate influence symptoms, the relationship between individual and group therapy in combined treatment, and how treatment affects Heart Rate Variability. The investigators also seek to evaluate the treatment economically with a societal perspective, carrying out cost-utility analyses.
Study Type
INTERVENTIONAL
Individual psychotherapeutic treatment and case-management delivered by public outpatient clinics or private practicing psychologist/psychiatrist
20 sessions group psychotherapy for patients with PTSD, focused on psychoeducation and skills-training.
20 sessions group psychotherapy for patients with PTSD, focused on psychoeducation and skills-training
Traumepoliklinikken, Modum Bad i Oslo
Oslo, Norway
Global Assessment of Functioning - change from baseline
Daily life functioning and severity of symptoms last week, assessed by interview
Time frame: 1 week after completed treatment
Global Assessment of Functioning- change from baseline
Daily life functioning and severity of symptoms last week, assessed by interview
Time frame: 6 months after completed treatment
Heart rate variability- change from baseline
Resting state heart rate variability
Time frame: 1 week after completed treatment
Heart rate variability - change from baseline
Resting state heart rate variability
Time frame: 6 months after completed treatment
PTSD Symptom Scale - Self-Report - change from baseline
Time frame: 1 week after completed treatment
PTSD Symptom Scale - Self-Report - change from baseline
Time frame: 6 months after completed treatment
Symptom Checklist 90 Revised - change from baseline
Time frame: 1 week after completed treatment
Symptom Checklist 90 Revised - change from baseline
Time frame: 6 months after completed treatment
Inventory of Interpersonal Problems - change from baseline
Time frame: 1 week after completed treatment
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Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
158
Inventory of Interpersonal Problems - change from baseline
Time frame: 6 months after completed treatment
Dissociative Experiences Scale II - change from baseline
Time frame: 1 week after completed treatment
Dissociative Experiences Scale II - change from baseline
Time frame: 6 months after completed treatment
Behavior Checklist - change from baseline
registers function and self-destructive behavior
Time frame: 1 week after completed treatment
Behavior Checklist - change from baseline
registers function and self-destructive behavior
Time frame: 6 months after completed treatment
Short Form 36 - change from baseline
Time frame: 1 week after completed treatment
Short Form 36 - change from baseline
Time frame: 6 months after completed treatment