Treatment of Depressive Symptoms in Adult Survivors of Childhood Trauma

Abstract

This study examined differences in depression symptoms between four Personality Disorder (PD) groups in 123 adult survivors of abuse who completed a 6-week inpatient program for Post-traumatic Stress Disorder (PTSD). Data were collected at admission, discharge, 3-months, and 1-year post-treatment. Participants completed self-report measures at each time point. Based on Millon Clinical Multiaxial Inventory-II scores, participants were divided into four PD groups: avoidant, borderline, dependent, and histrionic. MANOVAs and ANOVAs were calculated to examine depression symptoms over time. Depression and hopelessness symptoms decreased post-treatment, and treatment gains were maintained at 1-year. Multiple regressions were calculated to determine which PD trait was the best predictor of response to treatment Erin R. Kraftcheck, MA, MD, is currently training within the department of Family and Community Medicine at the University of Toronto.

The Relationship between Personality Disorder Features and Symptom Improvement at an Inpatient Treatment Program for Posttraumatic Stress Disorder

“…Yet, these clients also appeared to experience the greatest difficulty transitioning from inpatient treatment to the community, as indicated by the significant difference between the results at discharge and those at follow-up. These results are consistent with Kraftcheck et al (2007), who found that high dependency predicted improvement in depression at discharge but not at three-month follow-up. As an eight-week program for PTSD is unequipped to help individuals make long-term changes in their dependency, clinicians need to help dependent individuals to find consistent social supports.…”

“…Relatively few studies examining personality in relation to inpatient trauma treatment exist. Previous research (on a different sample) involving the program investigated in this study found that among individuals participating in an inpatient PTSD program, comorbid dependent or borderline PDs were associated with a greater reduction in depression symptoms than comorbid histrionic PD (Kraftcheck et al, 2007). Also, higher levels of dependent features at admission were associated with reduced hopelessness scores at discharge.…”

“…Previous evaluations of the program investigated in this study (Program for Traumatic Stress Recovery; PTSR) also indicated positive findings. The program has been studied by two research labs that have found improvements in symptoms of PTSD, overall psychiatric symptoms, hopelessness, and attachment orientation (Kraftcheck, Muller, & Wright, 2007;Muller & Rosenkranz, 2009;Rosenkranz & Muller, 2011;Stalker, Palmer, Wright, & Gebotys, 2005;Wright, Woo, Muller, Fernandes, & Kraftcheck, 2003).…”

“…Many studies have used a categorical classification of PDs to predict treatment success (Kraftcheck et al, 2007;Messina et al, 2002;Sumerall et al, 2000). Other studies used continuous definitions of personality but failed to include a range of items related to PDs (Daud et al, 2008;Holeva & Tarrier, 2001;Lauterbach & Vrana, 2001;Rademaker et al, 2011).…”