Dissociation : Vol. 5, No. 4, p. 221-226 : Natural history of severe symptoms in borderline women treated in an incest group

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Title: Dissociation : Vol. 5, No. 4, p. 221-226 : Natural history of severe symptoms in borderline women treated in an incest group
Author: Goodwin, Jean, 1946-; Wilson, Nancy; Connell, Virginia
Abstract: In 1989 the authors described a cluster of severe symptoms in 10 women treated in a time-limited group for incest survivors who had been psychiatrically hospitalized. All had experienced multiple prior hospitalizations and multiple suicide attempts. Multiple diagnoses including borderline and affective disorders were present in the first l0 and in a replication sample. The present study explores two clinical questions raised in the treatment and follow-up of these patients: 1) Did the trauma focused groups exacerbate severe symptoms in some patients? and 2) On long-term follow-up did group treatment lead to a greater likelihood of recovery? We used chart review to follow emergency contacts and hospitalizations through three intervals: the two years that preceded treatment, and the two years that included treatment, and a two year follow-up interval. Acute contacts actually decreased during the treatment interval and on follow-up only one group-treated patient remained severely ill and suicidal. In comparison a control group of hospitalized borderline women showed increased rather than decreased acuity in the treatment interval, but a similarly high level of pre-treatment acuity and a similar 50% likelihood of "recovery" by the follow-up interval. Better outcome for group participants was most evident when we compared the most severe cases in the two groups. The only suicide in the study sample occurred in the control group. Lack of appreciation both of the high level of baseline severity and the tendency of borderlines to respond negatively to any form of treatment contributed to our erroneous impression that group treatment exacerbated symptoms. Dissociative diagnoses were associated with poor outcome.
Description: p. 221-226
URI: http://hdl.handle.net/1794/1724
Date: 1992-12


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