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Cognitive Processing Therapy (CPT) for Posttraumatic Stress Disorder and Borderline Personality Disorder (PTSD-BPD)
Not Recruiting
Trial ID: NCT04230668
Purpose
Posttraumatic Stress Disorder (PTSD) with co-occurring Borderline Personality Disorder (BPD)
(i.e., PTSD-BPD) is common (as high as 58%), debilitating, costly, and limited treatment
options available for this population. PTSD-BPD is associated with even greater functional
impairment and higher healthcare burden than either disorder alone. There are surprisingly
few treatments available for this clinical profile, despite its association with major
negative health outcomes, cost, and morbidity. There is a pressing need to innovate
treatments that can effectively and efficiently treat PTSD-BPD. The existing treatments used
for PTSD-BPD are lengthy, laborious, resource-intensive, and require complete cessation of
suicidal behaviors prior to treatment. Furthermore, no integrated treatment has been
innovated to deliver the active ingredients to efficiently affect the mechanisms underpinning
this comorbidity. The investigators propose to examine an adapted version of a first-line
PTSD intervention, Cognitive Processing Therapy, augmented with a Suicide Risk Management,
i.e., (CPT+SRM) as a brief (12 sessions) and more parsimonious treatment alternative that
strategically targets shared mechanisms underpinning PTSD and BPD. The purpose of this pilot
study is to 1) collect initial feasibility, acceptability, and safety data on this adapted
treatment, 2) conduct a pilot randomized clinical trial evaluating the efficacy of CPT+SRM
versus Treatment as Usual (TAU) + SRM, and 3) evaluate two targets (i.e, improvements in
emotional intensity and cognitive dysfunction) as mechanisms leading to change in our primary
outcomes. Both treatment conditions will be administered via telehealth.
Potential benefits include reduction in participants' PTSD, BPD and other mental health
symptoms. Additionally, this work could benefit the community by improving the treatment
repertoire for PTSD-BPD. Potential risks include emotional distress, suicidality, and/or
self-harm. Participants may experience discomfort and/or distress while discussing
participants trauma(s) and mental health. These risks will be mitigated using a suicide risk
management protocol which therapists in the assessment of risk and protective factors of
suicide, followed by documentation for the decision-making around the management of risk.
Official Title
A Pilot Effectiveness Trial of Cognitive Processing Therapy Augmented With Suicide Risk Management for Individuals With Comorbid PTSD and BPD
Stanford Investigator(s)
Debra Lee Kaysen
Professor of Psychiatry and Behavioral Sciences (Public Mental Health & Population Sciences)
Eligibility
Inclusion Criteria:
- Aged 18-65 years
- Must reside in the Bay Area, CA
- Current DSM-5 diagnosis of PTSD and BPD
- Must be willing to be audio- or videorecorded for assessment and treatment sessions
Exclusion Criteria:
- Acute mania, acute psychosis, or intellectual disability
- Conditions requiring medical attention to a potentially life-threatening illness
(e.g., severe anorexia nervosa)
- Severe impairments in written and aural comprehension
- EU individuals
Intervention(s):
behavioral: Cognitive Processing Therapy with Suicide Risk Management
behavioral: Treatment as Usual with Suicide Rick Management
Not Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305