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Göran Rydén, Kent-Inge Perseius
Compliance and patience is needed when meeting patients with personality disorder To encounter patients with personality disorders in health care settings is often challenging. Most treatment studies published have included only patients with borderline personality disorder. Of evaluated psychological treatments in borderline personality disorder, dialectical behaviour therapy (DBT) has the strongest research support, followed by mentalization based therapy (MBT). Pharmacological treatment in personality disorders should focus on time-limited crisis intervention and treatment of comorbidity...
December 6, 2016: Läkartidningen
Marc-Andreas Edel, Vanessa Raaff, Giancarlo Dimaggio, Anna Buchheim, Martin Brüne
OBJECTIVES: Borderline personality disorder (BPD) is characterized by emotional instability, interpersonal dysfunction, and other features that typically develop before a background of insecure attachment and traumatic experiences. Dialectical behaviour therapy (DBT) has proven highly effective in reducing self-harm and improving emotion regulation, whereby problems concerning social cognition, which are also characteristic of BPD, may need additional approaches such as mentalization-based treatment (MBT)...
March 2017: British Journal of Clinical Psychology
Delphine Cayn, Alexandra Pham-Scottez
Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients...
November 2016: Soins. Psychiatrie
Shelley F McMain, Tim Guimond, Ryan Barnhart, Liat Habinski, David L Streiner
OBJECTIVE: Evidence-based therapies for borderline personality disorder (BPD) are lengthy and scarce. Data on brief interventions are limited, and their role in the treatment of BPD is unclear. Our aim was therefore to evaluate the clinical effectiveness of brief dialectical behaviour therapy (DBT) skills training as an adjunctive intervention for high suicide risk in patients with BPD. METHOD: Eighty-four out-patients were randomized to 20 weeks of DBT skills (n = 42) or a waitlist (WL; n = 42)...
February 2017: Acta Psychiatrica Scandinavica
M Swales, R A B Hibbs, L Bryning, R P Hastings
PURPOSE: Adults presenting with borderline personality disorder (BPD) score poorly on measures of health related quality of life (HRQoL). Little is known about HRQoL in adolescents with BPD type presentations and how treatment impacts quality of life. Our primary aim was to use routinely collected quality-of-life outcome measures pre and post-treatment in dialectical behaviour therapy (DBT) for adolescents to address this gap. Secondary aims were to benchmark these data against EuroQol 5 dimensions (EQ-5D™) outcomes for clients treated in clinical trials and to assess the potential of the EQ-5D™ as a benchmarking tool...
2016: SpringerPlus
Louisa McNair, Ceri Woodrow, Dougal Hare
BACKGROUND: There is mixed evidence regarding the effectiveness of psychological therapies for people with intellectual and developmental disorders. Although systematic reviews have supported the use of dialectical behaviour therapy with people with borderline personality disorder, there are no comparable reviews regarding DBT with people with intellectual and development disabilities. METHODS: Studies were identified using a systematic approach and were selected if they reported an intervention that included a DBT skills group and then assessed using the Evaluative Method for Determining Evidence Based Practice...
July 26, 2016: Journal of Applied Research in Intellectual Disabilities: JARID
Keith Hawton, Katrina G Witt, Tatiana L Taylor Salisbury, Ella Arensman, David Gunnell, Philip Hazell, Ellen Townsend, Kees van Heeringen
BACKGROUND: Self-harm (intentional acts of non-fatal self-poisoning or self-injury) is common, particularly in young adults aged 15-35 years, often repeated, and strongly associated with suicide. Effective aftercare of individuals who self-harm is therefore important. We have undertaken a Cochrane systematic review and meta-analysis of the effectiveness of psychosocial interventions for self-harm in adults. METHODS: We searched five electronic databases (CCDANCTR-Studies and References, CENTRAL, MEDLINE, Embase, and PsycINFO) between Jan 1, 1998, and April 29, 2015, for randomised controlled trials of psychosocial interventions for adults after a recent (within 6 months) episode of self-harm...
August 2016: Lancet Psychiatry
Sarosh Khalid-Khan, Shira C Segal, Ellen N Jopling, Kathy Southmayd, Patricia Marchand
OBJECTIVE: Early intervention with evidence-based treatment is important to halt the progression from early manifestations of personality disorder traits to adult personality disorders. The purpose of this study is to evaluate dialectical behaviour therapy (DBT) modified for an adolescent population with borderline personality disorder (BPD), offered within a stepped-care model. METHODS: Seven adolescents (M=1, F=6, Mage=16.86) diagnosed with either BPD or BPD traits participated in a modified 15-week DBT group...
July 9, 2016: International Journal of Adolescent Medicine and Health
Samantha Backhaus, Dawn Neumann, Devan Parrot, Flora M Hammond, Claire Brownson, James Malec
BACKGROUND: Brain injury (BI) can adversely affect marriage satisfaction, which can impact rehabilitation outcomes. The objectives of this study were to (1) examine the feasibility of providing a group intervention to individuals with BI and (2) examine if improvements occur in relationship satisfaction and communication following participation. METHODS: Nine individuals with BI and their partner participated in a 16-week group intervention targeting relationship skills training...
2016: Brain Injury: [BI]
Keith Hawton, Katrina G Witt, Tatiana L Taylor Salisbury, Ella Arensman, David Gunnell, Philip Hazell, Ellen Townsend, Kees van Heeringen
BACKGROUND: Self-harm (SH; intentional self-poisoning or self-injury) is common, often repeated, and associated with suicide. This is an update of a broader Cochrane review first published in 1998, previously updated in 1999, and now split into three separate reviews. This review focuses on psychosocial interventions in adults who engage in self-harm. OBJECTIVES: To assess the effects of specific psychosocial treatments versus treatment as usual, enhanced usual care or other forms of psychological therapy, in adults following SH...
May 12, 2016: Cochrane Database of Systematic Reviews
Kirsten Barnicot, Rafael Gonzalez, Rosemarie McCabe, Stefan Priebe
BACKGROUND AND OBJECTIVES: Dialectical behaviour therapy (DBT) trains participants to use behavioural skills for managing their emotions. The study aimed to evaluate whether skills use is associated with positive treatment outcomes independently of treatment processes that are common across different therapeutic models. METHOD: Use of the DBT skills and three common treatment processes (therapeutic alliance, treatment credibility and self-efficacy) were assessed every 2 months for a year in 70 individuals with borderline personality disorder receiving DBT...
September 2016: Journal of Behavior Therapy and Experimental Psychiatry
Ueli Kramer
Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Skills training concepts based on dialectical-behaviour therapy (DBT) are common and effective treatment options for specifically addressing lacking skills in emotion regulation. However, so far it is unclear which aspects of coping change over the course of DBT skills training and if these coping strategies predict symptom change. The present process-outcome analysis, based on a randomized controlled study, aims at investigating these questions, by referring to a general conception of coping and by using an observer-rated approach to assess coping strategies directly in the therapy sessions...
April 21, 2016: Clinical Psychology & Psychotherapy
J Rampling, V Furtado, C Winsper, S Marwaha, G Lucca, M Livanou, S P Singh
BACKGROUND: For people with mental illness that are violent, a range of interventions have been adopted with the aim of reducing violence outcomes. Many of these interventions have been borrowed from other (offender) populations and their evidence base in a Serious Mental Illness (SMI) population is uncertain. AIMS: To aggregate the evidence base for non-pharmacological interventions in reducing violence amongst adults with SMI and PD (Personality Disorder), and to assess the efficacy of these interventions...
April 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
Albert Feliu-Soler, Juan Carlos Pascual, Matilde Elices, Ana Martín-Blanco, Cristina Carmona, Ausiàs Cebolla, Vicente Simón, Joaquim Soler
The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CM group. Mechanistic explanations and therapeutic implications of the findings are discussed...
January 28, 2016: Clinical Psychology & Psychotherapy
Geoffrey L Dickens, Nutmeg Hallett, Emma Lamont
OBJECTIVES: There is some evidence that mental health nurses have poor attitudes towards people with a diagnosis of borderline personality disorder and that this might impact negatively on the development of helpful therapeutic relationships. We aimed to collate the current evidence about interventions that have been devised to improve the responses of mental health nurses towards this group of people. DESIGN: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement...
April 2016: International Journal of Nursing Studies
Keith Hawton, Katrina G Witt, Tatiana L Taylor Salisbury, Ella Arensman, David Gunnell, Ellen Townsend, Kees van Heeringen, Philip Hazell
BACKGROUND: Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents...
December 21, 2015: Cochrane Database of Systematic Reviews
Adelln A H Sng, Aleksandar Janca
PURPOSE OF REVIEW: Third-wave cognitive-behaviour therapies such as dialectical behaviour therapy have demonstrated effectiveness in the treatment of personality disorders, which are considered difficult to treat. These therapies typically incorporate some component of mindfulness practice. The current study examines current applications and effectiveness of mindfulness to the treatment of personality disorders. RECENT FINDINGS: The majority of evidence available focuses on borderline personality disorder, and highlights positive associations between mindfulness practice and reduced psychiatric and clinical symptoms, less emotional reactivity, and less impulsivity...
January 2016: Current Opinion in Psychiatry
L M C van den Bosch, R Sinnaeve
BACKGROUND: More and more evidence-based treatments for severe personality disorders are becoming available. Nevertheless, there are problems with the implementation of these treatments and it is proving difficult to keep the treatment programmes running. However, teams which offer dialectical behavior therapy (DBT) seem to survive. AIM: To find out which factors enable dbt teams to survive. METHOD: Twenty-five Dutch DBT teams received a questionnaire about factors that could be influencing the continuation of the DBT treatment programmes...
2015: Tijdschrift Voor Psychiatrie
Ildikó Papp, Irena Szumska, Ferenc Túry
The binge eating disorder is a relatively new type of eating disorders, which was first described in 1992, and became a distinct nosological entity in the system of DSM-5 in 2013. Its central symptom is the binge, which is not followed by compensatory behaviours as in bulimia nervosa. Therefore, the patients are generally obese. The prevalence of the disorder is 1-3% in the general population, but much higher in help-seeking obese subjects. The two main goals of the therapy is body weight reduction, and the cessation of binges...
2015: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
Kirsten Barnicot, Laura Couldrey, Sima Sandhu, Stefan Priebe
Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme...
2015: PloS One
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