Borderline personality disorder (BPD) is a highly prevalent and chronic psychiatric problem characterized by a pattern of chaotic, self-defeating interpersonal relationships, emotional instability, poor impulse control, chronic anger, frequent suicidality, self-mutilation and has a high risk of suicide. Not surprisingly, BPD has been associated with higher levels of service use in emergency room, daycare, and inpatient settings. Although, preliminary evidence suggest that psychotherapy treatment is helpful in reducing borderline pathology, controlled studies are rare and the mechanisms that promote change remain unspecified. Clinical investigators have noted that fundamental aspects of borderline personality disorder can be understood as stemming from impairments in patients underlying attachment organization. The attachment theory constructs of internal working models, coherence, and reflective function provide an important means for understanding how psychotherapy may directly influence BPD. In a sample of 140 patients with BPD, randomly assigned to either a modified psychodynamic treatment called transference-focused psychotherapy (TFP), a cognitive behavioral therapy called Dialectic Behavioral Therapy (DBT), or a treatment as ususal. Supportive Psychotherapy (SPT), the current study using a multi-method approach to data collection, including self-report, interview, and global and micro- analytic coding of observational data, assesses the efficacy of these treatments and the mediating role of attachment, through examining effect sizes and growth curve analyses and regression analyses. By examining the psychological mechanisms that contribute to and mediate BPD this study hopes to inform psychological interventions and promote adaptation and optimal mental health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32MH012530-02
Application #
6402803
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Light, Enid
Project Start
2001-06-24
Project End
Budget Start
2001-06-24
Budget End
2002-06-23
Support Year
2
Fiscal Year
2001
Total Cost
$34,832
Indirect Cost
Name
Weill Medical College of Cornell University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
201373169
City
New York
State
NY
Country
United States
Zip Code
10065
Diamond, Diana; Levy, Kenneth N; Clarkin, John F et al. (2014) Attachment and mentalization in female patients with comorbid narcissistic and borderline personality disorder. Personal Disord 5:428-33
Fertuck, Eric A; Mergenthaler, Erhard; Target, Mary et al. (2012) Development and criterion validity of a computerized text analysis measure of reflective functioning. Psychother Res 22:298-305
Meehan, Kevin B; Levy, Kenneth N; Clarkin, John F (2012) Construct Validity of a Measure of Affective Communication in Psychotherapy. Psychoanal Psychol 29:145-165
Kernberg, Otto F; Yeomans, Frank E; Clarkin, John F et al. (2008) Transference focused psychotherapy: overview and update. Int J Psychoanal 89:601-20