The effect of skills training and social support in enhancing well-being of caregivers who are relatives of persons with borderline personality disorder

Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.

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Telehealth Treatment of Patients With Borderline Personality Disorder in a Partial Hospital Setting During the COVID-19 Pandemic: Comparative Safety, Patient Satisfaction, and Effectiveness of In-Person Treatment

Journal of Personality Disorders ◽

10.1521/pedi_2021_35_539 ◽

2021 ◽

pp. 1-19

Author(s):

Mark Zimmerman ◽

Madeline Ward ◽

Catherine D'Avanzato ◽

Julianne Wilner Tirpak

Keyword(s):

Patient Satisfaction ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Psychiatric Treatment ◽

Well Being ◽

Borderline Personality ◽

Hospital Treatment ◽

Level Of Care ◽

Hospital Level ◽

Partial Hospital

There are no studies of the safety and effectiveness of telehealth psychiatric treatment of partial hospital level of care, in general, and for borderline personality disorder (BPD) in particular. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, the authors compared the effectiveness of their partial hospital treatment program in treating patients with BPD. For both the in-person and telehealth partial hospital level of care, patients with BPD were highly satisfied with treatment and reported a significant reduction in symptoms from admission to discharge. Both groups reported a significant improvement in functioning, coping ability, positive mental health, and general well-being. A large effect size of treatment was found in both treatment groups. No patients attempted suicide. Telehealth partial hospital treatment was as effective as in-person treatment in terms of patient satisfaction, symptom reduction, and improved functioning and well-being for patients with BPD.

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A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of borderline personality disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420931164 ◽

2020 ◽

Vol 54 (10) ◽

pp. 1020-1034

Author(s):

Carla J Walton ◽

Nick Bendit ◽

Amanda L Baker ◽

Gregory L Carter ◽

Terry J Lewin

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Randomised Trial ◽

Skills Training ◽

Borderline Personality ◽

Individual Therapy ◽

Behaviour Therapy ◽

Psychotherapeutic Treatment ◽

Dialectical Behaviour Therapy ◽

Self Injury

Objectives: Borderline personality disorder is a complex mental disorder that is associated with a high degree of suffering for the individual. Dialectical behaviour therapy has been studied in the largest number of controlled trials for treatment of individuals with borderline personality disorder. The conversational model is a psychodynamic treatment also developed specifically for treatment of borderline personality disorder. We report on the outcomes of a randomised trial comparing dialectical behaviour therapy and conversational model for treatment of borderline personality disorder in a routine clinical setting. Method: Participants had a diagnosis of borderline personality disorder and a minimum of three suicidal and/or non-suicidal self-injurious episodes in the previous 12 months. Consenting individuals were randomised to either dialectical behaviour therapy or conversational model and contracted for 14 months of treatment ( n = 162 commenced therapy). Dialectical behaviour therapy involved participants attending weekly individual therapy, weekly group skills training and having access to after-hours phone coaching. Conversational model involved twice weekly individual therapy. Assessments occurred at baseline, mid-treatment (7 months) and post-treatment (14 months). Assessments were conducted by a research assistant blind to treatment condition. Primary outcomes were change in suicidal and non-suicidal self-injurious episodes and severity of depression. We hypothesised that dialectical behaviour therapy would be more effective in reducing suicidal and non-suicidal self-injurious behaviour and that conversational model would be more effective in reducing depression. Results: Both treatments showed significant improvement over time across the 14 months duration of therapy in suicidal and non-suicidal self-injury and depression scores. There were no significant differences between treatment models in reduction of suicidal and non-suicidal self-injury. However, dialectical behaviour therapy was associated with significantly greater reductions in depression scores compared to conversational model. Conclusion: This research adds to the accumulating body of knowledge of psychotherapeutic treatment of borderline personality disorder and supports the use of both dialectical behaviour therapy and conversational model as effective treatments in routine clinical settings, with some additional benefits for dialectical behaviour therapy for persons with co-morbid depression.

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Mindfulness and Emotional Well-being in Women with Borderline Personality Disorder

Mindfulness ◽

10.1007/s12671-011-0085-y ◽

2011 ◽

Vol 3 (2) ◽

pp. 117-123 ◽

Cited By ~ 8

Author(s):

Siobhan K. O’Toole ◽

Eric Diddy ◽

Mark Kent

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Well Being ◽

Borderline Personality

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Child abuse potential in mothers with early life maltreatment, borderline personality disorder and depression

The British Journal of Psychiatry ◽

10.1192/bjp.2018.74 ◽

2018 ◽

Vol 213 (1) ◽

pp. 412-418 ◽

Cited By ~ 5

Author(s):

Katja Dittrich ◽

Katja Boedeker ◽

Dorothea Kluczniok ◽

Charlotte Jaite ◽

Catherine Hindi Attar ◽

...

Keyword(s):

Child Abuse ◽

Emotion Regulation ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Early Life ◽

Child Psychopathology ◽

Well Being ◽

Borderline Personality ◽

Abuse Potential ◽

History Of

BackgroundEarly life maltreatment (ELM), borderline personality disorder (BPD) and major depressive disorder (MDD) have been shown to increase the potential of abuse. Emotion regulation is an identified mediator for the association of ELM and BPD with abuse potential. Until now, there has been no study to account for the co-occurrence of these risk factors in one analysis, although BPD and MDD are known as common sequelae of ELM. This is paired with a lack of studies investigating the effects of abuse potential on child well-being.AimsOur study aims at (a) disentangling the effects of maternal ELM, MDD and BPD on abuse potential; (b) exploring the role of emotion regulation as a mediator; and (c) testing for intergenerational effects of abuse potential on child psychopathology.MethodThe research design included 114 mothers with/without ELM, BPD and MDD in remission and their children, all of which were between 5 and 12 years of age. A path analysis was conducted to investigate the multiple associations between our variables.ResultsELM, MDD and BPD were all associated with abuse potential, with emotion regulation acting as a mediator for BPD and MDD. Furthermore, an elevated abuse potential was related to higher psychopathology in the child.ConclusionsHistory of ELM as well as the common sequelae, BPD and MDD, pose risks for child abuse. Our findings suggest improvement of emotion regulation as a potential target for intervention programs. These programs should also aim at non-substantiated cases because even an elevated abuse potential affected child mental health.Declaration of interestNone.

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Delineating the unique contributions of mindfulness skills in predicting engagement in suicide attempts and non-suicidal self-injury among individuals with borderline personality disorder

10.32920/ryerson.14648217.v1 ◽

2021 ◽

Author(s):

Lillian Krantz

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Dialectical Behavior Therapy ◽

Suicide Attempts ◽

Skills Training ◽

Borderline Personality ◽

Control Group ◽

Treatment Change ◽

Mindfulness Skills ◽

Self Injury

The current research tested whether four dimensions of mindfulness – acceptance without judgment, observing, describing and acting with awareness – taught during 20 weeks of dialectical behavior therapy skills training (DBT-ST) predicted frequency of two forms of self-inflicted injury (SII), i.e. suicide attempts (SAs) and non-suicidal self-injury (NSSI), at baseline and mediated the relationship between pre-post treatment change in frequency of SAs/NSSI and DBT-ST. Eighty-four suicidal individuals with borderline personality disorder were enrolled in a single-blinded randomized trial comparing DBT-ST treatment to a waitlist control group. A series of regressions revealed no relationship between dimensions of mindfulness and self-inflicted injury at baseline. Although no significant effect of DBT-ST on SAs was found, a causal mediation analysis revealed acceptance without judgment significantly mediated the relation between DBT-ST and change in frequency of NSSI.

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Good defiance and flourishing

10.1093/med/9780199663866.003.0003 ◽

2016 ◽

Author(s):

Nancy Nyquist Potter

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Mental Disorder ◽

Well Being ◽

Borderline Personality ◽

Defiant Behavior ◽

The Relationship

This chapter examines the relationship between defiance and flourishing by analyzing three cases and unpacking some of the epistemic and ontological assumptions that undergird our naïve ideas about flourishing. The aim is to clarify under what conditions a person with a mental disorder might be able to flourish, what a claim of flourishing entails, and why some defiant behavior is central to this theory of flourishing—it counts as good defiance. It argues against Aristotle’s account of human virtue as a function of excellent reasoning and against positive psychology’s conception of mental health as well-being and flourishing. Instead, it identifies features of non-ideal flourishing that are then applied to three people with diagnoses: one with schizophrenia, one with depression, and one with Borderline Personality Disorder. The author then explains how she would evaluate these three cases in terms of their defiant behavior.

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Family Psychoeducation Approaches for Borderline Personality Disorder

10.1093/med/9780199997510.003.0019 ◽

2017 ◽

Author(s):

Valerie Porr

Keyword(s):

Social Support ◽

Treatment Outcome ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Family Members ◽

Borderline Personality ◽

Family Psychoeducation ◽

Improve Treatment ◽

Improve Treatment Outcome ◽

The Family

This chapter provides a rationale for training family members of individuals with borderline personality disorder (BPD) to help them develop into therapeutic allies and treatment adjuncts. It also describes the experiences of family members in finding help for their loved ones with BPD and the family psychoeducation programs currently available for BPD and other disorders. By default, families often are the only alternative available to handle crisis situations since some individuals with BPD refuse to participate in therapy, have dropped out of therapy, or appropriate BPD services are not available in their communities. With an understanding of BPD, social support, and appropriate training, families can potentially develop as adjuncts and that can help improve treatment outcome

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