Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial

Abstract

BackgroundEvidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages in diagnosing adolescent BPD, there is a lack of cost-effective evidence-based treatment programs for adolescents. Mentalization-based treatment is an evidence-based program for BPD, originally developed for adults.Methods/DesignAims/hypotheses: We will investigate whether a specifically designed mentalization-based treatment in groups is an efficacious treatment for adolescents with BPD or subthreshold BPD compared to treatment as usual. The trial is a four-center, two-armed, parallel-group, assessor-blinded randomized clinical superiority trial. One hundred twelve patients aged 14 to 17 referred to Child and Adolescent Psychiatric Clinics in Region Zealand are randomized to 1 year of either mentalization-based treatment in groups or treatment as usual. Patients will be included if they meet at least four DSM-5 criteria for BPD. The primary outcome is self-reported borderline features at discharge. Secondary outcomes will include self-harm, depression, BPD criteria, externalizing and internalizing symptoms, and social functioning, together with parental reports on borderline features, externalizing and internalizing symptoms. Measures of attachment and mentalization will be included as mediational variables. Follow-up assessment will take place at 3 and 12 months after end of treatment.DiscussionThis is the first randomized controlled trial to test the efficacy of a group-based mentalization-based treatment for adolescents with BPD or subthreshold BPD. If the results confirm our hypothesis, this trial will add to the treatment options of cost-effective treatment of adolescent BPD.Trial registrationClinicaltrials.gov NCT02068326, February 19, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1431-0) contains supplementary material, which is available to authorized users.

Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial

“…The study is a randomized two‐armed, parallel group, assessor‐blinded outcome superiority trial, comparing a group‐based MBT program with TAU (Beck et al, ). This trial is registered with ClinicalTrials.gov Identifier: NCT02068326.…”

Mediators between adverse childhood experiences and suicidality

“…MBT, which is based on attachment theory and psychodynamic principles, has a high degree of structure and a clear treatment goal of improving patients' metalizing skills. The parent-child relationship is also regarded as an important treatment target (Beck et al, 2016). Parent-child interaction therapy (PCIT) and child-parent psychotherapy (CPP) are evidence-based treatment modalities to prevent and manage ACEs and their impact on intra-familial relationships (Center on the Developing Child at Harvard University, 2016).…”

Dialectical Behavior Therapy: A Portuguese Pilot Program

“…Borderline personality disorder (BPD) is a severe mental disorder mainly characterized by affective instability, impulsivity and self-harm (Beck et al, 2016). BPD is also characterized as having a unstable self-image or sense of self (American Psychiatric Association, 2013).…”

“…It is estimated that 11% of psychiatric outpatients meet the criteria for this disorder, which is associated with many severe impairments like higher rates of psychiatric comorbidity and increased risk of suicide attempts, difficulties in finding and maintaining satisfying relationships and employment, as well as high rates of mental health utilization (Beck et al, 2016;Gunderson, 1984;Wilks, Korslund, Harned, & Linehan, 2016;Clarkin, Widiger, Frances, Hurt, & Gilmore, 1983). One of the reasons may have to do with their tendency of raising preoccupation in the professionais due to their frequent complainings and somatic symptoms (Sansone & Sansone, 2004).…”

“…Therefore, an early detection and an effective treatment of BPD is essential to prevent its individual, psychosocial, and economic consequences (Beck et al, 2016).…”