Which Factors Are Relevant for Treatment Outcome in Dialectical Behaviour Therapy for Borderline Personality Disorder?

Recruiting

• Conditions: Borderline Personality Disorder; Non-suicidal Self-injury; Deliberate Self Harm
• Interventions: Behavioral: Dialectibal Behaviour Therapy

• Registration Number: NCT06106555
• Lead Sponsor: Region Skane

Brief Summary

The objective of this project is to investigate factors that contribute to the success and lack of success in DBT among individuals with BPD and a history of self-harm in a clinical psychiatric setting.

1. Do certain personality factors and identity disturbance predict the treatment outcome of DBT in individuals with BPD?

2. Do changes in identity disturbance, self-hate, or emotion regulation mediate the treatment outcome of DBT in individuals with BPD?

3. Do specific personality profiles moderate the treatment outcomes of DBT for individuals with BPD?

4. When does the primary treatment effect occur, and does this effect persist after a 12-month follow-up period?

Detailed Description

Borderline Personality Disorder (BPD) is a complex and enduring mental health condition characterized by a range of symptoms. The consequences of BPD are severe, causing individual suffering, impairments in daily functioning, and increased mortality rates. Dialectical behavior therapy (DBT) is one of the most widely used treatment models for BPD and self-harm. DBT has demonstrated positive outcomes but not all individuals benefit equally from this therapy, highlighting the need for further exploration. Specifically, there is a knowledge gap regarding what predicts positive treatment response. Research exploring this topic, has highlighted the potential significance of emotion regulation, personality profiles, self-concept, and identity disturbance in understanding the outcomes of individuals with BPD.

The primary objective of this research project is to investigate the factors that contribute to the success and lack of success in DBT.

All individuals referred to DBT-treatment in the Adult psychiatric clinic in Lund will be offered participation in the study. All study participants receive the same treatment as those who chose not to participate. Measures will commence after treatment contracts have been negotiated and the treatment will continue up to a maximum treatment length of one year.

Data will be retrieved from databases, medical records as well as collected as self-report forms. Self-report measures will be conducted every three months, at end of treatment and at follow up 12 months after end of treatment. Data from registries and charts will be collected at time of consent and at follow up 12 months after treatment.

Study Timeline

• Study Start: 2023-09-01
• Study First Submitted: 2023-10-24
• Study First Submitted QC: 2023-10-24
• Study First Posted: 2023-10-30
• Status Verified: 2024-02
• Last Update Submitted: 2024-02-27
• Last Update Posted: 2024-02-28
• Primary Completion: 2027-08-31
• Study Completion: 2027-08-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Borderline personality disorder as defined by the DSM-V (assessed with SCID or uquivalent).
• Self-harm over the past 12 months
• Offered DBT at the Lund adult psychiatric clinic

Exclusion Criteria

• Unable to read or communicate in Swedish

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Individuals with BPD	Dialectibal Behaviour Therapy	Individuals with BPD, as defined by the DSM-V, and a recent history (past 12 months) of self-harming behaviour.

Primary Outcome Measures

Name	Time	Method
Five Self-harm Behaviour Groupings Measure (5S-HM)	Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.	Indirect and direct self-harm

Secondary Outcome Measures

Name	Time	Method
The Borderline Symptom List-23 (BSL-23)	Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.	Borderline symptoms
The Personality Inventory for DSM-V Brief Form (PID-5-BF)	Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.	Personality structure
Hospitilization days	Treatment at end of treatment and at follow up at 24 months.	Days admitted to a psychiatric ward past year
The World Health Organization Disability Assessment Schedule II (WHODAS 2)	Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.	Daily functioning and impairment
The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS 2.0)	Treatment start, 3,6,9 and at end of treatment and at follow up at 24 months.	Personality functioning

Trial Locations

Locations (1)

Lund adult psychiatric hospital; 🇸🇪 Lund, Skåne, Sweden