Evaluating three treatments for borderline personality disorder: A multiwave study
Evaluating three treatments for borderline personality disorder: A multiwave study
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DOI：
10.1176/appi.ajp.164.6.922
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发表时间：
2007-06-01
影响因子：
17.7
通讯作者：
Kernberg, Otto F.
中科院分区：
文献类型：
--
作者：
Clarkin, John F.;Levy, Kenneth N.;Kernberg, Otto F.
目的：作者研究了三年的门诊治疗边缘型人格障碍：辩证行为疗法，转移为重点的心理治疗，和一个动态的支持treatment.Method：90例被诊断为边缘型人格障碍的患者被随机分配到转移为重点的心理治疗，辩证行为疗法，或支持治疗，并接受药物治疗时表示。在治疗前和4个月的时间间隔，在1年的时间内，盲评分评估域的自杀行为，侵略，冲动，焦虑，抑郁，和社会适应在一个多波studydesign.Results：个人的增长曲线分析显示，在所有三个治疗组的患者表现出显着的积极变化，抑郁，焦虑，全球功能，和社会适应在1年的治疗。移情焦点心理治疗和辩证行为治疗与自杀倾向的改善显著相关。只有以移情为中心的心理治疗和支持性治疗与愤怒的改善有关。转移集中的心理治疗和支持性治疗都与冲动性方面的改善有关。只有转移为重点的心理治疗是显着预测的变化，易怒和口头和直接attack.Conclusions：边缘型人格障碍患者的结构化治疗在门诊设置的结果在多个领域的变化。一种结构化的动态治疗，以迁移为中心的心理治疗与六个领域的多个结构的变化相关;辩证行为治疗和支持性治疗与较少的变化相关。未来的研究需要检查这些治疗中超出常见结构的具体变化机制。
Objective: The authors examined three yearlong outpatient treatments for borderline personality disorder: dialectical behavior therapy, transference-focused psychotherapy, and a dynamic supportive treatment.Method: Ninety patients who were diagnosed with borderline personality disorder were randomly assigned to transference-focused psychotherapy, dialectical behavior therapy, or supportive treatment and received medication when indicated. Prior to treatment and at 4-month intervals during a 1-year period, blind raters assessed the domains of suicidal behavior, aggression, impulsivity, anxiety, depression, and social adjustment in a multiwave study design.Results: individual growth curve analysis revealed that patients in all three treatment groups showed significant positive change in depression, anxiety, global functioning, and social adjustment across 1 year of treatment. Both transference-focused psychotherapy and dialectical behavior therapy were significantly associated with improvement in suicidality. Only transference-focused psychotherapy and supportive treatment were associated with improvement in anger. Transference-focused psychotherapy and supportive treatment were each associated with improvement in facets of impulsivity. Only transference-focused psychotherapy was significantly predictive of change in irritability and verbal and direct assault.Conclusions: Patients with borderline personality disorder respond to structured treatments in an outpatient setting with change in multiple domains of outcome. A structured dynamic treatment, transference-focused psychotherapy was associated with change in multiple constructs across six domains; dialectical behavior therapy and supportive treatment were associated with fewer changes. Future research is needed to examine the specific mechanisms of change in these treatments beyond common structures.