Adding EMDR for PTSD at the onset of treatment of borderline personality disorder: A pilot study

Bobbie Wilhelmus; Marlies A E Marissen; David van den Berg; Annemieke Driessen; Mathijs L Deen; Karin Slotema

doi:10.1016/j.jbtep.2023.101834

Adding EMDR for PTSD at the onset of treatment of borderline personality disorder: A pilot study

J Behav Ther Exp Psychiatry. 2023 Jun:79:101834. doi: 10.1016/j.jbtep.2023.101834. Epub 2023 Jan 11.

Authors

Bobbie Wilhelmus¹, Marlies A E Marissen², David van den Berg³, Annemieke Driessen⁴, Mathijs L Deen⁵, Karin Slotema⁶

Affiliations

¹ Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands. Electronic address: b.wilhelmus@parnassiagroep.nl.
² Erasmus School of Social and Behavioural Sciences, Burg. Oudlaan 50, 3062, PA, Rotterdam, the Netherlands. Electronic address: marissen@essb.eur.nl.
³ Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands; Department of Clinical Psychology, VU University and Amsterdam Public Health Research, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands. Electronic address: d.vandenberg@parnassia.nl.
⁴ Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands. Electronic address: a.driessen@psyq.nl.
⁵ Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands. Electronic address: m.deen@parnassiagroep.nl.
⁶ Parnassia Psychiatric Institute, Lijnbaan 4, 2512, VE, The Hague, the Netherlands; Erasmus School of Social and Behavioural Sciences, Burg. Oudlaan 50, 3062, PA, Rotterdam, the Netherlands. Electronic address: c.slotema@psyq.nl.

PMID: 36645926
DOI: 10.1016/j.jbtep.2023.101834

Abstract

Background and objectives: Eye movement desensitization and reprocessing (EMDR) is an effective treatment for individuals suffering from posttraumatic stress disorder (PTSD). However, EMDR is not typically offered to people with PTSD who also meet the criteria for borderline personality disorder (BPD). This study examines the feasibility and clinical benefits of EMDR for PTSD delivered in addition to the onset of treatment as usual (TAU) for BPD.

Methods: In a non-concurrent, multiple baseline design, 12 patients with BPD and PTSD received fifteen weekly 45-min sessions of TAU. During this period, eight weekly 90-min EMDR sessions were added. Outcome measures were obtained weekly for self-reported PTSD symptoms (PTSD checklist for DSM-5), levels of psychopathology (Brief Symptom Checklist), and the effect of psychopathology on different areas of life (Sheehan Disability Scale).

Results: 9 participants completed the treatment protocol. In the EMDR phase, PTSD severity scores decreased significantly between sessions, while no between-session drop in scores occurred during the TAU only phase. Similar results were obtained for general symptoms and disability. No adverse events were reported.

Limitations: Results on the efficacy and safety of EMDR in patients with BPD and PTSD need to be replicated in larger samples and in RCTs before they can be generalized to the entire population.

Conclusions: The results of our study suggest that EMDR may be feasible and effective in reducing PTSD symptoms in patients concurrently receiving BPD treatment. EMDR appears to be a promising intervention for patients with BPD and comorbid PTSD.

Keywords: Borderline personality disorder; Comorbidity; EMDR; Multiple baseline design; Posttraumatic stress disorder.

MeSH terms

Borderline Personality Disorder* / therapy
Eye Movement Desensitization Reprocessing* / methods
Humans
Pilot Projects
Stress Disorders, Post-Traumatic* / therapy
Treatment Outcome