Borderline Personality Disorder and Comorbid Addiction

Kienast, Thorsten; Stoffers, Jutta M; Bermpohl, Felix; Lieb, Klaus

doi:10.3238/arztebl.2014.0280

Cited by 75 publications

(78 citation statements)

References 31 publications

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“…These include dialectical behavior therapy [73], dynamic deconstructive therapy [74], and dual focus schema therapy [14] and are PD-focused interventions that have been developed to treat the combination of BPD and substance use disorders in general. These approaches are developments from core PD treatments, recognizing the need to address addiction behaviors and cognitions while implicitly seeing these issues as “secondary.” The reviews of Kienast et al [20] and Lee et al [21] summarize the literature from the 10 studies to date. These show promise in symptom reductions in both SUD and PD, although all the interventions are trialed by the developers of the therapy – so-called “product experts” [75] – with short-term follow-up and require both replication and longer-term outcome reporting to suggest that they are generalizable to standard clinical practice.…”

Section: The Emerging Literature Of the Impact Of Aud On The Outcome mentioning

confidence: 99%

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Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

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Background: Clinically, personality disorder (PD) commonly coexists with alcohol use disorder (AUD), although within mainstream mental health services both of these mental disorders are routinely overlooked. Despite a rich literature examining the interactions between AUD and personality functioning, personality traits, and PD, there remains conflicting evidence as to the degree of association and impact of one on the other. Methods: A narrative review and a synthesis of the literature were done. Results: The lifetime prevalence of AUD approaches 50% in some PD populations. The rates of PD in AUD populations are less clear but likely similar. Personality influences outcomes in AUD regardless of whether a categorical personality diagnosis or dimensional trait domain approach is taken. There are, however, no good data to inform clinicians on the impact of AUD on the outcomes of PD. Understanding the extent of this impact is complicated by the multiple tools used for diagnosis (of both PD and AUD) and the statistical methods used. Overall, caution is required in interpreting the data due to the quality of the current literature; however, comorbidity between the two disorders is likely significant and the impact of PD on AUD outcomes is sufficient to require consideration. Conclusions: From a research perspective, better agreement on both diagnoses and outcomes is urgently needed to improve the overall quality of the evidence. Clinically, despite the limitations in the literature, it is unacceptable for PD services to ignore AUD and for AUD services not to screen for PD. Both are likely to have an impact on health and functioning and should be considered in routine reviews. A better conceptualization of the putative mechanisms of this interaction, as well as an understanding of the neurobiology and reasons for the impact on treatment outcomes, will help to move the field forward.

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Section: The Emerging Literature Of the Impact Of Aud On The Outcome mentioning

confidence: 99%

“…Recent reviews in this area have focused largely on BPD [20, 21], summarizing the impact of 4 therapies that have been developed for this “dual diagnosis.” Our aims are broader, taking an overview of the impact of PD in AUD and the impact of AUD in PD. We consider diagnosis, epidemiology, and impact.…”

mentioning

confidence: 99%

Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

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“…Bisherige Studien zur Wirksamkeit der DBT zeigen klassischerweise nachhaltige Effekte hinsichtlich der Abnahme von Suizidalität, Selbstverletzung und Klinikeinweisung [Kienast et al, 2014;Stiglmayr et al, 2014a] sowie Kosteneffizienz Priebe et al, 2012;van den Bosch et al, 2014]. Kleindienst et al [2008] stellten in einer kontrollierten Studie (19 Patientinnen der Wartegruppe vs. 31 Patientinnen einer 4-monatigen stationären DBT) dar, dass DBT signifikant die Borderline-typische Symptomatik verbesserte, während in der Wartegruppe keine Verände-rung gemessen werden konnte.…”

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“…Als Prädiktoren für geringe Ansprechbarkeit gelten komorbide Essstörungen, posttraumatische Belastungsstörungen (PTBS) und Suchterkrankungen [Kienast et al, 2014]. Aber auch in einer randomisierten kontrollierten Studie reduzierten komorbide Dissoziationen während der DBT bei BPS und gleichzeitig vorliegender PTBS deren Therapieerfolg [Kleindienst et al, 2016].…”

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Tagesklinische dialektisch-behaviorale Therapie: Eine Verlaufsuntersuchung nach Entlassung. Gibt es Prädiktoren für eine Verschlechterung?

Richter

2018

Verhaltenstherapie

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Einleitung: Die dialektisch-behaviorale Therapie (DBT) für Patienten mit Borderline-Persönlichkeitsstörung (BPS) ist evidenzbasiert. Es gibt jedoch nur eine kleine Anzahl von Studien, die die Frage einer möglichen anhaltenden Wirkung von DBT untersuchen. Über Prädiktoren dieser Nachhaltigkeit ist wenig bekannt. Methode: Am Beispiel eines zertifizierten tagesklinischen Settings wird der posttherapeutische Verlauf untersucht. Mögliche Prädiktoren einer Verschlechterung nach Therapieende sollen erkannt werden. Hierzu wurden Patienten der DBT-Tagesklinik, deren Daten schon in eine prospektive, naturalistische, offene und nicht kontrollierte Vorstudie eingingen, erneut retrospektiv befragt. Somit konnten die Scores der Borderline-Symptomliste 95 (BSL-95) und des Beck-Depressions-Inventars (BDI) zu 3 verschiedenen Zeitpunkten (Z1 = Start, Z2 = Therapieende, Z3 = Katamnesezeitpunkt) verglichen werden. Der Fragebogen zu «Nebenwirkungen stationärer Psychotherapien» (NESTAP) lieferte weitere mögliche Prädiktoren. Ergebnisse: Der Katamnesezeitraum betrug 3-51 Monate. 82 Patienten wurden angeschrieben, es antworteten 41. Anhand des BDI und der BSL-95 (Differenz Z1 zu Z3, p < 0,05) ist eine Symptombesserung in dieser Gruppe auch weit über das Therapieende feststellbar. In einem linearen Regressionsmodell mit einer Effektstärke von 1,04 (Cohen) zeigt eine Subgruppe (25%), gekennzeichnet durch hohe Werte des Prädiktors «Dysphorie» im BSL-95 (Z2 zu Z1) eine geringe anhaltende Wirkung der DBT (Differenz der BSL-95- und BDI-Scores zu Z2 und Z3). Schlussfolgerungen: Es konnten Hinweise für ein tagesklinisches DBT-Programm zur anhaltenden Symptombesserung bis 51 Monate nach Therapieende dargestellt werden. Für 50% der Patienten ist hierfür keine Aussage möglich. Auch gab es keine Kontrollgruppe. Die Veränderung von «Dysphorie» während der Therapiephase scheint diese therapeutische Wirkung über diesen Katamnesezeitraum zu beeinflussen. Weitere Studien sollten folgen, um die Daten zu prüfen oder andere Prädiktoren zu finden.

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“…According to the national institute on drug abuse (NIDA), more than 22 million people have a disorder associated with drugs in 2012 (1). Based on research results, personality could play a significant role in substance use and it's etiology (2,3). Addicted individuals are often different from normal people in personality traits, such as behavioral disinhibition, impulsivity, pessimism, and neuroticism (4).…”

Section: Introductionmentioning

confidence: 99%

The Relation Between Evolutionary Life Strategy, Temperament and Character in Individuals with Opioid Use Disorder

Ghazanfari

Lavasani

Atef-Vahid

et al. 2018

Int J High Risk Behav Addict

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Background: Although many risk factors have been proposed for the etiology of the addiction, little research has been conducted from the perspective of evolutionary psychology. The theory of life strategies (with respect to evolutionary causes) has led to a new understanding of addiction. While researchers have shown that Cloninger's bio-psychological model is one of the most important personality factors in the etiology of addiction, there is no research about the relationship between life strategy and the temperament-character component of addiction. The main objective of this study was to show the relationship between these two variables in individuals with opioid use disorder in comparison with the normal group. Methods: This correlational study included 96 participants with opioid use disorder selected by convenience sampling from the Iranian national center for addiction studies (INCAS) and 97 participants without any substance use disorder, who were matched to the opioid-use group. After administering the mini-form of Arizona life history battery (ALHB) and the temperament and character inventory (TCI), data were analyzed with Pearson's correlation coefficient and multivariate regression. Results: Results showed a relationship between fast-life strategy and novelty seeking in the group with opioid use disorder and a positive relationship between slow-life strategy and co-operation in the control group. The regression analysis indicated that novelty seeking was able to predict fast-life strategy in the opioid use group and co-operation could predict slow-life strategy in the control group. Conclusions: Life strategy could be a new variable in understanding and planning addiction prevention programs.

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Borderline Personality Disorder and Comorbid Addiction

Cited by 75 publications

References 31 publications

Personality Disorder and Alcohol Use Disorder: An Overview

Personality Disorder and Alcohol Use Disorder: An Overview

Tagesklinische dialektisch-behaviorale Therapie: Eine Verlaufsuntersuchung nach Entlassung. Gibt es Prädiktoren für eine Verschlechterung?

The Relation Between Evolutionary Life Strategy, Temperament and Character in Individuals with Opioid Use Disorder

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