A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder.
Abstract
The authors introduce a manual-based treatment, labeled dynamic deconstructive psychotherapy, developed for those patients with borderline personality disorder who are most difficult to engage in therapy, such as those having co-occurring substance use disorders. This treatment model is based on the hypothesis that borderline pathology and related behaviors reflect impairment in specific neurocognitive functions, including association, attribution, and alterity that form the basis for a coherent and differentiated self. Dynamic deconstructive psychotherapy aims to activate and remediate neurocognitive self-capacities by facilitating elaboration of affect-laden interpersonal experiences and integration of attributions, as well as providing novel experiences in the patient-therapist relationship that promote self-other differentiation. Treatment involves weekly individual sessions for a predetermined period of time and follows sequential stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
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Some studies concentrated on participants with distinct comorbid conditions, such as alcohol abuse or dependence, post-traumatic stress disorder, or major depressive disorder episodes.
“Some studies, however, concentrated on participants with distinct comorbid conditions, such as alcohol abuse or dependence (Gregory 2008), post-traumatic stress disorder (Steil 2010) or major depressive disorder episodes (Bellino 2006;Bellino 2007).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
In Gregory 2008, DDP participants received fewer overall treatment contact hours than did participants receiving community care.
“DDP participants received fewer overall treatment contact hours than did participants receiving community care.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
Gregory 2008 data indicate no statistically significant difference between conditions in proportion of participants with self-mutilating behaviour (RR 0.89; N = 30; 95% CI 0.47 to 1.67, Analysis 1.9).
“Gregory 2008 report data that indicate no statistically significant difference between both conditions in terms of proportion of participants with self-mutilating behaviour (RR 0.89; N = 30; 95% CI 0.47 to 1.67, Analysis 1.9).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
In Gregory 2008, control group participants did not receive less professional attention despite not receiving an alternate, obligatory control treatment.
“Though participants of the control group did not receive an alternate, obligatory control treatment, but were free to join alternative treatments, they did not receive less professional attention.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
DDP was used in a RCT conducted by its developer (Gregory 2008).
“DDP was used in a RCT conducted by its developer (Gregory 2008).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
Gregory 2008 was at low risk of detection bias for blinding of outcome assessment.
“Blinding of outcome assessment (detection bias) All outcomes Low risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
Gregory 2008 was at low risk of selection bias for random sequence generation because a minimization method was employed for group assignment, ensuring comparability on key variables.
“Random sequence generation (selection bias) Low risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
Dynamic Deconstructive Psychotherapy (DDP) was also investigated in a single trial only (Gregory 2008).
“Dynamic Deconstructive Psychotherapy (DDP) was also investigated in a single trial only (Gregory 2008).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
Gregory 2008 was at low risk of selection bias for allocation concealment because participants were assigned by the research coordinator.
“Allocation concealment (selection bias) Low risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
DDP participants received fewer overall treatment contact hours than did participants receiving community care.
“Indeed,”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
In Gregory 2008, control group participants did not get an obligatory control treatment but were referred to alternative treatments in the community and had markedly more professional contact hours during most of the study period.
“The participants allocated to the control group of Gregory 2008 did not get an obligatory control treatment, but were referred to alternative treatments in the community and had not less but markedly more professional contact hours during most of the study period.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
The risk of attention bias was judged low for Gregory 2008.
“The risk of attention bias was therefore also judged low for this trial.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
DDP was indicated to be superior to control in BPD severity, parasuicidality, and depression with small to moderate effects, although there were no statistically significant results.
“There were no statistically significant results, but DDP was indicated to be superior to the control group in terms of BPD severity and parasuicidality and depression with small to moderate effects.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Gregory 2008
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- Authors
- Gregory, R. J., & Remen, A. L.
- Affiliations
- SUNY Upstate Medical University (US)
- ORCID
- Gregory, Robert J.
- Venue
- Psychotherapy: Theory, Research, Practice, Training
- Published
- 2008
- Volume
- 45
- Issue
- 1
- Pages
- 15-27
- ISSN
- 0033-3204 (ISSN-L)
- 1939-1536
- OpenAlex
- W2018025294
- Cited by
- 66
- References
- 51
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 1 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Department of Biotechnology, Ministry of Science and Technology, India
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- borderline personality disorder, substance use disorders, co-occurring disorders, self-other distinction, attribution, otherness, therapeutic relationship
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