Treatment for borderline personality disorder: perils of the randomized controlled trial paradigm

Can Trainees Effectively Deliver Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder? Outcomes From a Training Clinic

“…Though prevalence estimates vary widely, replicated rates suggest that approximately 2.7% of the general population meet criteria for the disorder (Trull, Jahng, Tomko, Wood, & Sher, ), with prevalence increasing substantially in mental health treatment facilities (Tomoko, Trull, Wood, & Sher, 2014). BPD is associated with high social, occupational, and educational impairment, leading to recurrent job loss/unemployment, divorce, interrupted education, and heavy health service (individual and group therapy, emergency services, and psychiatric hospitalization) utilization (American Psychiatric Association [APA], ; Bender, ; Ritschel & Kilpela, ; Zanarini, Frankenburg, Reich, Conkey, & Fitzmaurice, ). Between 60% and 70% of individuals with BPD attempt suicide at least once and 8%–10% die by suicide—50 times that of the general population (Oldham, ; Ritschel & Kilpela, ).…”