scholarly journals Assessing the efficacy of a stepped-care group treatment programme for borderline personality disorder: study protocol for a pragmatic trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Judy A. Pickard ◽  
Adam Finch ◽  
Elizabeth Huxley ◽  
Michelle L. Townsend ◽  
Stephanie Deuchar ◽  
...  
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Health Services ◽  
Group Treatment ◽  
Pragmatic Trial ◽  
Borderline Personality ◽  
Stepped Care ◽  
Care Group

Abstract Background Borderline personality disorder (BPD) is a high prevalence and serious mental health disorder that has historically challenged the finite resources of health services. Despite empirical evidence supporting structured psychological therapy as the first line of treatment, there remains significant barriers in providing timely access to evidence-based treatment for this population. The primary aim of this study is to evaluate the effectiveness of providing a stepped-care structured psychological group treatment to individuals with BPD within local mental health services. The secondary aims of the study are to identify the variables that predict the need to step up or down in care and the effectiveness of treatment on psychosocial functioning. Methods Participants seeking treatment at two community mental health services will be invited to participate. Randomised controlled trial assignment will be to either (i) group skills treatment or (ii) treatment as usual. Group treatment will be offered via a stepped-care pathway with participants initially attending a 12-week group with the option of a subsequent 16-week group. The criteria for inclusion in continuing treatment includes meeting > 4 BPD diagnostic criteria or severity on GAF (< 65) at the completion of the 12-week group. Data will be collected at baseline and at five follow-up time points over a 12-month period. Discussion This pragmatic trial will provide valuable information regarding the effectiveness of a progressive stepped-care group treatment for individuals with BPD in the real-world setting of a community mental health service. It will further the current understanding of variables that predict treatment dose and duration. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018

Effects of a modified DBT Skills Group for military personnel and Veterans with OSIs and borderline personality disorder or traits

2021 ◽  
pp. e20190067
Author(s):  
Pamela L. Holens ◽  
Jeremiah N. Buhler ◽  
Stephanie Yacucha ◽  
Alyssa Romaniuk ◽  
Brent Joyal
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Military Personnel ◽  
Group Treatment ◽  
Stress Disorder ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Negative Thoughts ◽  
Skills Group

LAY SUMMARY This study looked at the use of a group treatment known as dialectical behaviour therapy skills group (DBT-SG) to see if it was helpful for military personnel and veterans who had a variety of mental health disorders related to their service. The results of the study showed improvements in symptoms of borderline personality disorder, reductions in negative thoughts and feelings, and reductions in unhelpful behaviours. Results also showed improvements in all examined areas of functioning among participants, with the largest change occurring in the area of social functioning. The presence of posttraumatic stress disorder (PTSD), depression, or chronic pain did not impact results, but the presence of a substance abuse disorder did. Overall, the results provide preliminary support for DBT-SG as an intervention for borderline personality disorder symptoms among military and veterans, and perhaps particularly for persons who also have other mental health challenges, or persons considered inappropriate for other treatment.

Low Vocational Outcome Among People Diagnosed With Borderline Personality Disorder During First Admission to Mental Health Services in Denmark: A Nationwide 9-Year Register-Based Study

2019 ◽  
Vol 33 (3) ◽  
pp. 326-340 ◽  
Author(s):  
Lene Halling Hastrup ◽  
Mickey T. Kongerslev ◽  
Erik Simonsen
Keyword(s):  
Mental Health ◽  
Labor Market ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Borderline Personality ◽  
Vocational Outcome ◽  
First Admission

Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.

Borderline Personality Disorder

2017 ◽  
pp. 199-204
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Poor Prognosis ◽  
Social Supports ◽  
Borderline Personality ◽  
Definitive Trial ◽  
Interpersonal Situations

Borderline personality disorder (BPD) is a prevalent, debilitating syndrome. Patients with BPD heavily utilize mental health services and have historically had a poor prognosis. In the IPT adaptation for BPD, the therapist presents BPD to the patient as a poorly named syndrome that has a significant depressive component. The goals of IPT in this population are threefold: to link mood (including anger) to interpersonal situations, to find better ways of handling such situations, and to build better social supports and skills. When patient–therapist problems crop up, the therapist addresses them in a here-and-now, interpersonal fashion rather than making psychodynamic interpretations. Because patients with BPD are sensitive to abandonment, termination is discussed early and often. Research on the use of IPT in patients with BPD is tantalizing but fragmentary, in need of a larger and more definitive trial.

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