BackgroundThe short form of the Borderline Symptom List (BSL-23) is a self-rating instrument used to assess specific symptoms of borderline personality disorder (BPD). The original German version has shown good psychometric proprieties. The BSL-23 can also be used to measure the effects of therapy on patients with BPD. The aim of this study was to assess the psychometric properties of the French version of the BSL-23.MethodsThe French version of the BSL-23 was given to 265 subjects with BPD. Factor structure, reliability, test-retest stability, convergent validity, divergent validity, and sensitivity to change were analysed. Forty-five subjects suffering from attention-deficit hyperactivity disorder (ADHD) were used as controls to evaluate the specificity of BSL-23.ResultsA one-factor structure was obtained in the French version of the BSL-23, showing high internal consistency (Cronbach’s alpha = .94) and test-retest reliability (r = .841). The French version of the BSL-23 was highly correlated with depression severity, hopelessness, anger, motor impulsiveness, and BPD diagnosis. It was an efficient tool to discriminate between BPD patients and ADHD patients, and showed good sensitivity to change in a group of BPD patients who took part in a one-month DBT intervention.ConclusionsThe French version of the BSL-23 shows similar psychometric properties as the original German version. This study therefore provides clinicians and researchers with a French instrument to measure BPD symptomatology.
Résumé
Objectif:
La pandémie due à la COVID-19 a impacté l’accessibilité à la psychothérapie pour des patients particulièrement vulnérables pendant la période de confinement. Nous présentons les adaptations d’un programme de thérapie comportementale dialectique et les conséquences du confinement sur le vécu de patients souffrant d’un trouble de personnalité borderline.
Méthode:
Nous avons, pour sept patients, comparé deux périodes de huit semaines, avant et pendant le confinement. Nous avons analysé leurs cartes journalières (n = 426) et le recensement hebdomadaire de la fréquence de leurs comportements problèmes (n = 69).
Résultats:
L’analyse des cartes journalières indique que la période de confinement prédit une diminution significative des sentiments de peur, de honte ou culpabilité et de tension mais une augmentation de la détresse. Le suivi hebdomadaire montre une diminution significative des comportements hyperphagiques.
Discussion:
Malgré le petit nombre de patients inclus, cette étude se base sur des échantillonnages d’expérience au quotidien et des mesures hebdomadaires. Ces deux types de mesures répétées indiquent certaines améliorations pendant le confinement, attestant des capacités d’adaptation de ces patients, soutenus par un cadre thérapeutique intensif poursuivi qui a été maintenu.
Objective“Michael’s game” (MG) is a card game targeting the ability to generate alternative hypotheses to explain a given experience. The main objective was to evaluate the effect of MG on delusional conviction as measured by the primary study outcome: the change in scores on the conviction subscale of the Peters delusions inventory (PDI-21). Other variables of interest were the change in scores on the distress and preoccupation subscales of the PDI-21, the brief psychiatric rating scale, the Beck cognitive insight scale, and belief flexibility assessed with the Maudsley assessment of delusions schedule (MADS).MethodsWe performed a parallel, assessor-blinded, randomized controlled superiority trial comparing treatment as usual plus participation in MG with treatment as usual plus being on a waiting list (TAU) in a sample of adult outpatients with psychotic disorders and persistent positive psychotic symptoms at inclusion.ResultsThe 172 participants were randomized, with 86 included in each study arm. Assessments were performed at inclusion (T1: baseline), at 3 months (T2: post-treatment), and at 6 months after the second assessment (T3: follow-up). At T2, a positive treatment effect was observed on the primary outcome, the PDI-21 conviction subscale (p = 0.005). At T3, a sustained effect was observed for the conviction subscale (p = 0.002). Further effects were also observed at T3 on the PDI-21 distress (p = 0.002) and preoccupation subscales (p = 0.001), as well as on one of the MADS measures of belief flexibility (“anything against the belief”) (p = 0.001).ConclusionThe study demonstrated some significant beneficial effect of MG.
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