2 - (SYM 21) Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR): A New Treatment for ICD-11 Complex Post Traumatic Stress Disorder

Complex PTSD (CPTSD) has been introduced in ICD-11 in 2019. ICD-11 CPTSD comprises of six symptom clusters including re-experiencing of the traumatic event in the here and now, avoidance, hyperarousal, affective dysregulation, interpersonal difficulties and pervasive low sense of self. There is a need to test existing therapies for the treatment of CPTSD as well as to explore new ones. ESTAIR is a flexible 4-module CBT intervention that provides skills training in core areas of functioning (e.g. emotional regulation) as well as traumatic memory processing. ESTAIR has been tested in a pilot randomised controlled trial against treatment as usual (TAU). A total of N = 56 eligible veterans with CPTSD were randomised to either ESTAIR (n = 28) or TAU (n = 28). The primary outcome was measured by the International Trauma Questionnaire (ITQ). Treatment dropout in ESTAIR and TAU was low and equivalent (18% vs. 11%; X² (1) = 1.19, p = 0.275) and study retention was high. No serious adverse effects and very few adverse effects occurred, none of which were deemed related to the study. ESTAIR provided significantly greater reduction in CPTSD severity across time for ITQ PTSD (p < 0.001) and DSO (p < 0.001) symptoms compared to TAU. CPTSD pre-to-post effect sizes for ESTAIR were large (PTSD d = 1.78; DSO d = 2.00). Remission of probable CPTSD diagnosis at post-treatment was substantially greater in ESTAIR compared to TAU with only 13.6% versus 84% (p < 0.001) retaining the diagnosis. Preliminary results suggest that ESTAIR can be a useful treatment for those with CPTSD. Implications for further research will be discussed.