The overall goal of this study is to continue a prospective study of the long-term course and outcome of borderline personality disorder (BPD). BPD is a common, symptomatically severe disorder associated with marked levels of psychosocial impairment and high levels of mental health and other social service utilization. Initial assessment data are available for a sample of 362 inpatients between the ages of 18 and 35; 290 borderline patients and 72 Axis II controls. In addition, the 95 percent of the surviving patients currently eligible for their 2, 4, and 6-year follow-up evaluations have been re-interviewed. The first specific aim is to prospectively assess the six, eight, and ten-year course and outcome of these patients. Four main aspects of the course and outcome will be studied: (1) severity of borderline symptoms, (2) impairment in psychosocial functioning, (3) prevalence of comorbid Axis I and Axis II disorders, and (4) type and amount of psychiatric and medical treatment received. The second specific aim is to determine the best predictive model for each of four outcomes: remission of BPD, recurrence of BPD, the attainment of good psychosocial functioning, and suicide. The third specific aim is to assess the pathways to health reported by those borderline patients who improve substantially. The fourth specific aim is to compare the predictive power of three models of BPD: the categorical model, the severity model of dimensionality, and the 5-Factor Model of dimensionality. Demographic data, social and vocational functioning, psychiatric and medical treatment, borderline symptoms, Axis I and Axis II comorbidity, life stress, basic aspects of temperament, and pathways to health will be assessed at each follow-up period by one of two masters level research assistants blind to all previously collected data. In addition, knowledgeable informants will be interviewed concerning each patient's psychosocial functioning, and medical, work, and school records will be collected and reviewed.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH062169-01
Application #
6192293
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Breiling, James P
Project Start
2000-09-30
Project End
2005-08-31
Budget Start
2000-09-30
Budget End
2001-08-31
Support Year
1
Fiscal Year
2000
Total Cost
$352,108
Indirect Cost
Name
Mc Lean Hospital (Belmont, MA)
Department
Type
DUNS #
City
Belmont
State
MA
Country
United States
Zip Code
02478
Zanarini, Mary C; Temes, Christina M; Frankenburg, Frances R et al. (2018) Description and prediction of time-to-attainment of excellent recovery for borderline patients followed prospectively for 20 years. Psychiatry Res 262:40-45
Gad, Mohammad A; Pucker, Hannah E; Hein, Katherine E et al. (2018) Facets of identity disturbance reported by patients with borderline personality disorder and personality-disordered comparison subjects over 20 years of prospective follow-up. Psychiatry Res 271:76-82
Goodman, Marianne; Tomas, Irene Alvarez; Temes, Christina M et al. (2017) Suicide attempts and self-injurious behaviours in adolescent and adult patients with borderline personality disorder. Personal Ment Health 11:157-163
Zanarini, Mary C; Temes, Christina M; Ivey, Alexandra M et al. (2017) The 10-year course of adult aggression toward others in patients with borderline personality disorder and axis II comparison subjects. Psychiatry Res 252:134-138
Borkum, Dana B; Temes, Christina M; Magni, Laura R et al. (2017) Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD. Personal Ment Health 11:189-194
Zanarini, Mary C; Frankenburg, Frances R; Reich, D Bradford et al. (2016) Fluidity of the Subsyndromal Phenomenology of Borderline Personality Disorder Over 16 Years of Prospective Follow-Up. Am J Psychiatry 173:688-94
Zanarini, Mary C; Frankenburg, Frances R; Reich, D Bradford et al. (2015) Treatment rates for patients with borderline personality disorder and other personality disorders: a 16-year study. Psychiatr Serv 66:15-20
Zanarini, Mary C; Frankenburg, Frances R; Reich, D Bradford et al. (2015) The course of marriage/sustained cohabitation and parenthood among borderline patients followed prospectively for 16 years. J Pers Disord 29:62-70
Reed, Lawrence Ian; Fitzmaurice, Garrett; Zanarini, Mary C (2015) The relationship between childhood adversity and dysphoric inner states among borderline patients followed prospectively for 10 years. J Pers Disord 29:408-17
Zanarini, Mary C; Frankenburg, Frances R; Bradford Reich, D et al. (2015) Rates of psychotropic medication use reported by borderline patients and axis II comparison subjects over 16 years of prospective follow-up. J Clin Psychopharmacol 35:63-7

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