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While studies indicate that engaging in psychotherapy can reduce CPTSD symptom severity, data on long\u2010term effectiveness of interventions is scarce. The aim of this study was to evaluate long\u2010term CPTSD trajectories of affected individuals after a 6\u2010week multimodal psychodynamic inpatient rehabilitation treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational single center study participants completed questionnaires on CPTSD symptoms (ITQ), anxiety, depression, and somatization (BSI\u201018), functional impairment (WHODAS\u201012), mentalizing (MZQ\u20106) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2) as well as &gt; 12 months after treatment. Repeated measures analyses of variance (ANOVAs) and reliable change index (RCIs) for the ITQ as primary outcome variable were calculated to evaluate mean symptom change. The influence of a range of potential factors affecting change was evaluated using correlation coefficients and ANOVAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of <jats:italic>n<\/jats:italic>\u2009=\u200938 individuals diagnosed with CPTSD completed the questionnaires 14\u221228 (median: 21.2) months after treatment. Participants reported a significant reduction of CPTSD symptoms with large effect sizes at follow\u2010up (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>d<\/jats:italic>\u2009=\u20091.70) as well as reduced symptoms of depression (<jats:italic>p<\/jats:italic>\u2009=\u20090.009, <jats:italic>d<\/jats:italic>\u2009=\u20090.84) and anxiety (<jats:italic>p<\/jats:italic>\u2009=\u20090.009, <jats:italic>d<\/jats:italic>\u2009=\u20090.1.24) and improved social participation (<jats:italic>p<\/jats:italic>\u2009=\u20090.012, <jats:italic>d<\/jats:italic>\u2009=\u20091.06). At follow\u2010up, 59% of participants no longer fulfilled CPTSD criteria. Improved epistemic trust (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.007), and reduced epistemic credulity (<jats:italic>r<\/jats:italic>\u2009=\u20090.44, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) were associated with reduced CPTSD symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>To the authors knowledge, this is the first study to report long\u2010term CPTSD symptom trajectories after psychodynamic inpatient treatment. The results indicate lasting symptom change and identify improvements in epistemic trust as associated with symptom change. Due to the observational nature of the study, no causal attributions as to the effectiveness of the treatment can be drawn.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jclp.23809","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T09:29:07Z","timestamp":1747042147000},"page":"739-754","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long\u2010Term Improvements of Complex Post\u2010Traumatic Stress Disorder (CPTSD) Symptoms After Multimodal Psychodynamic Inpatient Rehabilitation Treatment\u2013An Observational Single Center Pilot Study"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0518-3144","authenticated-orcid":false,"given":"David","family":"Riedl","sequence":"first","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research Vienna Austria"},{"name":"University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Thaler","sequence":"additional","affiliation":[{"name":"Rehabilitation Center Montafon Schruns Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Kirchhoff","sequence":"additional","affiliation":[{"name":"University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Kampling","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy Justus Liebig University Giessen Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy Justus Liebig University Giessen Giessen Germany"},{"name":"Department for Psychosomatic Medicine and Psychotherapy Medical Center of the Philipps University Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Nolte","sequence":"additional","affiliation":[{"name":"Anna Freud National Centre for Children and Families London UK"},{"name":"Research Department for Clinical Educational and Health Psychology, UCL London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Campbell","sequence":"additional","affiliation":[{"name":"Anna Freud National Centre for Children and Families London UK"},{"name":"Research Department for Clinical Educational and Health Psychology, UCL London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Grote","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research Vienna Austria"},{"name":"Department of Orthopaedics and Trauma Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research Vienna Austria"},{"name":"Rehabilitation Center Kitzbuehel Kitzbuehel Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Lampe","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Rehabilitation Research Vienna Austria"},{"name":"Rehabilitation Center Montafon Schruns Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Bateman A.\u201cMentalization Based Treatment\u2014Trauma Focused (MBT\u2010TF): Rationale of a Mentalizing Model for Treatment of People Who Have Experienced Developmental Trauma.\u201d 2023. 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