Borderline personality disorder
In this podcast Martin Bohus gives an overview of Borderline Personality Disorder (BPD), explaining the condition in terms of its features and symptoms, and describing a number of psychological treatments available including that of his own specialty, Dialectical Behavioural Therapy. He also addresses the limited evidence for medical treatments. He discusses theories of aetiology including links with genetics and childhood physical traumatisation.
ConclusionsThe findings identify novel evidence of common therapeutic processes across DBT and MBT that may help to reduce self-harm. The findings also highlight the potential iatrogenic effect of difficulties in the alliance with therapists or with other group members. This underscores the importance of listening to patients ’ voices about what they are finding difficult during therapy and working to address these relational challenges, so that the patient is able to progress and make best use of the treatment.Practitioner points Regardless of whether dialectical behaviour therapy or mentalization based therapy is...
CONCLUSION: The findings suggest that AVH is a legitimate and distressing symptom of BPD and a treatment priority for some patients. The relative independence of AVH from other BPD symptoms and emotional states suggests that psychological treatment may need to be targeted specifically at the symptom of AVH. This treatment could be adapted from Cognitive Behaviour Therapy, the psychological intervention that is recommended for the treatment of AVH in the context of psychosis.PMID:34322956 | DOI:10.1002/cpp.2655
ConclusionAt this stage, it is not feasible to draw conclusions regarding the efficacy of third-wave interventions for the treatment of EDs in adolescence due to the low quality of the empirical evidence. Since almost all of the identified studies used DBT, it is unfortunately not possible to assess other third-wave treatments ’ efficacy.
Conclusions: Young people reported improvements in emerging BPD symptomology after completing DBT. Parents and carers reported improvements in their young person and families since starting DBT. A longer DBT programme, earlier DBT intervention, and the time-consuming nature of DBT were highlighted as areas for improvement.
This study is one of the first to use neuroimaging measures to predict and better understand treatment response in patients with PTSD and comorbid personality disorders. A heterogeneous, naturalistic sample will be included, ensuring generalizability to a broad group of treatment seeking PTSD patients.Trial registrationClinical Trials,NCT03833453&NCT03833531. Retrospectively registered, February 2019.
Many patients with borderline personality disorder (BPD) do not improve after dialectical behaviour therapy (DBT). The identification of prospective markers of treatment response may improve outcomes. Performance-based neurocognitive measures may provide unique information associated with treatment response. No study has investigated the association between performance-based neurocognition and response to comprehensive DBT for BPD.
CONCLUSIONS: DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.PMID:33875025 | DOI:10.1017/S0033291721001355
The objective of this study was to assess the response to AT in comparison with treatment as usual (based on cognitive ‐behavioural therapy) in patients with BPD. Regarding the comparison of the differences post‐therapy–pre‐therapy between both groups, some metabolic variables improved more in the AT group, with medium–large effect sizes. Almost all psychometric variables evolved better in the AT group, wi th negligible effects. AT could be considered in BPD treatment because it results in healthier lifestyle habits and increases functionality and quality of life in patients who are prone to self‐destru...
World J Biol Psychiatry. 2021 Feb 1:1-17. doi: 10.1080/15622975.2020.1858155. Online ahead of print.ABSTRACTOBJECTIVES: We aimed to investigate whether pre-treatment cardiac autonomic nervous system (ANS) activity, indexed by heart rate (HR) and heart rate variability (HRV) predicts clinical outcome and therapy drop-outs in adolescents with borderline personality (BPD) pathology receiving dialectical behavioural therapy (DBT-A). We further tested for an association between changes in ANS function and clinical outcome over time. Traumatic experiences were considered as potential confounding factor.METHODS: N = 43 (95.4% fem...