[Inpatient Treatment of Complex PTSD Following Childhood Abuse: Effectiveness and Predictors of Treatment Outcome].

BACKGROUND

There is a lack of studies investigating the effectiveness of inpatient trauma-focused psychotherapy of complex post-traumatic stress disorder. The first aim of this retrospective investigation was to analyze the course of PTSD. Second, possible predictors of treatment response were investigated.

METHODS

150 inpatients of Clinic St. Irmingard with complex PTSD following childhood physical and childhood sexual abuse were assessed regarding childhood abuse, PTSD symptomatology, mindfulness, dissociation and general psychopathology. Differences in pre and post scores were analyzed using regression analyses. A classification tree was used to identify predictors of response.

RESULTS

The significant reduction of PTSD symptoms corresponded to a large effect (d=1.8) and a reponse rate of 52% according to the reliable change index (p<0.05). Effect sizes for other symptoms were medium to large (0.5<d<1.1) and both drop-outs (7%) and worsenings (4%) were scarce. Somatoform symptoms, complex dissociative disorders and mindfulness deficits were identified as negative predictors of reliable change.

CONCLUSIONS

Trauma-focused inpatient treatment is safe and effective for patients with complex PTSD under naturalistic conditions. Yet, despite significant improvements there is a high rate of nonresponse. Future studies should further investigate the negative predictors of treatment outcome we identified. Possible ways to reduce nonresponse are discussed.