Which Factors Are Relevant for Treatment Outcome in Dialectical Behaviour Therapy for Borderline Personality Disorder?
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Dialectibal Behaviour Therapy.
- Who it may be relevant to
- Registry conditions: Borderline Personality Disorder, Non-suicidal Self-injury, Deliberate Self Harm. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Sweden
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Vilka Faktorer påverkar Behandlingsutfall Vid Dialektisk Beteendeterapi för Borderline Personlighetssyndrom?
Overview
The objective of this project is to investigate factors that contribute to the success and lack of success in DBT among individuals with BPD and a history of self-harm in a clinical psychiatric setting. 1. Do certain personality factors and identity disturbance predict the treatment outcome of DBT in individuals with BPD? 2. Do changes in identity disturbance, self-hate, or emotion regulation mediate the treatment outcome of DBT in individuals with BPD? 3. Do specific personality profiles moderate the treatment outcomes of DBT for individuals with BPD? 4. When does the primary treatment effect occur, and does this effect persist after a 12-month follow-up period?
Detailed description
Borderline Personality Disorder (BPD) is a complex and enduring mental health condition characterized by a range of symptoms. The consequences of BPD are severe, causing individual suffering, impairments in daily functioning, and increased mortality rates. Dialectical behavior therapy (DBT) is one of the most widely used treatment models for BPD and self-harm. DBT has demonstrated positive outcomes but not all individuals benefit equally from this therapy, highlighting the need for further exploration. Specifically, there is a knowledge gap regarding what predicts positive treatment response. Research exploring this topic, has highlighted the potential significance of emotion regulation, personality profiles, self-concept, and identity disturbance in understanding the outcomes of individuals with BPD.
The primary objective of this research project is to investigate the factors that contribute to the success and lack of success in DBT.
All individuals referred to DBT-treatment in the Adult psychiatric clinic in Lund will be offered participation in the study. All study participants receive the same treatment as those who chose not to participate. Measures will commence after treatment contracts have been negotiated and the treatment will continue up to a maximum treatment length of one year.
Data will be retrieved from databases, medical records as well as collected as self-report forms. Self-report measures will be conducted every three months, at end of treatment and at follow up 12 months after end of treatment. Data from registries and charts will be collected at time of consent and at follow up 12 months after treatment.
Interventions
- Behavioral Dialectibal Behaviour Therapy
Standard Dialectical Behaviour Therapy of up to 12 months as described Professor Linehan
Primary outcome measures
- Five Self-harm Behaviour Groupings Measure (5S-HM) [Time frame: Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.]
Secondary outcome measures (5)
- The World Health Organization Disability Assessment Schedule II (WHODAS 2) [Time frame: Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.]
- The Borderline Symptom List-23 (BSL-23) [Time frame: Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.]
- The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS 2.0) [Time frame: Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.]
- The Personality Inventory for DSM-V Brief Form (PID-5-BF) [Time frame: Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.]
- Hospitilization days [Time frame: Treatment at end of treatment and at follow up at 24 months.]
Eligibility criteria
Inclusion criteria
- Borderline personality disorder as defined by the DSM-V (assessed with SCID or uquivalent).
- Self-harm over the past 12 months
- Offered DBT at the Lund adult psychiatric clinic
Exclusion criteria
- Unable to read or communicate in Swedish
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-only
Study locations
Sweden · 1 center
- Lund adult psychiatric hospital — Lund
Publications
- Alvarez-Tomas I, Ruiz J, Guilera G, Bados A. Long-term clinical and functional course of borderline personality disorder: A meta-analysis of prospective studies. Eur Psychiatry. 2019 Feb;56:75-83. doi: 10.1016/j.eurpsy.2018.10.010. Epub 2018 Dec 24. PMID 30599336
- van Asselt AD, Dirksen CD, Arntz A, Severens JL. The cost of borderline personality disorder: societal cost of illness in BPD-patients. Eur Psychiatry. 2007 Sep;22(6):354-61. doi: 10.1016/j.eurpsy.2007.04.001. Epub 2007 Jun 4. PMID 17544636
- Chen SY, Cheng Y, Zhao WW, Zhang YH. Effects of dialectical behaviour therapy on reducing self-harming behaviours and negative emotions in patients with borderline personality disorder: A meta-analysis. J Psychiatr Ment Health Nurs. 2021 Dec;28(6):1128-1139. doi: 10.1111/jpm.12797. Epub 2021 Sep 20. PMID 34519138
- Cipriano A, Cella S, Cotrufo P. Nonsuicidal Self-injury: A Systematic Review. Front Psychol. 2017 Nov 8;8:1946. doi: 10.3389/fpsyg.2017.01946. eCollection 2017. PMID 29167651
- Ellison WD, Rosenstein LK, Morgan TA, Zimmerman M. Community and Clinical Epidemiology of Borderline Personality Disorder. Psychiatr Clin North Am. 2018 Dec;41(4):561-573. doi: 10.1016/j.psc.2018.07.008. Epub 2018 Oct 16. PMID 30447724
- Gad MA, Pucker HE, Hein KE, Temes CM, Frankenburg FR, Fitzmaurice GM, Zanarini MC. Facets of identity disturbance reported by patients with borderline personality disorder and personality-disordered comparison subjects over 20 years of prospective follow-up. Psychiatry Res. 2019 Jan;271:76-82. doi: 10.1016/j.psychres.2018.11.020. Epub 2018 Nov 10. PMID 30469092
- Gratz KL, Bardeen JR, Levy R, Dixon-Gordon KL, Tull MT. Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behav Res Ther. 2015 Feb;65:29-35. doi: 10.1016/j.brat.2014.12.005. Epub 2014 Dec 13. PMID 25557395
- Weekers LC, Hutsebaut J, Kamphuis JH. The Level of Personality Functioning Scale-Brief Form 2.0: Update of a brief instrument for assessing level of personality functioning. Personal Ment Health. 2019 Feb;13(1):3-14. doi: 10.1002/pmh.1434. Epub 2018 Sep 19. PMID 30230242
Identifiers
NCT: NCT06106555 · Dnr 2023-03990-01