A 5-day dialectical behavior therapy partial hospital program for women with borderline personality disorder: predictors of outcome from a 3-month follow-up study

J Psychiatr Pract. 2009 May;15(3):173-82. doi: 10.1097/01.pra.0000351877.45260.70.

Abstract

Objective: This study describes naturalistic 3-month follow-up after discharge from a 5-day partial hospitalization dialectical behavior therapy (DBT) program for women diagnosed with borderline personality disorder (BPD). We also examined individual BPD criteria as predictors of treatment response.

Methods: Fifty women diagnosed with BPD were consecutively recruited from a partial hospital DBT program, 47 of whom (94%) completed all assessments including baseline (prior to discharge) and 3-months post-discharge assessments. Most continued with some combination of individual psychotherapy and pharmacotherapy, and all had the option of continuing with weekly DBT skills classes. Baseline scores were compared to 3-month scores using paired two-tailed non-parametric (sign) tests. Regression analyses were conducted to identify predictors of outcome.

Results: Depression, hopelessness, anger expression, dissociation, and general psychopathology scores significantly decreased over the 3-month follow-up interval, although scores on several measures remained in the clinical range. Those who endorsed emptiness, impulsivity, and relationship disturbance demonstrated improvement on a number of outcomes, while those who endorsed identity disturbance and fear of abandonment had less improvement on some outcomes.

Conclusion: These findings illustrate (1) that improvement occurred over a 3-month interval on a number of measures in patients receiving treatment as usual following discharge from a partial hospitalization program, and (2) that BPD is a complex, heterogeneous disorder for which there is no single pathognomonic criterion, so that each criterion should be considered individually in determining its potential effect on treatment outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aftercare
  • Behavior Therapy / methods*
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / psychology
  • Borderline Personality Disorder / therapy*
  • Combined Modality Therapy
  • Day Care, Medical / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Meditation
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Psychotherapy, Group / methods
  • Psychotropic Drugs / therapeutic use
  • Young Adult

Substances

  • Psychotropic Drugs