A manualized adapted schema therapy approach is effective in treating Dissociative Identity Disorder
ID
Bron
Verkorte titel
Aandoening
Dissociative Identity Disorder
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Dissociative symptoms (DSS), Post Traumatic Stress Disorder symptoms (PCL-5), Symptoms clusters of Dissociative Identity Disorder: depersonalisation, derealisation, identity confusion and amnesia (SCID-D-R), therapy dropout percentage.
Achtergrond van het onderzoek
One category of disorders frequently associated with a history of trauma are the dissociative disorders, of which Dissociative Identity Disorder (DID) is the most severe and chronic form. Patients suffering from DID show high levels of impairment, high treatment utilization, and high treatment costs. The aim of this study is to improve treatment for patients with Dissociative Identity Disorder, by applying an adapted form of schema therapy, a treatment which is highly effective in related disorders.
A multicentre, non-concurrent multiple baseline design will be used and 32 outpatients will be included from three mental health institutions in the Netherlands. Patients are randomly assigned to a baseline length (i.e., 13 weeks, 14 weeks, etc. up to 20 weeks). After a short education phase of 8 weeks (added for research purposes), the intervention phase will start. Patients receive 3 years of schema therapy (two years twice a week and one year once a week). Finally, six monthly booster sessions will follow.
The current study builds on a previous pilot study that provided a first test of the efficacy of a manualized adapted schema therapy approach for Dissociative Identity Disorder. Some adjustments have been made to the pilot study-protocol for the present study. These adjustments concern: a) the addition of monthly 45-minute sessions with a social psychiatric nurse to solve practical problems; b) replacement of several assessment instruments by measurements that are theoretically more attuned to the treatment goals of schema therapy for dissociative identity disorder, and updated instruments adapted to DSM-5 criteria.
Doel van het onderzoek
A manualized adapted schema therapy approach is effective in treating Dissociative Identity Disorder
Onderzoeksopzet
Measurements will take place at baseline, after the education phase of 8 weeks (i.e., added for research purposes), every 6 months during treatment, post-treatment (which takes 3 years), after booster sessions (6 monthly sessions) and 6 months after the booster sessions as follow-up. Process measures will be taken weekly during the baseline and education phase, and every other week biweekly during the treatment phase.
Onderzoeksproduct en/of interventie
A form of schema therapy, adapted to the needs of the patients with Dissociative Identity Disorder
Publiek
Wetenschappelijk
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
• Main diagnosis of Dissociative Identity Disorder, diagnosed with the SCID-D-R
• The initial Dissociative Identity Disorder diagnosis was classified max 3 years ago
• Participant has not received schema therapy before
• Participant has not completed successful trauma treatment
• Participant is motivated to undertake trauma treatment and to actively participate in achieving the treatment goals (reading literature at home, doing home assignments etc.) and to practice behavioral change
• Participant agrees to be recorded; in diagnostic interviews on video and treatment sessions on audio
• Age ≥ 18 and < 60
• Participant is able to understand, read, write, and speak Dutch
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
• DSM-5 substance dependence, as measured with the MINI-plus, that requires detox
• Florid psychotic episodes, as determined with the MINI-plus
• Acute suicide risk, as measured with several questions on suicidal behavior, which are administered as part of the intake.
• IQ < 80. IQ testing is requested by default by the intaker when education level is lower than intermediate vocational education. In that case, the screener for intelligence and mild intellectual disability (SCIL) is administered, with further IQ tests (WAIS) if indicated
• Other comorbid Axis I and Axis II disorders are allowed. They will be classified with the MINI-plus and the SCID-5-PD
Opzet
Deelname
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