Psychological Treatments for Personality Disorders

2007 ◽  
pp. 641-658 ◽  
Author(s):  
Paul Crits-Christoph ◽  
Jacques P. Barber
Keyword(s):  
Social Skills ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Social Skills Training ◽  
Suicide Ideation ◽  
Skills Training ◽  
Borderline Personality

A Type 2 randomized clinical trial (RCT) of psychosocial treatment for avoidant personality disorder compared three group-administered behavioral interventions (graded exposure, standard social skills training, intimacy-focused social skills training) with a wait-list control; although all three treatments were more efficacious than the control condition, no differences among the treatments were identified either after the 10-week treatment or at follow-up. For the treatment of borderline personality disorder, a Type 1 RCT randomized 101 women with recent suicidal and self-injurious behaviors and borderline personality disorder to either dialectical behavior therapy (DBT) or community-treatment-by-experts psychotherapists (CTBE). Over the 2-year treatment and follow-up period, DBT was superior to CTBE on rates of suicide attempt, hospi-talization for suicide ideation, and overall medical risk (combining suicide attempts and self-injurious acts). Patients in the DBT group were also less likely to drop out of treatment and had fewer psychiatric emergency room visits and fewer psychiatric hospitalizations. There were no significant group differences on measures of depression, reasons for living, and suicide ideation, with patients in both treatment groups improving significantly on these measures. Four additional Type 2 and Type 3 studies support the efficacy of DBT as a treatment for borderline personality disorder with or without comorbid substance abuse or dependence. No RCTs of psychological treatment for other personality disorders have been reported. Several review articles have found a consistent adverse impact of personality disorders on outcomes of treatment for a wide range of Axis I disorders.

THE TREATMENT OF DELIBERATE SELF-HARM IN BORDERLINE PERSONALITY DISORDER USING DIALECTICAL BEHAVIOUR THERAPY: A PILOT STUDY IN A HIGH SECURITY HOSPITAL

2001 ◽  
Vol 29 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Gail Low ◽  
David Jones ◽  
Conor Duggan ◽  
Mick Power ◽  
Andrew MacLeod
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Borderline Personality ◽  
Institutional Setting ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Self Harm

Deliberate self-harm (DSH) presents a significant health problem, especially as treatments have not been particularly successful in reducing repetition. Dialectical behaviour therapy (DBT; Linehan, 1993) is one approach that has reported some success in reducing self-harm rates in borderline personality disorder patients, who self-harm frequently, though it remains largely untested outside its original setting. The present study aimed to assess the effectiveness of DBT in self-harming women in an institutional setting in the United Kingdom where self-harm is common. Female patients at Rampton Hospital who were displaying self-harming behaviour and met criteria for borderline personality disorder (N = 10) participated in the full one-year treatment package of DBT. Patients were assessed on self-harm rates and on a number of psychological variables, pre-, during- and post-therapy, including a 6-month follow-up. There was a significant reduction in DSH during therapy, which was maintained at 6-month follow-up. This was paralleled by a reduction in dissociative experiences and an increase in survival and coping beliefs, alongside improvements in depression, suicide ideation, and impulsiveness. The findings are preliminary but the results suggest that DBT might provide an effective treatment for severe self-harm in institutional settings, and also highlight some of the psychological mechanisms that might mediate these improvements in self-harming behaviour.

The Treatment of Avoidant Personality Disorder by Social Skills Training in the Clinic or in Real-Life Settings

1994 ◽  
Vol 39 (8) ◽  
pp. 377-383 ◽  
Author(s):  
Ariel Stravynski ◽  
Marc Belisle ◽  
Marielle Marcouiller ◽  
Yvon-Jacques Lavallée ◽  
Robert Eue
Keyword(s):  
Social Skills ◽  
Personality Disorder ◽  
Social Skills Training ◽  
Real Life ◽  
Skills Training ◽  
Avoidant Personality Disorder ◽  
End Of Treatment ◽  
Significant Difference ◽  
Long Term Impact

Twenty-eight outpatients who met DSM-III diagnostic criteria for avoidant personality disorder completed 14 one and a half hour sessions of social skills training in the clinic only or a combination of four sessions in the clinic, four sessions in real-life and six follow-up sessions in the clinic. Subjects were assessed before treatment began, after four sessions, at the end of treatment and at three month follow-up points. Training in real-life did not enhance social skills training; no significant difference between the groups at any assessment points was found. In both groups improvement in time was significant and clinically worthwhile. The treatment effects were maintained up to the three month follow-up, where available. Social skills training appears to be a useful and promising intervention for avoidant personality disorder but its long term impact remains to be investigated.

Treatment Attitude and Therapy Outcome in Patients With Borderline Personality Disorder

2008 ◽  
Vol 22 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Amy Wenzel ◽  
Elizabeth L. Jeglic ◽  
Hollie J. Levy-Mack ◽  
Aaron T. Beck ◽  
Gregory K. Brown
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Preliminary Evidence ◽  
Borderline Personality ◽  
Therapy Outcome ◽  
Future Research ◽  
Positive Attitudes ◽  
Two Measures

This study investigated the degree to which two ways of defining attitude toward treatment (i.e., attitude toward talking with a therapist about problems, expectation for improvement) predicted therapy outcome. The sample consisted of 28 patients who participated in an open clinical trial evaluating the efficacy of cognitive therapy for borderline personality disorder and who completed assessments at baseline and 12-month follow-up (Brown, Newman, Charlesworth, Crits-Cristoph, & Beck, 2004). When attitude toward treatment was defined as attitude toward talking with a therapist, this variable predicted suicide ideation and scores on two measures of depression at the 12-month assessment. When attitude toward treatment was defined as expectation for improvement, this variable predicted scores on one measure of depression and number of borderline personality disorder criteria met at the 12-month assessment. These results provide preliminary evidence that positive attitudes toward treatment are associated with more clinical improvement, although future research should replicate this finding with a better developed measure of treatment attitudes.

Predictors of Slower Time-to-Cessation of Individual Therapy for Borderline Patients Over 16 Years of Prospective Follow-Up

2019 ◽  
Vol 33 (1) ◽  
pp. 135-144
Author(s):  
Dana B. Borkum ◽  
Frances R. Frankenburg ◽  
Garrett M. Fitzmaurice ◽  
Argyro Athanasiadi ◽  
Christina M. Temes ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Childhood Adversity ◽  
Borderline Personality ◽  
Individual Therapy ◽  
Childhood Neglect ◽  
Borderline Patients ◽  
History Of

The current study assesses time-to-cessation of individual therapy for patients with borderline personality disorder (BPD) and comparison subjects with other personality disorders (OPD) after 16 years of prospective follow-up. It also details the multivariate factors that predict this outcome for those with BPD. At baseline, 290 patients met criteria for BPD and 72 met criteria for OPD. Individuals with BPD had a significantly slower time-to-cessation of individual therapy than OPD comparison subjects. Seven baseline variables were found to be significant multivariate predictors of a slower time-to-cessation of individual therapy: older age, being white, severity of childhood neglect, history of a mood disorder, an IQ less than 90, poor vocational record prior to index admission, and higher level of trait neuroticism. The results of this study suggest that prediction of slower time-to-cessation of individual therapy is multifactorial in nature, involving factors related to demographics, childhood adversity, comorbidity, individual competence, and temperament.

Predictors of 18-month outcome for patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1026-1026 ◽  
Author(s):  
D. Karaklic ◽  
J. Thuile ◽  
B. Granger ◽  
I. Secret ◽  
C. Bungener
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Life Events ◽  
Borderline Personality ◽  
Self Report ◽  
Global Functioning ◽  
Borderline Patients

IntroductionFor quite a long time, borderline personality disorder (BPD) has been viewed as a chronic disorder and borderline patients as extremely difficult to treat. However, those views are changing and there is an increasing recognition that the BPD has a far more benign course than previously thought, but predictors of its outcome remain poorly explored.Objective and aimsThe purpose of this study was to determine the most clinically relevant predictors of the outcome of BPD at the 18-month follow-up.MethodsBorderline patients (n = 75) were compared to patients with other personality disorders (OPD) (n = 40). All subjects were assessed at baseline and 6, 12, and 18 months with a series of semi structured interviews (personality disorders, global functioning, mental disorders, life events, …) and self-report measures (alexithymia and impulsivity). Logistic regression was used to estimate hazard ratios.ResultsAt the 18-month follow up, 57 BPD patients and 22 with OPD have been evaluated, 45% of borderline subjects and 50% of the OPD subjects achieved remission. Low impulsivity, low alexithymia, good global functioning, and older age at onset of symptoms were found to be significant predictors of good outcome of BPD. Our clinical data suggest that life events and the quality of current relationships are determinant in the outcome of BPD.Conclusions45% of patients with BPD are likely to improve in 18-months. Specific factors, such as impulsivity, alexithymia, life events and quality of current relationships, determine the short-term outcome of this disorder.

scholarly journals Dialectical Behavior Therapy and Emotion Regulation Changes in Patients with Borderline Personality Disorder in Delta Region of Egypt

2021 ◽  
pp. 96-104
Author(s):  
Noha F. M. Fnoon ◽  
Mai A. Eissa ◽  
Ehab E. Ramadan ◽  
Hossam E. El-Sawy ◽  
Ahmed M. A. Abd El-Karim
Keyword(s):  
Emotion Regulation ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Skills Training ◽  
Borderline Personality ◽  
Delta Region ◽  
Treatment As Usual

Background: Researchers have proved the role of dialectical behavior therapy (DBT) in improving emotion regulation skills in patients with borderline personality disorder (BPD). Further researches for its effect in different cultures was needed. The current study aimed to examine the effectiveness of DBT relative to treatment as usual “TAU” in improving emotional regulation in BPD patients of the delta region of Egypt. Subjects and Methods: We conducted a prospective, comparative, non-randomized study. Eligible patients were assigned at their convenience or according to the immediate availability of treatment slots to a comprehensive DBT program integrating DBT skills into skills training schedule or treatment as usual (TAU). Patients were assessed at baseline, and follow up assessment at 4, 8, 12, and 16 months was done using the Arabic version of, Difficulties in Emotion Regulation Scale (DERS), Results: DBT patients showed better and lower scores of emotion regulation and distress tolerance scales in comparison to TAU. Overall, these positive outcomes were maintained in follow-up for four months post-treatment year. Conclusions: We provide the superior efficacy of DBT in improving emotion regulation in delta region's patients with BPD in comparison to TAU.

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