The Frisian Trauma and Personality Studies: Two-year course of personality disorders and trauma-related disorders in patients in mental health care

Personality disorders and trauma-related disorders are associated with
significant personal and societal burden for a large part because of the
development of chronicity and public health consequences. Data on the long-term
prognosis (course) of trauma-related disorders and personality disorders, in
particular among victims of chronic childhood traumatization are scarce. The
available data suggest that both disorders tend to run a chronic course,
however, most studies tend to focus on the naturalistic short-term course of
the disorders in patients referred to mental health care centres and do not
focus on the (course of the) comorbidity between both disorders. Proper insight
into the naturalistic course of personality disorders and trauma-related
disorders, in particular data indicating whether the naturalistic course of
comorbidity of the disorders differs across both categories of disorders, is of
great importance for clinical practice. Therefore, research efforts
investigating the naturalistic long-term course of personality disorders and
trauma-related disorders, and especially what the effect of the comorbidity
between these disorders is on course prediction in patients referred to mental
health care centres are needed. These studies are also important to examine to
what extent demographics (e.g., gender, age), clinical features of the
disorders itself (e.g., severity, number of criteria present, type/cluster) and
other clinical factors (e.g., type and severity of comorbid symptoms, severity
of childhood abuse or perceived neglect) are important for prognosis. In
addition, based on this research the prognostic value of Draijer*s (2003)
theoretical model of the relationship between trauma-related disorders and
personality disorders in early traumatized individuals can be examined.

The general research question of this study is: what is the course of (symptoms
of) trauma related and personality disorders in a sample of patients in
treatment over a follow-up period of two years?
More specifically, what is the course of the core symptoms (PTSD, dissociation,
personality pathology, affect regulation and general functioning) in a sample
of treatment seeking adults? Is it possible to relate the diagnostic square to
changeability of psychopathology within a period of two year? What are
demographic (gender, age) and clinical (dissociation, comorbidity in general,
personality pathology) predictors of a favourable course after two years? To
what extent is course outcome dependent on the type or duration of treatment
(e.g., inpatient, outpatient, crisis, and pharmacotherapy, psychotherapy or
supportive therapy)?
This study contributes to the perception of trauma related disorders. It
provides insight in the relation between symptoms of trauma related disorders
and personality disorders and how they affect each other during time, while
they are frequently treated separately nowadays. Based on the results of this
study, it is possible to appeal for an more integrated treatment of these
disorders. Identifying factors, which influence the course of the trauma
related and personality disorders, makes it possible to make predictions about
the future course and offers indicators for treatment. Furthermore, the study
can contribute to improve diagnosing trauma related disorders.

Observational, non-invasive, follow-up cohort study.

During the assessment, participants can experience an temporary increase of
tension. However, all participants are familiar with the assessment, due to
their participation in the baseline study.