Effectiveness of PTSD-treatment Compared to Integrated PTSD-PD-treatment in Adult Patients With Comorbid PTSD and BPD

  • End date
    Apr 2, 2023
  • participants needed
  • sponsor
Updated on 25 January 2021


The goal of PROSPER-B is to study effectiveness of EMDR compared to integrated DBT-EMDR in treatment-seeking, adult patients with comorbid PTSD and Borderline Personality Disorder (BPD).


Posttraumatic stress disorder (PTSD) is highly comorbid with personality disorders (PD), mainly borderline (BPD) and cluster C personality disorders (CPD). It is not clear yet what treatment is most effective for those who suffer both PTSD and PD. There is growing preference in clinicians for evidence-based PTSD treatments, such as Eye Movement Desensitization and Reprocessing (EMDR) or Imagination and Rescripting (ImRs), because these treatments are relative short, and there is some evidence that comorbid PD symptoms might resolve as well. However, at least 30-44% PTSD patients do not sufficiently respond to PTSD treatments or are excluded because of suicidality or self-harm. PD treatments are more intensive than PTSD treatments, e.g. Dialectical Behavior Therapy (DBT) and Schema-Focused Therapy (SFT) . There is some evidence that integrated PTSD-PD treatment is twice as effective than PD treatment alone, but integrated PTSD-PD treatment is not yet directly compared to PTSD treatment alone. This study will address this knowledge gap, including secondary outcome measures on functioning, quality of life and cost-effectiveness.

For patients with comorbid PTSD and BPD, EMDR-only will be compared to integrated EMDR-DGT (PROSPER-B).

Psychological (cognitive, affective, and relational) and neurobiological candidate predictors and mediators of treatment outcome will be investigated through a machine-learning paradigm, in order to develop a clinically useful and individual prediction instrument of treatment outcome. Example predictors and mediators are educational level , working memory, hyper- and hypo-arousal , therapeutic alliance and social support, resting state fMRI, an emotional face task fMRI , cortisol levels from hair samples and (epi)genetic markers. For the neurobiological prediction, a subgroup of patients will undergo MRI scans, as will healthy controls as control subjects.

Condition Borderline Personality Disorder, Post-Traumatic Stress Disorder, Post-Traumatic Stress Disorders, PTSD, borderline personality
Treatment DBT, EMDR
Clinical Study IdentifierNCT03833453
Last Modified on25 January 2021


Yes No Not Sure

Inclusion Criteria

Is your age between 18 yrs and 65 yrs?
Gender: Male or Female
Do you have any of these conditions: Borderline Personality Disorder or Post-Traumatic Stress Disorders or Post-Traumatic Stress Disorder?
Do you have any of these conditions: Post-Traumatic Stress Disorders or Post-Traumatic Stress Disorder or PTSD or Borderline Personality Disorder or borderline personality?
Diagnosed with PTSD (309.81), and
Diagnosed with a borderline personality disorder (301.83) or at least 4 BPD symptoms
To be eligible for the study, both patients and healthy controls (for the MRI
scans) have
Be aged between 18 and 65 years
Give written informed consent
Speak / understand Dutch sufficiently

Exclusion Criteria

Current psychosis
Comorbidity interfering with treatment or randomisation (severe outward aggression, antisocial PD, treatment interfering addiction or eating disorders, somatic problems)
Primary diagnosis of paranoid, schizoid, schizotypal, narcissistic, histrionic or antisocial PD
Mental retardation
Additional exclusion criteria for the MRI substudy are
Metal implants (such as pacemakers, etc.)
Somatic disorders interfering with brain functioning
High dose use of benzodiazepines
For the healthy controls, current psychiatric diagnosis is an additional
exclusion criterion
Clear my responses

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