Borderline Personality Treatment
New Study Compares Effectiveness of Three Types of BPD Therapy
Aug 22, 2007
A new study published in the June 2007 issue of The American Journal of Psychiatry compared the efficacy of three different therapies commonly used to treat patients suffering from Borderline Personality Disorder: Dialectical Behavior Therapy, Transference-Focused Psychotherapy, and Dynamic Supportive Treatment. All were shown to have a significant effect in reducing symptoms commonly associated with the disorder. However, differences were noted in the specific borderline traits most improved by each therapeutic approach.
What Is Borderline Personality Disorder?
According to the DSM-IV-TR, psychology's diagnostic bible, BPD is a type of psychological personality disorder that interferes with an individual’s ability to regulate emotion. The characteristic emotional instability results in dramatic and abrupt shifts in mood, impulsivity, poor self-image, tumultuous interpersonal relationships, and threats of and attempts at suicide.
In addition to appropriate drug therapy, psychotherapy has proven to be the most effective means of treating BPD, and in recent years, new therapies such as Dialectical Behavior Therapy (DBT) and Transference-Focused Psychotherapy (TFP) have been designed specifically to treat this disorder. These two therapies are commonly used to treat Borderline Personality, as well as more generalized, traditional supportive psychotherapy.
New Research Comparing BPD Therapies
Traits of BPD Examined
For this one year study, ninety patients, who had been diagnosed with Borderline Personality Disorder were randomly assigned to one of the three treatment groups; one third received DBT, a third TFP, and the remainder treated with Dynamic Supportive Psychotherapy.
The researchers evaluated each of the three therapies based on positive changes observed in twelve variables assessed across six domains of maladaptive behavior commonly associated with Borderline Disorder; including (1) suicidal behavior, (2) aggression, (3) impulsivity, (4) anxiety, (5) depression and (6) social adjustment. The patients were assessed prior to the start of therapy and at 4-month intervals over the course of one year. Need for drug therapy was assessed on an individual basis and not evaluated as part of the study.
The Best Therapies for BPD
All three therapeutic approaches proved to be effective in improving at least some of the six domains of borderline behavior evaluated; each resulted in a general improvement in the borderline patients studied. There were, however, differences in the specific type and extent of behavioral changes produced by each therapy.
Overall, Transference-Focused Psychotherapy produced a positive change in the most variables studied (10 of 12) across the six behavioral domains; Dialectical Behavior Therapy in 5 of the 12 variables studied; and supportive treatment in 6 of the 12. Specifically, both TFP and DBT resulted in reduced suicidality. This is not surprising, as both types of therapy particularly focus on the reduction of suicidal behavior of bipolar patients. Only TFP and supportive treatment were both associated with improvement in anger management and aspects of impulsivity. Transference-Focused Psychotherapy was the only therapeutic method related to reductions in irritability and both verbal and physical assault.
More Information on Borderline Personality Disorder
There are numerous on-line and in print resources with additional information on the treatment of BPD and personality disorders including: Psychology Prof Online, Borderline Personality Disorder Resource Center and the article Personality Disorders: Brief Summary of the Ten Disorders of Personality.
This article describes three therapeutic options, used by professionals, to treat BPD. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.
Additional BPD Sources
Clarkin, J.F., Levy, K.N., Lenzenweger, M.F., and Kenberg, O.F. (2007). Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study. The American Journal of Psychaiatry. Vol. 164, 6.
American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
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