Psychological Treatments for Personality Disorders

2015 ◽  
Author(s):  
Paul Crits-Christoph ◽  
Jacques P. Barber
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Meta Analysis ◽  
Skills Training ◽  
Borderline Personality ◽  
Single Type ◽  
Treatment As Usual ◽  
Behavioral Techniques

For the treatment of borderline personality disorder, a meta-analysis found statistically significant effects indicating a beneficial effect of dialectical behavior therapy (DBT) over treatment as usual for reduction in anger, parasuicidality, and mental health. All of these effects were moderate to large. However, DBT is not uniquely effective for borderline personality disorder. Two type 1 randomized controlled trials found equal effects for versions of psychodynamic therapy. Single type 1 studies have also supported the efficacy, compared to treatment as usual, of cognitive therapy, schema therapy, and Systems Training for Emotional Predictability and Problem Solving (STEPPS, a therapy that combines cognitive-behavioral techniques and skills training with a systems component) as treatments for borderline personality disorder.

scholarly journals Effectiveness of Psychological Treatments for Borderline Personality Disorder and Predictors of Treatment Outcomes: A Multivariate Multilevel Meta-Analysis of Data from All Design Types

2021 ◽  
Vol 10 (23) ◽  
pp. 5622
Author(s):  
Sophie A. Rameckers ◽  
Rogier E. J. Verhoef ◽  
Raoul P. P. P. Grasman ◽  
Wouter R. Cox ◽  
Arnold A. P. van Emmerik ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Treatment Effectiveness ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Sensitivity Analyses ◽  
Treatment As Usual ◽  
Logarithmic Relationship

We examined the effectiveness of psychotherapies for adult Borderline Personality Disorder (BPD) in a multilevel meta-analysis, including all trial types (PROSPERO ID: CRD42020111351). We tested several predictors, including trial- and outcome type (continuous or dichotomous), setting, BPD symptom domain and mean age. We included 87 studies (N = 5881) from searches between 2013 and 2019 in four databases. We controlled for differing treatment lengths and a logarithmic relationship between treatment duration and effectiveness. Sensitivity analyses were conducted by excluding outliers and by prioritizing total scale scores when both subscale and total scores were reported. Schema Therapy, Mentalization-Based Treatment and reduced Dialectical Behavior Therapy were associated with higher effect sizes than average, and treatment-as-usual with lower effect sizes. General severity and affective instability showed the strongest improvement, dissociation, anger, impulsivity and suicidality/self-injury the least. Treatment effectiveness decreased as the age of participants increased. Dichotomous outcomes were associated to larger effects, and analyses based on last observation carried forward to smaller effects. Compared to the average, the highest reductions were found for certain specialized psychotherapies. All BPD domains improved, though not equally. These findings have a high generalizability. However, causal conclusions cannot be drawn, although the design type did not influence the results.

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.

Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents

2019 ◽  
Vol 33 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Arne Buerger ◽  
Gloria Fischer-Waldschmidt ◽  
Florian Hammerle ◽  
Kristin von Auer ◽  
Peter Parzer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Suicide Attempts ◽  
Treatment Options ◽  
Skills Training ◽  
Borderline Personality ◽  
Secondary Outcomes ◽  
The Impact

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.

scholarly journals Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis

2018 ◽  
Vol 52 (10) ◽  
pp. 949-961 ◽  
Author(s):  
Matthijs Oud ◽  
Arnoud Arntz ◽  
Marleen LM Hermens ◽  
Rogier Verhoef ◽  
Tim Kendall
Keyword(s):  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Confidence Interval ◽  
Dialectical Behavior Therapy ◽  
Borderline Personality ◽  
Medium Effect ◽  
Treatment As Usual ◽  
Standardized Mean Difference ◽  
Quality Evidence

Objective: Borderline personality disorder affects up to 2% of the population and is associated with poor functioning, low quality of life and increased mortality. Psychotherapy is the treatment of choice, but it is unclear whether specialized psychotherapies (dialectical behavior therapy, mentalization-based treatment, transference-focused therapy and schema therapy) are more effective than non-specialized approaches (e.g. protocolized psychological treatment, general psychiatric management). The aim of this systematic review is to investigate the effectiveness of these psychotherapies. Methods: PubMed, PsycINFO, CINAHL, EMBASE and CENTRAL were searched from inception to November 2017. Included randomized controlled trials were assessed on risk of bias and outcomes were meta-analyzed. Confidence in the results was assessed using the Grading of Recommendations Assessment, Development and Evaluation method. The review has been reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 20 studies with 1375 participants were included. Specialized psychotherapies, when compared to treatment as usual or community treatment by experts, were associated with a medium effect based on moderate quality evidence on overall borderline personality disorder severity (standardized mean difference = –0.59 [95% confidence interval: –0.90, –0.28]), and dialectical behavior therapy, when compared to treatment as usual, with a small to medium effect on self-injury (standardized mean difference = –0.40 [95% confidence interval: –0.66, –0.13]). Other effect estimates were often inconclusive, mostly due to imprecision. Conclusion: There is moderate quality evidence that specialized psychotherapies are effective in reducing overall borderline personality disorder severity. However, further research should identify which patient groups profit most of the specialized therapies.

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

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.

A meta-analysis of treatment as usual for borderline personality disorder.

2019 ◽  
Vol 10 (6) ◽  
pp. 491-499 ◽  
Author(s):  
Ellen F. Finch ◽  
Evan A. Iliakis ◽  
Sara R. Masland ◽  
Lois W. Choi-Kain
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Treatment As Usual

scholarly journals Dialectical behavior therapy as treatment for borderline personality disorder

2016 ◽  
Vol 6 (2) ◽  
pp. 62-67 ◽  
Author(s):  
Jennifer M May ◽  
Toni M Richardi ◽  
Kelly S Barth
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Psychiatric Symptoms ◽  
Sense Of Self ◽  
Skills Training ◽  
Borderline Personality ◽  
Adjunctive Treatment ◽  
Telephone Consultation

Abstract Dialectical behavior therapy (DBT) is a structured outpatient treatment developed by Dr Marsha Linehan for the treatment of borderline personality disorder (BPD). Dialectical behavior therapy is based on cognitive-behavioral principles and is currently the only empirically supported treatment for BPD. Randomized controlled trials have shown the efficacy of DBT not only in BPD but also in other psychiatric disorders, such as substance use disorders, mood disorders, posttraumatic stress disorder, and eating disorders. Traditional DBT is structured into 4 components, including skills training group, individual psychotherapy, telephone consultation, and therapist consultation team. These components work together to teach behavioral skills that target common symptoms of BPD, including an unstable sense of self, chaotic relationships, fear of abandonment, emotional lability, and impulsivity such as self-injurious behaviors. The skills include mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Given the often comorbid psychiatric symptoms with BPD in patients participating in DBT, psychopharmacologic interventions are oftentimes considered appropriate adjunctive care. This article aims to outline the basic principles of DBT as well as comment on the role of pharmacotherapy as adjunctive treatment for the symptoms of BPD.

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