Ten-week Intensive Group Program (IGP) for borderline personality disorder: making the case for more accessible and affordable psychotherapy

2021 ◽  
pp. ebmental-2020-300195
Author(s):  
Dervila Gec ◽  
Jillian Helen Broadbear ◽  
David Bourton ◽  
Sathya Rao
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Symptom Severity ◽  
Integrated Treatment ◽  
Borderline Personality ◽  
Self Report ◽  
Evidence Based ◽  
Short Term ◽  
Intensive Group

BackgroundThe availability of specialist psychotherapies for treating borderline personality disorder (BPD) is limited by costs associated with training, resourcing and treatment duration. Developing a programme that incorporates effective strategies from a range of evidence-based specialist treatments, concentrates their delivery and uses a group-based format will improve treatment access.ObjectiveTo assess the short-term clinical efficacy, acceptability and feasibility of a bespoke manualised programme for the treatment of BPD. This 10-week group-based outpatient programme was delivered 2 days per week in 4 hour sessions; participants received 80 hours of treatment in total.MethodsForty-three participants, many having severe BPD symptomatology, were assessed before and after the 10-week programme using a range of validated self-report questionnaires and a self-appraisal feedback form. The primary outcome measured was BPD symptom severity.FindingsStatistically significant improvements were measured in BPD symptom severity, depression, trait anxiety, emotional regulation, general health, hopefulness, self-compassion and anger, several with moderate to large effect sizes. Many of these improvements remained at 4–6 months post treatment. More than 90% of surveyed participants expressed a moderate or high level of satisfaction with the programme.ConclusionsThis integrated treatment programme delivered in a highly concentrated format demonstrated short-term efficacy across many BPD-relevant endpoints; its acceptability was endorsed by most clients.Clinical implicationsIncorporation of key aspects of evidence-based treatment using a time-intensive group format could greatly enhance the capacity of mental health services to meet the needs of people who experience BPD within a population-based mental health service framework.

scholarly journals Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Vera Flasbeck ◽  
Stoyan Popkirov ◽  
Andreas Ebert ◽  
Martin Brüne
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Evoked Potentials ◽  
Symptom Severity ◽  
Emotional Awareness ◽  
Borderline Personality ◽  
Self Report ◽  
Interoceptive Awareness ◽  
Future Research ◽  
Healthy Controls

Abstract Background Patients with borderline personality disorder (BPD) experience difficulties in emotional awareness (alexithymia), and often develop dissociative symptoms, which may reflect broader deficits in interoceptive awareness. Whether this is associated with alterations in cortical processing of interoception is currently unknown. Methods We utilized an electrophysiological marker of interoception, i.e. heartbeat-evoked potentials (HEP), and examined its relationship with electrocardiographic correlates of autonomic nervous system (ANS) functioning (heart rate variability), and with self-report measures of alexithymia, dissociation and borderline symptom severity in patients with BPD. Results Individuals with BPD had higher HEP amplitudes over frontal electrodes compared to healthy controls. Sympathetic ANS activity was greater in BPD patients than in controls. Across groups, HEP amplitudes were associated with parasympathetic activity over central electrodes and correlated with alexithymia over frontal electrodes. Conclusions These findings support the idea that difficulties in emotional awareness in BPD are reflected in altered frontal electrophysiological markers of interception. Therefore, emotional awareness can be understood as failures of modulation between interoceptive and exteroceptive attention. Future research may aim to investigate whether altered interoception and its electrophysiological correlates are malleable by therapeutic intervention.

Affective and Behavioral Characteristics of Adolescent and Adult Borderline Personality Disorder

2020 ◽  
pp. 1-11
Author(s):  
Nicole D. Cardona ◽  
Christina M. Temes ◽  
Laura R. Magni ◽  
Katherine E. Hein ◽  
Blaise A. Aguirre ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Symptom Severity ◽  
Borderline Personality ◽  
Self Report ◽  
Behavioral Characteristics ◽  
Typically Developing ◽  
Adolescents And Adults ◽  
Affective Lability ◽  
Symptom Measures

Adults with borderline personality disorder (BPD) report greater affective lability, impulsivity, and aggression compared to same-age peers, but no studies have examined whether these findings are replicable among adolescents with BPD and their peers, or whether adolescents and adults with BPD report symptoms of comparable severity. One hundred and one adolescent (age 13–17) BPD inpatients and 60 age-matched, psychiatrically healthy adolescents completed self-report measures for affective lability, impulsivity, and aggression. Comparison samples included 29 and 41 adult outpatients with BPD and 127 community adults with BPD. Adolescents with BPD reported greater severity of all symptoms except nonplanning impulsiveness compared to peers. They reported similar symptom severity to adults but reported less severe verbal aggression and anger. Adolescents with BPD are distinguishable from typically developing adolescents on self-reported, dimensional affective and behavioral symptom measures, and may experience these symptoms at comparable severity to adult counterparts.

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

2020 ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

scholarly journals Therapeutic interventions in primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

2020 ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Evidence Based ◽  
Data Set ◽  
Evidence Based Guidelines

Abstract Background This study aimed to investigate what therapeutic interventions are currently being applied by clinicians working with young people who have a diagnosis of Borderline Personality Disorder or borderline traits. Given the current lack of evidence-based guidelines with this client population, investigating what is occurring currently is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning with these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centres across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the sort of intervention used at each client session and outcome measures routinely captured were analysed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based guidelines for early intervention in young people with borderline personality disorder.

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

Attitudes Toward Borderline Personality Disorder: A Survey of 706 Mental Health Clinicians

CNS Spectrums ◽  
2011 ◽  
Vol 16 (3) ◽  
pp. 67-74 ◽  
Author(s):  
Donald W. Black ◽  
Bruce Pfohl ◽  
Nancee Blum ◽  
Brett McCormick ◽  
Jeff Allen ◽  
...  
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Social Workers ◽  
The United States ◽  
Borderline Personality ◽  
Staff Nurses ◽  
Self Report ◽  
Mental Health Clinicians ◽  
Care Providers

AbstractObjectiveWe sought to determine attitudes toward patients with borderline personality disorder (BPD) among mental health clinicians at nine academic centers in the United States.MethodsA self-report questionnaire was distributed to 706 mental health clinicians, including psychiatrists, psychiatry residents, social workers, nurses, and psychologists.ResultsThe study showed that most clinicians consider BPD a valid diagnosis, although nearly half reported that they preferred to avoid these patients. The clinician's occupational subgroup was significantly related to attitude. Staff nurses had the lowest self-ratings on overall caring attitudes, while social workers had the highest. Social workers and psychiatrists had the highest ratings on treatment optimism. Social workers and psychologists were most optimistic about psychotherapy effectiveness, while psychiatrists were most optimistic about medication effectiveness. Staff nurses had the lowest self-ratings on empathy toward patients with BPD and treatment optimism.DiscussionNegative attitudes persist among clinicians toward BPD, but differ among occupational subgroups. Overall, caring attitudes, empathy, and treatment optimism were all higher among care providers who had cared for a greater number of BPD patients in the past 12 months.ConclusionThese findings hold important implications for clinician education and coordination of care for patients with BPD.

Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Coping Styles ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Coping Behaviors ◽  
Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

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