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.

Recovery from Borderline Personality Disorder

2018 ◽  
pp. 117-128 ◽  
Author(s):  
Mary C. Zanarini
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Full Time ◽  
Important Goal ◽  
Symptomatic Recurrence ◽  
Borderline Patients ◽  
Vocational Functioning ◽  
Symptomatic Remission

As important as our findings concerning the high rates of symptomatic remission and low rates of symptomatic recurrence are, the rates of recovery are even more important. This is so because we defined “recovery” as concurrent symptomatic remission and good social and good full-time vocational functioning. After 10 years of prospective follow-up, 50% of borderline patients achieved this important goal. After 16 years of prospective follow-up, 60% of borderline patients achieved this key outcome. In general, recovery is more difficult to achieve and maintain than remission. Two vignettes are presented in this chapter. The first deals with a patient who remitted but never recovered, and the second deals with a patient who both remitted and recovered.

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.

Mooney Problem Check List Characteristics of DSM-III Borderline Personality Disorder Inpatients

1987 ◽  
Vol 60 (3) ◽  
pp. 907-910
Author(s):  
Wesley M. Pitts ◽  
Quintin L. Gustin ◽  
Scott Snyder ◽  
Walter A. Goodpaster
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Check List ◽  
Personal Problems ◽  
Borderline Patients

Scores on the Mooney Problem Check List, a 288-item, self-administered, listing of common personal problems, for 36 borderline personality disorder inpatients and other inpatients with a diagnosis of other character disorders without borderline features were compared. Borderline patients endorsed 30% of the listing (other personality disorders 19%) and also shared more of the same problems.

Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses

CNS Spectrums ◽  
2003 ◽  
Vol 8 (10) ◽  
pp. 737-754 ◽  
Author(s):  
Linda M. Bierer ◽  
Rachel Yehuda ◽  
James Schmeidler ◽  
Vivian Mitropoulou ◽  
Antonia S. New ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Antisocial Personality ◽  
Abuse And Neglect ◽  
History Of

ABSTRACTBackground:Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.Methods:This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Results:Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.Conclusion:These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.

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