Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges

Links, Paul S.; Shah, Ravi; Eynan, Rahel

doi:10.1007/s11920-017-0766-x

Cited by 24 publications

(23 citation statements)

References 39 publications

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“…Beyond the specific characteristics of these various methods and the knowledge that all efficacious treatments for BPD include a careful reflection of and investment in the therapeutic alliance, all evidence-based psychotherapies aim to improve patients’ emotion regulation capacity [7-9]. In addition, treatment targets have recently been extended to foster more coherent self-identity and sense of agency and to increase the capability to mentalize others’ mental states [10]. …”

Section: Introductionmentioning

confidence: 99%

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

et al. 2018

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Emotion dysregulation is a hallmark of borderline personality disorder (BPD). Most interventions for patients with BPD, therefore, aim at the improvement of emotion regulation. In the current paper, we provide an overview of studies investigating the effects of psychotherapeutic or pharmacological interventions on neurobiological correlates of various aspects of emotion regulation. In fact, studies suggest that the prefrontal-limbic circuit may play a major role in mediating effects of clinically efficacious psychotherapeutic treatments, i.e., they lead to clinical improvement via modulating the function and structure of the amygdala, the insula, and the dorsal anterior cingulate cortex, as well as prefrontal areas involved in the cognitive regulation of emotions, and enhancing the coupling of limbic and prefrontal areas. Oxytocin as a promising pharmacological approach to emotion dysregulation in BPD was shown to dampen amygdala activity in response to emotional stimuli. Understanding the brain mechanisms that mediate treatment effects will harness further development of targeted mechanism-based interventions for patients with BPD.

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Section: Introductionmentioning

confidence: 99%

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

et al. 2018

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“…In both clinics, patients benefit from an integrative and structured approach that draws upon principles and techniques from evidence‐based models described in the literature, including DBT, mentalization‐based treatment, and Systems Training for Emotional Predictability and Problem Solving . Comparative trials comparing specialized treatments suggest that patients with BPD benefit from any method that is well structured and integrated …”

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confidence: 99%

“…Soler et al 13 A stepped care model could be of particular value for BPD, in which scarce resources need to be triaged, but in which prognosis is highly variable. 9,15 The model, which allows for shorter duration and husbanding of resources, 16 has been suggested for adults with BPD 10,17,18 as well as for adolescents, 19,20 and may gradually become the norm.…”

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confidence: 99%

“…24 Comparative trials comparing specialized treatments suggest that patients with BPD benefit from any method that is well structured and integrated. 16,23 In the ST clinic, patients receive 12 weekly sessions of individual therapy and 12 of group therapy. Group sessions make use of psychoeducation and group process to develop better emotion regulation, better interpersonal skills and decreased impulsivity.…”

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confidence: 99%

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Clinical outcomes of a stepped care program for borderline personality disorder

Laporte

Paris

Bergevin

et al. 2018

Personality & Mental Health

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These results support the concept that for the majority of patients with BPD, brief treatment can be effective. While some patients still need longer treatment, the results are encouraging for brief treatment as a first step for the majority of patients with BPD. While this study adds to the weight of evidence to support ST interventions for patients with BPD, further research using a control group is needed. Copyright © 2018 John Wiley & Sons, Ltd.

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“…Concerning BPD, limited research has focused on improvement of functional outcomes after psychotherapy. In fact, the majority of studies of specific psychotherapies for BPD patients were aimed to assess the efficacy of interventions in terms of decrease of symptoms severity [46,47]. Nevertheless, BPD patients have a high level of interpersonal reactivity and instability that produce a severe impairment in daily functioning [48].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Real-World Functioning Improvement in a Sample of Psychiatric Outpatients

Bellino¹,

Bozzatello²,

Montemagni³

et al. 2018

Neuropsychiatry

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Objective: the aim was to identify in 511 outpatients, with diagnoses of schizophrenia, major depressive disorder (MDD), bipolar disorders (BD), and borderline personality disorder (BPD), what clinical variables predict the improvement of real-world functioning during 12 months of usual treatment.Methods: sociodemographic variables were evaluated. Patients were assessed at baseline and endpoint with: Clinical Global Impression Scale -Severity (CGI-S); Satisfaction Profile (SAT-P), Drug Attitude Inventory-10 (DAI-10), and Personal and Social Performance (PSP). Statistical analysis was performed with Chi-square test and Pearson's correlation. Significant variables were included in a multiple regression analysis. Dependent variable was the difference of PSP after one year (ΔPSP). P ≤ 0.05 was significant.Results: in the total sample, ΔPSP was related to age of onset, SAT-P and psychotherapy and inversely related to suicide attempts and CGI-S. In schizophrenia, ΔPSP was related to SAT-P and DAI-10 and inversely related to CGI-S. In MDD, ΔPSP was related to SAT-P and psychotherapy and inversely related to suicide attempts and CGI-S. In BD, ΔPSP was related to SAT-P and inversely related to CGI-S. In BPD, only psychotherapy was related to ΔPSP. Conclusion:Symptoms severity predicted a worse community functioning in the total sample and in each group, except for BPD. Suicide attempts were inversely associated to functional improvement in the total sample and depression. Quality of life was related to the change of functioning in each group, except for BPD. Patients with MMD and BPD receiving psychotherapy gained a better functional improvement. Attitude to pharmacotherapy was related to functional improvement only in schizophrenia.

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Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges

Cited by 24 publications

References 39 publications

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

Clinical outcomes of a stepped care program for borderline personality disorder

Predictors of Real-World Functioning Improvement in a Sample of Psychiatric Outpatients

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