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.

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 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.

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

Benchmarks for Outpatient Dialectical Behavioral Therapy in Adults With Borderline Personality Disorder

2016 ◽  
Vol 28 (8) ◽  
pp. 895-906
Author(s):  
Micki Washburn ◽  
Allen Rubin ◽  
Shu Zhou
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Control Treatment ◽  
Dialectical Behavioral Therapy ◽  
Group Effect ◽  
Treatment As Usual

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of dialectical behavioral therapy (DBT) for borderline personality disorder (BPD) in adults aged 18–65 years. Method: Within-group effect sizes were calculated via the Glass approach and adjusted for sample size using Hedges’s g then aggregated to produce benchmarks for symptoms commonly associated with BPD, such as self-harm, depression, and anger. Results: Aggregate within-group effect sizes are presented separately for treatment (DBT) and control (treatment as usual) groups and for interviewer assessed and self-reported outcome measures. Discussion: Community-based practitioners can use these benchmarks as a comparison tool to evaluate the ways in which they are adopting or adapting the DBT intervention and to determine if the intervention should be modified or replaced, given their unique practice setting and client population.

Autobiographical Memory Impairment in Borderline Personality Disorder: A Quantitative Meta-Analysis Interpreted in Terms of the CaR-FA-X Model

2019 ◽  
Vol 33 (6) ◽  
pp. 818-831 ◽  
Author(s):  
Eszter Beran ◽  
Mara J. Richman ◽  
Zsolt Unoka
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Autobiographical Memory ◽  
Executive Control ◽  
Memory Impairment ◽  
Memory Performance ◽  
Meta Analysis ◽  
Demographic Variables ◽  
Borderline Personality ◽  
Effect Sizes

Borderline personality disorder (BPD) is characterized by impaired functioning of autobiographical memory (AM). We use a quantitative meta-analysis to assess AM performance in adults diagnosed with BPD as compared to healthy controls (HC). Moderator variables included type of autobiographical memory as well as clinical and demographic variables. Large significant deficits were seen in the BPD group in comparison to the HC group. In the BPD group, effect sizes were large for overgenerality, omission, and specific memories, while not significant for recall. Age influenced the performance of the BPD group; in addition, there was a significant interaction between age and specificity of memory. Gender and IQ did not influence memory performance. Our results confirm that BPD patients show impairment in AM. We explain these impairments in terms of the CaR-FA-X model, based on mechanisms of capture and rumination, functional avoidance, and impaired executive control.

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.

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