Five Factor Model Treatment for Borderline Personality Disorder

NCT04587518 | Completed

• 1 other identifier: 60042
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The primary purpose of this study is to explore acceptability, feasibility, and preliminary efficacy of a novel cognitive-behavioral treatment for borderline personality disorder (BPD). Extant treatments for this condition are intensive, long-term (usually at least one year), and have, understandably, focused on targeting the life-threatening and therapy-interrupting behaviors that often characterize this disorder. BPD, however, is a heterogeneous disorder with diagnostic criteria that can be combined to create over 300 unique symptom presentations (Ellis, Abrams, \& Abrams, 2008); to date, no treatments have been explicitly designed with lower risk presentations of BPD in mind. This is unfortunate, as there is evidence to suggest that the majority of individuals with BPD do not demonstrate the recurrent life-threatening behaviors that warrant intensive, long-term care (Trull, Useda, Conforti, \& Doan, 1997; Zimmerman \& Coryell, 1989). Additionally, various studies have shown that the difficulties experienced by individuals with BPD can be understood as manifestations of maladaptive variants of personality traits (e.g., Mullins-Sweatt et al., 2012). Specifically, individuals with BPD demonstrate high levels of neuroticism, and low levels of agreeableness (antagonism) and conscientiousness (disinhibition); these traits may not be universally present across all individuals with BPD, perhaps underscoring the heterogeneity in presentations of this condition.

Conditions

Borderline Personality Disorder

Keywords

borderline personality disorder; treatment; CBT; five-factor model

Outcome Measures

Primary Outcomes (5)

• Change in clinician-rated borderline personality disorder symptoms

  Change in borderline personality disorder symptoms will be measured using Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) - clinician-rated version. Scores range from 0-36; higher scores indicate greater severity of borderline personality disorder symptoms

  44 weeks (baseline, post-treatment/waitlist, 6 month follow-up)

• Change in patient-reported borderline personality disorder symptoms

  Change in borderline personality disorder symptoms will be measured using Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) - self-report version. Scores range from 0-36; higher scores indicate greater severity of borderline personality disorder symptoms

  18 weeks (week 1[baseline for immediate treatment condition, post-waitlist for delayed treatment condition], week, 2, week 3, week, 4.....week 18)

• Change in clinician-rated clinical severity

  Clinical severity will be measured using the Diagnostic Interview for Anxiety, Mood, and Obsessive Compulsive and Related Neuropsychiatric Disorders (DIAMOND) dimensional clinician ratings. Scores range from 1-7; higher scores indicate greater severity.

  44 weeks (baseline, post-treatment/waitlist, 6 month follow-up)

• Change in Anxiety Symptoms

  Anxiety symptoms will be measured using the Overall Anxiety Severity and Interference Scale (OASIS). This is a self-report measure in which scores range from 0-20; higher scores indicate more severe anxiety symptoms.

  12 weeks (baseline, week 1, week, 2, week, 3.....week 12)

• Change in Depressive Symptoms

  Depressive symptoms will be measured using the Overall Depression Severity and Interference Scale (ODSIS). This is a self-report measure in which scores range from 0-20; higher scores indicate more severe anxiety symptoms.

  12 weeks (baseline, week 1, week, 2, week, 3.....week 12)

Study Arms (2)

Immediate Treatment

EXPERIMENTAL

Participants in this group will receive the intervention immediately.

Behavioral: Personality-Based Cognitive Behavioral Therapy

Waitlist/Delayed Treatment

EXPERIMENTAL

Participants in this group will receive the intervention after an 18-week wait.

Behavioral: Personality-Based Cognitive Behavioral Therapy

Interventions

Personality-Based Cognitive Behavioral Therapy BEHAVIORAL

The study treatment will take place across 18-sessions. The first session will involve psychoeducation regarding BPD.The next two sessions with include exercises drawn from Behavioral Activation (i.e., identification of value-based goals) and Motivational Interviewing (i.e., pros and cons \[long and short-term consequences\] of tolerating emotions, engaging in prosocial behavior, and delaying gratification). Next, patients will receive 5 sessions of cognitive interventions (i.e., cognitive reappraisal related to situations/emotions, schema related to relationships, 5 sessions of behavior change skills (i.e., acting opposite to emotion-driven urges, exposure, assertiveness training), and 5 sessions of mindfulness skills (i.e., nonjudgmental emotion awareness, compassion training, urge surfing). Finally, treatment will conclude with 2 sessions of Relapse Prevention strategies. All sessions will last for 60 minutes in duration.

Immediate Treatment; Waitlist/Delayed Treatment

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• diagnosis of borderline personality disorder (BPD)

You may not qualify if:

• diagnosed psychological conditions that would be better addressed by alternative treatments
• previously received more than 5 sessions of cognitive behavioral therapy in the past 5 years
• concurrent psychotherapy
• medication instability

Sponsors & Collaborators

• Shannon E. Sauer-Zavala: lead

Study Sites (1)

University of Kentucky

Lexington, Kentucky, 40506, United States

Location

Related Publications (1)

• Sauer-Zavala S, Southward MW, Fruhbauerova M, Semcho SA, Stumpp NE, Hood CO, Smith M, Elhusseini S, Cravens L. BPD compass: A randomized controlled trial of a short-term, personality-based treatment for borderline personality disorder. Personal Disord. 2023 Sep;14(5):534-544. doi: 10.1037/per0000612. Epub 2023 Jan 2.

  PMID: 36595435 DERIVED

MeSH Terms

Conditions

Borderline Personality Disorder

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders

Study Officials

• Shannon Sauer-Zavala

  University of Kentucky

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: October 7, 2020
• First Posted: October 14, 2020
• Study Start: September 3, 2020
• Primary Completion: May 3, 2024
• Study Completion: May 3, 2024
• Last Updated: September 19, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)