Extant treatments for borderline personality disorder (BPD) are time-intensive, consist of multiple components, and are informed by different theoretical perspectives. Comprehensive evaluation of the driving mechanism(s) maintaining BPD is warranted to maximize cost-effectiveness and efficiency of treatment. Focusing on impaired interpersonal functioning in BPD, a hallmark characteristic of the disorder, may provide a useful microcosm for evaluating different approaches to understanding what drives the full expression of the disorder. This study evaluated two brief, theoretically distinct interventions for BPD and their effects on interpersonal conflict using single case experimental design. Patients (N = 8; 6 female, mean age 27.00, range 19–55) were randomized to receive an intervention either informed by emotion dysregulation theory or attachment theory. Patients reported their frequency of daily interpersonal conflicts using ecological momentary assessment and completed weekly questionnaires including measurement of theoretically-consistent mechanisms and global BPD symptoms. It was hypothesized that patients would demonstrate a significant response (50% decrease in daily interpersonal conflicts) during either intervention compared to baseline. It was also hypothesized that patients would evidence decreases in the purported mechanism of whichever intervention they received. Regarding change in interpersonal conflicts, three participants responded after the first module (two in the attachment security intervention, one in the emotion regulation intervention), three were partial responders (two in attachment security, one in emotion regulation), and two were classified as non-responders (both in emotion regulation). Furthermore, there were decreasing trends in both mechanisms for the majority of patients who received the corresponding interventions. Interestingly, there were decreasing trends in the alternate mechanism even when patients did not receive the corresponding intervention. No significant differences between conditions were observed related to interpersonal conflict or mechanisms. Notably, there were decreases in global BPD symptoms across both conditions. Results indicate that interpersonal conflict specifically and BPD symptoms can improve in brief interventions informed by different theories. This study suggests that multiple mechanisms may be driving BPD symptomatology and/or mechanisms may be more similar than previously stated in the literature, and points to the importance of idiographic evaluation in BPD research and treatment.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/43966 |
| Date | 04 March 2022 |
| Creators | Tirpak, Julianne Wilner |
| Contributors | Sauer-Zavala, Shannon |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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