Cognitive Processing Therapy (CPT) for Posttraumatic Stress Disorder and Borderline Personality Disorder (PTSD-BPD)

Treatment Study on Cognitive Processing Therapy for Comorbid Posttraumatic Stress Disorder and Borderline Personality Disorder

Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) are two mental health conditions that often occur together (i.e., PTSD-BPD), with comorbidity rates as high as 58%. 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 that participants cease all suicidal behaviours prior to treatment. Furthermore, no integrated treatment has been innovated to address the specific mechanisms underpinning this comorbidity. We propose to examine an adapted version of a first-line PTSD intervention, Cognitive Processing Therapy (CPT) plus Suicide Risk Management (SRM), as a briefer (12 sessions) and more efficient treatment alternative that strategically targets shared mechanisms underpinning PTSD and BPD. The purpose of this uncontrolled study is to collect initial safety and efficacy data on this adapted treatment. Knowledge gleaned from this study will have significant direct clinical implications. Potential risks of the study include individual distress, suicide risk, and residual PTSD and BPD symptoms post-treatment. To minimize risk, study therapists will closely monitor participants using the suicide risk assessment and management protocol. Using this protocol, if participants remain distressed after a therapy session or psychological interview they will be encouraged to discuss their distress with their study assessor or therapist and coached to implement strategies to reduce their distress. If they express self-harming or suicidal urges the study assessor or therapist will implement a standardized protocol to monitor and address any escalations in risk. Potential benefits of this study include reductions in participants' PTSD, BPD and other mental health symptoms. Additionally, the study may benefit others by improving the treatment repertoire for PTSD-BPD with a more succinct treatment that can also be utilized for individuals with suicidal behaviours.

Cognitive Processing Therapy (CPT) for Posttraumatic Stress Disorder and Borderline Personality Disorder (PTSD-BPD)

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