Efficacy of “Family Connections”, a program for relatives of people with borderline personality disorder, in the Spanish population: study protocol for a randomized controlled trial

Abstract

Background: Patients with borderline personality disorder (BPD) experience significant affect regulation difficulties that cause serious consequences in their work, emotional, and social environments. This dysfunctional pattern also produces great suffering and a heavy burden on their relatives. Fortunately, some studies show that treatment of relatives of people with BPD begins to be important in the patients' recovery and in improving family dynamics. One of the treatments that has obtained the most empirical support is Family connections (FC). This 12-session program is an adaptation of different Dialectical Behavior Therapy strategies. To test the efficacy of FC, five uncontrolled clinical trials were conducted, with pre-post treatment and follow-up assessments. The results of these studies and subsequent replications showed an improvement in family attitudes and caregiver burnout. Our research team adapted FC for delivery in the Spanish population. We intend to test the efficacy of this program versus a treatment as usual condition. Moreover, we aim to test the efficacy of this program and study its effectiveness (in terms of participants' acceptance). This paper presents the study protocol. Methods: The study is a randomized controlled trial. The participants will be recruited in a Personality Disorders Unit and randomly assigned to one of two treatment conditions: Family Connections group (FC) or Treatment As Usual (TAU). Primary outcome measures will be the BAS and FAD-GFS. Secondary outcomes will include DASS-21, FES, GS, and QLI. Participants' treatment acceptance and degree of satisfaction will also be measured. Participants will be assessed at pre-, post-treatment, and 6-month follow-up. Intention to treat and per protocol analyses will be performed.

Spanish adaptation of the Burden Assessment Scale in family caregivers of people diagnosed with borderline personality disorder

“…The BAS can be a useful instrument for clinicians, who can assess burden in family caregivers of people diagnosed with BPD (or another SMD) and improve the efficiency of programs designed to provide resources and develop skills to manage the symptoms of the burden of caring, such as Family Connections (e.g. [ 10 , 11 , 20 ]), and positively influence their mental health and personal well-being (e.g. [ 1 , 9 ]).…”

The Burden Assessment Scale in Spanish family caregivers of people diagnosed with Borderline Personality Disorder

“…The BAS can be a useful instrument for clinicians, who can assess burden in family caregivers of people diagnosed with BPD (or another SMD) and improve the e ciency of programs designed to provide resources and develop skills to manage the symptoms of the burden of caring, such as Family Connections (e.g. Fernández-Felipe et al, 2020Hoffman et al, 2005), and positively in uence their mental health and personal well-being (e.g. Akbari et al, 2018;Durmaz & Okanli, 2014).…”

Arquegenealogia do sujeito borderline

“…Consideramos relevante pontuar esse inventário para localizarmos a perspectiva deste trabalho no campo dos estudos discursivos. No ensaio, as autoras apresentam como resultado uma busca nas bases de dados 1 Embase, Lilacs, PsycInfo, PubMed e Scopus, devido à relevância e pertinência dessas bases de dados de referência bibliográfica científica para os campos da medicina e psiquiatria, totalizando sessenta artigos científicos sobre o transtorno de personalidade borderline catalogados.…”

“…(HEBBLETHWAITE, 2009, p. 23). 32 Analisemos esses dois enunciados para sancionarmos um aparato histórico das condições de possibilidade do discurso clínico para que as técnicas disciplinares aplicadas nas internações psiquiátricas sejam percebidas, de modo a evidenciar como as relações de poder entre sujeitos médicos e sujeitos borderline se estabelecem no interior da instituição hospitalar 31 Conforme tradução nossa do original em inglês: "The intervention will aim: (1) to address unmet needs on symptomatology through appropriate pharmacological management and psychosocial support. It also includes diminishing and eliminating wherever possible the adverse physical and behavioural consequence of symptom management as well as those arising out of prolonged institutionalisation; […] The intervention will be discontinued given the following conditions: (1) if the participant wants to discontinue participation; […]."…”

“…(RAJA et al, 2020, p. 6). 32 Conforme tradução nossa do original em inglês: "Under the Ontario Mental Health Act (MHA), a person can be brought into hospital under the following three conditions: (1) when a person is acting in a disorderly manner, the police are allowed to bring the person to be examined by a physician if they believe the person is a danger to himself or herself or others or the person cannot care for himself or herself; […] Once the person is brought to a psychiatric facility, a physician may detain the person for up to 72 hours for psychiatric assessment, but no treatment is permitted without patient consent. After that time, a person must either be released or admitted as a voluntary or involuntary patient, as indicated in the Mental Health Act."…”