Inpatient Treatment for Early Sexually Abused Adults: A Naturalistic 12-Month Follow-Up Study

To date, most of the inpatient outcome studies among early traumatized individuals lack data on dissociative disorders. More research is needed to evaluate whether severely dissociative patients can improve following specialized inpatient treatment for chronic childhood abuse. The objectives of this study were to investigate symptomatic change in patients attending a 3-month specialized inpatient treatment program for adults with a history of childhood sexual abuse (CSA) and mixed trauma-related disorders. In particular, symptomatic changes in those with and without a complex dissociative disorder I + II (CDD) were contrasted. Fifty-six patients with CSA and trauma-related disorders (including 23 patients with CDD) completed the treatment program and a test battery at precare evaluation, admission, discharge, and at 1-year follow-up. There was an overall symptom reduction in dimensional measures maintained at the 1-year follow-up. Patients with CDD consistently had significantly higher symptom levels than the patients without these disorders. Both patient subgroups showed parallel improvement from admission to follow-up, although those high in dissociation (CDD patients) needed more time to show improvement and were still clinically worse at the end of treatment and at follow-up. The findings were matched by clinically significant changes. The results suggest that adults with reported childhood sexual abuse and mixed trauma-related disorders can improve in symptom severity following a trauma-based 3-month inpatient program regardless of CDD status. The high distress level in CDD patients indicates that patients with CDD need treatment that is in part different from the more general treatment of polysymptomatic CSA survivors, addressing the pathological aspects of dissociation more vigorously.