Effects of intensive trauma-focused treatment of individuals with both post-traumatic stress disorder and borderline personality disorder

Background: Research indicates that intensive trauma-focused therapy can be effective in alleviating symptoms of post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). However, these studies have relied on self-report of BPD symptoms and follow-up data are scarce.


Objective: The purpose of this feasibility study was to determine the effects of an intensive trauma-focused treatment programme on the severity of PTSD and BPD symptoms and the diagnostic status up to a 12-month follow-up.


Methods: A total of 45 (60% female) individuals meeting the diagnostic criteria of both PTSD and BPD participated in an intensive eight-day trauma-focused treatment programme which combined prolonged exposure and EMDR therapy in an inpatient treatment setting. Severity of PTSD and BPD symptoms were assessed at pre-treatment, post-treatment, 6 months, and 12 months after treatment (CAPS-5, BPDSI-IV). Diagnostic status was determined using clinical interviews (CAPS-5 and SCID-5-P) at pre-treatment and 12-month follow-up.


Results: Of all participants, 93.3% had been exposed to physical abuse, and 71.1% to sexual abuse prior to the age of 12 years. PTSD and BPD symptom severity significantly decreased from pre- to post-treatment (Cohen's ds: 1.58 and 0.98, respectively), and these results were maintained at 6- (ds: 1.20 and 1.01) and 12-month follow-up (ds: 1.53 and 1.36). Based upon CAPS-5, 69.2% no longer met the diagnostic criteria of PTSD at 12-month follow-up, while according to the SCID-5-P 73.1% no longer fulfilled the diagnostic criteria of BPD at that time. No significant worsening of symptoms occurred.


Conclusion: The findings of this study, which is the first to examine the effects of psychotherapeutic treatment of PTSD on the presence of a borderline personality disorder one year after treatment, add support to the notion that a brief intensive trauma-focused treatment can be a valuable option for individuals suffering from both PTSD and BPD.



  • Investigated the effects of trauma-focused treatment on BPD.
  • First study that evaluated the status of BPD diagnosis one year after treatment.
  • Trauma-focused treatment proved to be a feasible and safe treatment for patients diagnosed with both PTSD and BPD.
K. A. Kolthof, E. M. Voorendonk, A. Van Minnen & A. De Jongh | 2022
In: European Journal of Psychotraumatology ; ISSN: 2000-8066 | 13 | 2 | november | 2143076
Borderline Personality Disorder, Comorbidity, Diagnosis, Effects, EMDR, EMDR (Eye Movement Desensitization and Reprocessing), Posttraumatic Stress Disorder, Psychotrauma, PTSD (DSM-5), PTSD (en), Trauma Focused Cognitive Behavioral Therapy, Treatment