Borderline personality disorder (BPD) is a complex psychiatric condition whose severity is compounded by the heterogeneous psychological functioning of those who suffer from the disorder. This heterogeneity has made the identification of a unified treatment strategy difficult and attempts to resolve this variation within the disorder by investigating subtypes of BPD have been made. However, the clinical utility of this approach has not been examined. The major object of this research project was to investigate the presence of subtypes of BPD and to examine whether treatment effectiveness varied as a function of subtype. Data from 61, predominantly female, participants with BPD were entered into a cluster analysis. Using variables that are central to cognitive behavioural models of BPD and have been shown to be heterogeneously distributed in previous BPD samples, two subgroups were identified and defined on the basis of whether participants attributed the causes o f negative events as being themselves or other people. Consistent with hypotheses, the subgroup with a tendency to blame others for negative events showed far lower levels of change between admission and discharge than the subgroup who blamed themselves for negative events, on both measures of statistical and clinical significance. Alternate means of identifying participants who optimally responded to the intervention were explored and a cluster analysis identified two groups of participants that were separated on the basis of whether they had shown clinically significant change on a range of variables. It was found that data from admission to the program could successfully predict which participants would belong in the optimal or mixed response groups upon discharge. Taken together, the findings of this research project suggest that not only can theoretically valid subgroups of BPD be identified, but that they have clinical utility in understanding participants' response to intervention. Further, the findi ngs suggest that profiles of clinical change can be identified and predicted. The findings of this research project are discussed with respect to their methodological limitations, suggestions for future research, and their implications for both theory and practice.
| Identifer | oai:union.ndltd.org:ADTP/246518 |
| Date | January 2009 |
| Creators | Nesci, Julian, julian.nesci@gmail.com |
| Publisher | RMIT University. Health Science |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://www.rmit.edu.au/help/disclaimer, Copyright Julian Nesci |
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