The evaluation of a stepped care approach for early intervention of borderline personality disorder

• Verfasst von: Cavelti, Marialuisa [VerfasserIn]
• Verfasst von: Blaha, Yasmine [VerfasserIn]
• Verfasst von: Lerch, Stefan [VerfasserIn]
• Verfasst von: Hertel, Christian [VerfasserIn]
• Verfasst von: Berger, Thomas [VerfasserIn]
• Verfasst von: Reichl, Corinna [VerfasserIn]
• Verfasst von: Koenig, Julian [VerfasserIn]
• Verfasst von: Kaess, Michael [VerfasserIn]
• Titel: The evaluation of a stepped care approach for early intervention of borderline personality disorder
• Verf.angabe: Marialuisa Cavelti, Yasmine Blaha, Stefan Lerch, Christian Hertel, Thomas Berger, Corinna Reichl, Julian Koenig and Michael Kaess
• E-Jahr: 2024
• Jahr: 18 June 2024
• Umfang: 10 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 22.11.2024
• Titel Quelle: Enthalten in: Borderline Personality Disorder and Emotion Dysregulation
• Ort Quelle: London : BioMed Central, 2014
• Jahr Quelle: 2024
• Band/Heft Quelle: 11(2024), Artikel-ID 12, Seite 1-10
• ISSN Quelle: 2051-6673
• DOI: doi:10.1186/s40479-024-00256-1
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adolescence
• Sach-SW: Borderline personality disorder
• Sach-SW: Cutting down program
• Sach-SW: Dialectical behavioral therapy
• Sach-SW: Early intervention
• Sach-SW: Stepped care
• K10plus-PPN: 1909365831

Abstract

Background: The current study evaluated the stepped care approach applied in AtR!Sk; a specialized outpatient clinic for adolescents with BPD features that offers a brief psychotherapeutic intervention (Cutting Down Program; CDP) to all patients, followed by a more intensive Dialectical Behavioral Therapy for Adolescents (DBT-A) for those whose symptoms persist. Methods: The sample consisted of 127 patients recruited from two AtR!Sk clinics. The number of BPD criteria, psychosocial functioning, severity of overall psychopathology, number of days with non-suicidal self-injury (NSSI; past month), and the number of suicide attempts (last 3 months) were assessed at clinic entry (T0), after CDP (T1), and at 1- and 2-year follow-up (T2, T3). Based on the T1 assessment (decision criteria for DBT-A: ≥ 3 BPD criteria & ZAN-BPD ≥ 6), participants were allocated into three groups; CDP only (n = 74), CDP + DBT-A (eligible and accepted; n = 36), CDP no DBT-A (eligible, but declined; n = 17). Results: CDP only showed significantly fewer BPD criteria (T2: β = 3.42, p < 0.001; T3: β = 1.97, p = 0.008), higher levels of psychosocial functioning (T2: β = -1.23, p < 0.001; T3: β = -1.66, p < 0.001), and lower severity of overall psychopathology (T2: β = 1.47, p < 0.001; T3: β = 1.43, p = 0.002) over two years compared with CDP no DBT-A, while no group differences were found with regard to NSSI and suicide attempts. There were no group differences between CDP + DBT-A and CDP no DBT-A, neither at T2 nor at T3. Discussion: The findings support the decision criterion for the offer of a more intense therapy after CDP. However, there was no evidence for the efficacy of additional DBT-A, which might be explained by insufficient statistical power in the current analysis.