Group treatment for complex dissociative disorders: a randomized clinical trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Trauma Studies

Background:

• Complex dissociative disorders (CDD) are associated with significant childhood abuse, comorbidity, and functional impairment.
• Existing naturalistic studies suggest psychotherapy benefits CDD patients, but randomized controlled trials (RCTs) are lacking.
• This study addresses the need for RCTs by evaluating a structured group treatment for CDD.

Purpose of the Study:

• To evaluate a structured protocolled group treatment as an add-on to individual therapy for patients with CDD.
• To compare the efficacy of group treatment plus individual therapy versus individual therapy alone.
• To assess the impact of treatment on Global Assessment of Functioning (GAF), PTSD, dissociative symptoms, and general psychopathology.

Main Methods:

• Fifty-nine patients with CDD were randomized into two groups: stabilizing group treatment plus individual therapy, or individual therapy alone (delayed treatment design).
• The group treatment followed the 'Coping with Trauma-Related Dissociation' manual and consisted of 20 sessions.
• Primary outcome was GAF; secondary outcomes included PTSD and dissociative symptoms, general psychopathology, and interpersonal difficulties.

Main Results:

• No immediate differences were found between the group treatment and individual therapy alone on the primary outcome (GAF) or secondary outcomes.
• No significant within-group effects were observed from baseline to the end of treatment in either condition.
• Significant improvements in psychosocial function, PTSD symptoms, and general psychopathology were noted at the 6-month follow-up.

Conclusions:

• The first RCT for complex dissociative disorders indicates that stabilizing group treatment, as an add-on, does not yield immediate superior outcomes compared to individual therapy alone.
• Despite no immediate advantage, the treatment was associated with improvements in psychological functioning over time.
• Further research is needed to understand the long-term effects and optimal integration of group treatments for CDD.