Ear Acupuncture for Co-Occurring Substance Abuse and Borderline Personality Disorder: An Aid to Encourage Treatment Retention and Tobacco Cessation

2014 ◽  
Vol 32 (4) ◽  
pp. 318-324 ◽  
Author(s):  
Elizabeth B Stuyt
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Tobacco Cessation ◽  
Treatment Effectiveness ◽  
Borderline Personality ◽  
Ear Acupuncture ◽  
Successful Completion ◽  
And Gender ◽  
Evidenced Based ◽  
Dual Diagnosis Treatment

Objectives Retention of individuals with co-occurring borderline personality disorder (BPD) and substance use disorders in treatment is known to be difficult. An outcome study of a tobacco-free 90-day inpatient dual-diagnosis treatment programme that uses several evidenced-based treatments in addition to ear acupuncture (acudetox) was undertaken to determine overall treatment effectiveness. Methods Between January 2009 and December 2011, 231 patients were treated in the programme, 88% with nicotine dependence and 79% with personality disorder diagnoses. All patients completing the programme were invited to enrol in a 1-year follow-up study in which they responded to monthly questionnaires to assess outcomes. Results 185 patients (80%) successfully completed the programme. There was no correlation between successful programme completion and gender, race, age, primary drug dependence diagnosis or primary psychiatric diagnosis. The use of acudetox was positively correlated with successful completion (p=0.006). Of the 78 patients with BPD, 100% of men and 83% of women successfully completed the programme. Their use of acudetox was positively correlated with successful completion (p=0.026). At the end of the year, 140 questionnaires were returned: 51 patients with BPD reported outcomes similar to the group as a whole, with 55% sober and doing well. Conclusions The use of acudetox was positively correlated with both successful completion of the programme for those with BPD as well as successful tobacco cessation, which ultimately improves the ability to maintain sobriety.

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.

Borderline Personality Disorder

2017 ◽  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Management ◽  
Clinical Presentation ◽  
Early Stage ◽  
Significant Proportion ◽  
Borderline Personality ◽  
Self Injury ◽  
Evidenced Based

Until recently, borderline personality disorder (BPD) has been the stepchild of psychiatric disorders. Many researchers even questioned its existence. Clinicians have been reluctant to reveal the diagnosis to patients because of the stigma attached to it. But individuals with BPD suffer terribly and a significant proportion die by suicide and engage in nonsuicidal self-injury. The aim of this primer on BPD is to fill this void and provide clinicians with an accessible, easy-to-use, clinically oriented, evidenced-based guide for early-stage BPD. We present the most up to date data about BPD by leading experts in the field in a format accessible to trainees and professionals working with individuals with BPD and their family members. The volume is comprehensive and covers the etiology of BPD, its clinical presentation and comorbid disorders, genetics and neurobiology of BPD, effective treatment approaches to BPD, the role of advocacy, and the treatment of special subpopulations (e.g., forensic) in the clinical management of BPD.

Sexual Orientation and Gender of Intimate Relationship Partners Among Adolescents With BPD and Psychiatrically Healthy Adolescents

2020 ◽  
pp. 1-7
Author(s):  
Mary C. Zanarini ◽  
Laura R. Magni ◽  
Christina M. Temes ◽  
Katherine E. Hein ◽  
Blaise A. Aguirre ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Intimate Relationships ◽  
Intimate Relationship ◽  
Borderline Personality ◽  
Relationship Partners ◽  
Semistructured Interviews ◽  
Same Gender ◽  
And Gender

The first aim of this study was to describe reported sexual orientation in a group of adolescents diagnosed with borderline personality disorder compared to a group of psychiatrically healthy adolescents. The second purpose was to compare data on dating and gender of dating partners in the same two groups. Two semistructured interviews, which assessed sexual orientation, dating history, and gender of dating partners, were administered to 104 borderline adolescents and 60 psychiatrically healthy comparison subjects. Borderline adolescents were significantly more likely than comparison subjects to report having a gay/lesbian/bisexual orientation. They also were significantly more likely to date and to report dating a same-gender partner or same- and other-gender partners than comparison subjects. The results of this study suggest that same-gender attraction and/or intimate relationships may be an important interpersonal issue for approximately one-third of adolescents with BPD.

The Blending of Evidenced-Based Protocols in the Treatment of Borderline Personality Disorder

2016 ◽  
Vol 15 (5) ◽  
pp. 392-408
Author(s):  
James P. Loveless ◽  
Matthew C. Whited ◽  
Ashley C. Rhodes ◽  
Tony Cellucci
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Evidenced Based

Dialectical Behavior Therapy for Borderline Personality Disorder and Suicidality Among Sexual and Gender Minority Individuals

2019 ◽  
pp. 408-429
Author(s):  
David W. Pantalone ◽  
Colleen A. Sloan ◽  
Adam Carmel
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Suicidal Behavior ◽  
Borderline Personality ◽  
Gender Minority ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
Lgbt Individuals

Population-based estimates of borderline personality disorder (BPD) prevalence in lesbian, gay, bisexual, and transgender (LGBT) individuals are lacking. However, epidemiologic data point to high rates of suicidality, including suicide attempts and self-harm, for LGBT individuals—likely due to the high levels of stigma and discrimination that sexual and gender minority individuals experience. The first-line treatment for BPD and suicidal behavior is dialectical behavior therapy (DBT)—a cognitive–behavioral treatment with an emphasis on skills training, based on a biosocial model of disordered behavior—which aims to help clients end suicidal behavior, improve emotion regulation capabilities, and build a “life worth living.” Despite a lack of empirical support, a DBT conceptualization is highly consistent theoretically with the tenets of LGBT-affirmative therapy. This chapter discusses areas of convergence between the biosocial model and the minority stress model, and it presents two case studies of the application of DBT to LGBT clients.

Dialectical Behavior Therapy for Borderline Personality Disorder

2019 ◽  
pp. 257-283
Author(s):  
Heidi L. Heard ◽  
Marsha M. Linehan
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Empirical Support ◽  
Borderline Personality ◽  
Behavioral Theory ◽  
Biosocial Theory ◽  
Clinical Disorders ◽  
Evidenced Based

This chapter elaborates on the multiple integrative aspects of dialectical behavior therapy (DBT), an evidenced-based treatment for individuals who meet criteria for borderline personality disorder (BPD). It discusses how behavioral theory, Zen, and dialectics provide the primary principles and describes how the dialectical principles perform various integrating roles throughout the therapy. It also clarifies the construct of traumatic invalidation, a component of the treatment’s biosocial theory. The section on methods describes key therapeutic strategies, including problem-solving and validation. A case example illustrates the dialectical and integrative nature of the treatment. The chapter also reviews the results of randomized controlled trials examining the efficacy of DBT for BPD and identifies the settings, ages, and other clinical disorders for which the treatment also has empirical support.

Substance Use in Youth With Borderline Personality Disorder

2018 ◽  
Vol 32 (5) ◽  
pp. 603-617
Author(s):  
Franco Scalzo ◽  
Carol A. Hulbert ◽  
Jennifer K. Betts ◽  
Sue M. Cotton ◽  
Andrew M. Chanen
Keyword(s):  
Substance Use ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
General Population ◽  
Help Seeking ◽  
Population Sample ◽  
Borderline Personality ◽  
High Rate ◽  
The Past ◽  
And Gender

Co-occurring substance misuse and borderline personality disorder (BPD) in adults is associated with more severe dysfunction and poorer prognosis than BPD alone. However, it is unknown to what extent substance use in youth with BPD is normative for this age group or pathological. This study compared substance use in 117 help-seeking youth (aged 15–25 years) with their first presentation for treatment of BPD, with an epidemiological general population sample and with healthy, age- and gender-matched controls. Established instruments were used to diagnose BPD and assess substance use. Alcohol dependence, daily tobacco use, and use of illicit substances in the past month were between four and nine times more prevalent in the BPD group than in the general population. Similarly, the prevalence of substance use was disproportionately higher in youth with BPD than in matched controls. The findings indicate a non-normative, alarmingly high rate of substance use among youth with BPD.

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