The general aim of this research proposal is to develop an effective treatment intervention for individuals who meet criteria for both drug use disorders and for borderline personality disorder (BPD).
Specific aims are to pilot test and modify as needed an existing cognitive behavioral treatment (Dialectical Behavior Therapy; DBT) which has been shown to be effective for severely dysfunctional, chronically suicidal women who meet criteria for BPD. We will also develop and pilot an assessment battery for evaluating treatment with this population. To accomplish these objectives, we plan to conduct a one year pilot treatment outcome study with approximately 20 subjects meeting criteria for both drug use disorder and for BPD. Subjects will be randomly assigned to a DBT pilot treatment condition (n=10) or to a community treatment-as-usual (TAU) condition (n=10). Outcomes targeted and measured will include reductions in frequency and severity of substance abuse, suicidal behaviors, therapy-interfering behaviors, dysfunctional behaviors (other than substance abuse and suicidal behaviors) that severely limit the quality of life and negative affect and enhancement of general functioning and interpersonal skills. DBT therapists will be the PI as well as experienced psychotherapists and drug abuse counselors trained in DBT by the PI. The major outcome assessment battery will be administered at pre-, 4-month, 8-month, and 12-month points (immediately following the end of treatment) treatment points. Additional daily patient ratings, weekly client and therapist ratings by DBT subjects and random drug testing for all subjects will be conducted. Observation of treatment sessions (through one-way mirrors and by video), weekly case consultation meetings, and ongoing assessments will be used to monitor and document treatment delivery and make necessary changes to the treatment and assessment protocols.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA008674-03
Application #
2121319
Study Section
Special Emphasis Panel (SRCD)
Project Start
1993-09-30
Project End
1996-07-31
Budget Start
1995-08-01
Budget End
1996-07-31
Support Year
3
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Washington
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Neacsiu, Andrada D; Rizvi, Shireen L; Linehan, Marsha M (2010) Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behav Res Ther 48:832-9
Chapman, Alexander L; Derbidge, Christina M; Cooney, Emily et al. (2009) Temperament as a prospective predictor of self-injury among patients with borderline personality disorder. J Pers Disord 23:122-40
Chen, Eunice Yu; Brown, Milton Z; Harned, Melanie S et al. (2009) A comparison of borderline personality disorder with and without eating disorders. Psychiatry Res 170:86-90
Linehan, Marsha M; Dimeff, Linda A; Reynolds, Sarah K et al. (2002) Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend 67:13-26
Linehan, M M; Schmidt 3rd, H; Dimeff, L A et al. (1999) Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. Am J Addict 8:279-92
Linehan, M M (1997) Special feature: theory and treatment development and evaluation: reflections on Benjamin's ""models for treatment"". J Pers Disord 11:325-35