Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study

Clarkin, John F.; Levy, Kenneth N.; Lenzenweger, Mark F.; Kernberg, Otto F.

doi:10.1176/ajp.2007.164.6.922

Cited by 706 publications

(371 citation statements)

References 23 publications

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“…They are explicitly regarded as treatment mistakes also in psychoanalysis [121]. Furthermore, the risks associated with long-term treatments are not specific to psychoanalysis since some CBT treatments such as dialectical behavior therapy or schema-focused therapy are long-term as well [44,101]. It is of note that Berk and Parker [120] only referred to high-frequency long-term psychoanalytic therapy but did not include a discussion of manual-guided PDT.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the 9 studies listed by Connolly Gibbons et al [7] for specific mental disorders [40,41,42,43,44,45,46,47,48], 30 more recent RCTs of PDT fulfilling the criteria by Chambless and Hollon [8] were identified. We did not include RCTs of irritable bowel syndrome or functional dyspepsia as they represent functional somatic disorders.…”

Section: Methodsmentioning

confidence: 99%

“…Based on the results by Clarkin et al [44] and Levy et al [95], Connolly Gibbons et al [7] considered transference-focused therapy as possibly efficacious in borderline personality disorder. …”

Section: Methodsmentioning

confidence: 99%

“…In the case of conflicting evidence, the criteria by Chambless and Hollon [[8], p 18] require that the preponderance of evidence must be in favor of the empirically supported treatment [8]. As 2 other RCTs described above found transference-focused psychotherapy to be efficacious [44,95,96], the preponderance of evidence is in favor of transference-focused psychotherapy. …”

Section: Methodsmentioning

confidence: 99%

“…For transference-focused therapy, 2 RCTs carried out in independent research settings are available which provide evidence that the treatment is efficacious and specific in the treatment of borderline personality disorder [44,95,96]. The specific methods of PDT used in the studies by Bateman and Fonagy [98] and Gregory et al [97] can be considered as possibly efficacious.…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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Background: The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious' and 1 RCT for a designation as ‘possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. Methods: A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. Results: A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). Conclusions: Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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Ten-Year Course of Borderline Personality Disorder

Gunderson

Stout

McGlashan

et al. 2011

Arch Gen Psychiatry

593

192

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Context Borderline personality disorder (BPD) is traditionally considered chronic and intractable. Objective To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design A collaborative study of treatment-seeking, 18-to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Setting Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Participants Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P<.001) and minimally slower than for other personality disorders (P<.03). Twelve percent of patients with BPD relapsed, a rate less frequent and slower than for patients with MDD (P<.001) and other personality disorders (P=.008). All BPD criteria declined at similar rates. Social function scores showed severe impairment with only modest albeit statistically significant improvement; patients with BPD remained persistently more dysfunctional than the other 2 groups (P<.001). Reductions in criteria predicted subsequent improvements in DSM-IV Axis V Global Assessment of Functioning scores (P<.001). Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.

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Analyzing Effectiveness of Long-term Psychodynamic Psychotherapy

Röepke¹

2009

JAMA

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Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study

Cited by 706 publications

References 23 publications

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Ten-Year Course of Borderline Personality Disorder

Analyzing Effectiveness of Long-term Psychodynamic Psychotherapy

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