Background and objectives

We described a new treatment model for Posttraumatic Stress Disorder (PTSD) and Dissociative Identity Disorder (DID), based on cognitive-behavioural principles. In this model, dissociation is seen as a maladaptive avoidant coping strategy. In addition, we stress that patients have dysfunctional beliefs about dissociation. Both elements, avoidance behaviour and dysfunctional beliefs, are challenged during the brief, intensive trauma-focused treatment. When the PTSD-symptoms decrease, the patient is offered a fare-well ritual to say goodbye to their identities in one or more additional sessions.

Methods

We illustrate this treatment approach with a case report of a woman with PTSD as a result of sexual abuse in her childhood, and DID with four identities. Treatment outcome was measured at intake, at pre-treatment, at post-treatment and at 3 and 6 months follow-up.

Results

After the short treatment of only 2 weeks, she no longer fulfilled the DSM-5 diagnostic criteria for PTSD nor DID. These results were maintained at the follow-ups.

Limitations

Although we included a baseline-controlled time phase, it was not a controlled study, and only one patient was treated.

Conclusions

This new treatment model for DID-patients is promising but results should be interpreted cautiously since we described only one patient.

中文翻译：

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创伤后应激障碍和分离性身份障碍的简要认知行为治疗方法，病例报告

背景和目标

我们描述了一种基于认知行为原则的创伤后应激障碍 (PTSD) 和分离性身份障碍 (DID) 的新治疗模式。在这个模型中，分离被视为一种适应不良的回避应对策略。此外，我们强调患者对分离有功能失调的信念。在以创伤为重点的短暂强化治疗中，回避行为和功能失调的信念这两个要素都受到挑战。当 PTSD 症状减轻时，患者会被提供一种告别仪式，在一次或多次额外的治疗中告别他们的身份。

方法

我们通过一个案例报告来说明这种治疗方法，该案例报告了一名因童年时期遭受性虐待而患有 PTSD 的女性，以及具有四个身份的 DID。在摄入、治疗前、治疗后以及 3 个月和 6 个月的随访时测量治疗结果。

结果

在短短 2 周的治疗后，她不再符合 DSM-5 的 PTSD 和 DID 诊断标准。这些结果在随访中得以保持。

限制

虽然我们纳入了基线控制的时间阶段，但它不是一项对照研究，只有一名患者接受了治疗。

结论

这种针对 DID 患者的新治疗模式很有希望，但由于我们只描述了一名患者，因此应谨慎解释结果。