Recent research suggests that BPD is a common, serious but treatable disorder with a better than previously recognized prognosis. Despite these findings, many patients with BPD are not given the borderline diagnosis by the mental health professionals treating them. It is also true that many newly diagnosed borderline patients are not provided with up-to-date information on the disorder even though psychoeducation has been found to be a useful form of treatment for other serious psychiatric illnesses. Our group has conducted a preliminary randomized trial of psychoeducation for BPD that found that those provided with immediate psychoeducation had a significantly greater reduction in two core symptoms of BPD--general impulsivity and stormy relationships--than those with delayed psychoeducation. However, both instruction and assessment of change over time were conducted in person by paraprofessionals. The importance of the current study is that it will allow us to develop and test the efficacy of an internet-based program of psychoeducation for BPD that will be both cost efficient and easy to disseminate widely, particularly to underserved populations. This application has three main aims.
Our first aim i s to update the curriculum for teaching individuals with BPD the latest information concerning the disorder.
Our second aim i s to develop a website for teaching this curriculum and assessing change in three key outcomes: severity of borderline psychopathology, psychosocial impairment, and treatment utilization over time.
Our third aim i s to conduct a small-scale randomized controlled trial of psychoeducation for BPD using this set of web-based instructional and assessment tools. Half of the study's 80 subjects will receive this intervention a week after diagnostic disclosure and half will not. We plan to assess our three outcomes each week for 12 weeks (as we did in our prior study) to determine its immediate effects. We also plan to assess these outcomes at six, nine, and 12 months after randomization to determine if these effects are long lasting. The completion of this project will prepare us for an R01 application to test the effectiveness of this early form of treatment for BPD in community settings. In this phase, we will conduct a large-scale, multi-site randomized controlled trial to determine if gaining internet-based knowledge about BPD leads to significant improvement in the areas of symptom severity, psychosocial functioning, and treatment utilization.
Borderline personality disorder (BPD) is a common and serious psychiatric disorder. The proposed randomized trial of psychoeducation for BPD will use a web-based program for both instruction about BPD and the assessment of acute and long-term outcomes in the realms of symptom severity, psychosocial functioning, and treatment utilization. If successful, this web-based program will be a cost efficient method for the wide dissemination of this early form of treatment for BPD-a form of treatment that has proven effective for other serious psychiatric disorders.