Measuring Changes in Symptoms Relevant to Borderline Personality Disorder Following Short-Term Treatment across Partial Hospital and Intensive Outpatient Levels of Care
Abstract
OBJECTIVE: This study examined whether measurable changes in symptoms relevant to borderline personality disorder (BPD) occur following short-term treatment across partial hospital and intensive outpatient levels of care. Preliminary data on symptom changes among patients with BPD during the first 3 months of treatment in a step-down treatment program are presented. METHODS: Of the 42 patients who entered the BPD-specific treatment program during the 18-month study period, 36 consented to participate in the study. Patients began treatment in the partial hospitalization program (where the average length of stay is 8 weeks) and then transitioned into the intensive outpatient program. Patients completed questionnaire packets upon admission, and again at 1 month and 3 months into treatment. The questionnaires assessed BPD-relevant behaviors and symptoms, including: mood and emotion dysregulation, parasuicidality, symptom severity, and quality of life. RESULTS: Results indicate significant and progressive improvements in mood and emotion dysregulation, parasuicidality, and symptom severity following 1 and 3 months of treatment. However, neither global functioning nor quality of life dramatically improved. CONCLUSIONS: The findings from this study highlight the amenability of BPD-relevant symptoms to short-term treatments and demonstrate the possibility of measuring change in these symptoms within the very early phases of treatment.
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The DERS has good construct validity in adult psychiatric patients and sensitivity to change due to successful clinical intervention.
“The DERS has also exhibited good construct validity in adult psychiatric patients. Specifically, the measure has demonstrated sensitivity to change due to successful clinical intervention [52, 53].”
Cites
Gratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942 · see citing works
Self-citationJacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770 · see citing works
The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
Endicott, J. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770060086012 · Cited by 4,982 · see citing works
Cognitive-behavioral treatment of chronically parasuicidal borderline patients
Linehan, M. M. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810360024003 · Cited by 2,203 · see citing works
Bateman, A., & Fonagy, P. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.10.1563 · Cited by 1,416 · see citing works
Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory
Gratz, K. L. (2001) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1012779403943 · Cited by 1,166 · see citing works
Self-citationFrisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992) · Psychological Assessment · doi:10.1037/1040-3590.4.1.92 · Cited by 1,075 · see citing works
Axis I Comorbidity of Borderline Personality Disorder
Zanarini, M. C., Frankenburg, F. R., Dubo, E., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.12.1733 · Cited by 978 · see citing works
BATEMAN, A. W., & Fonagy, P. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.1.36 · Cited by 810 · see citing works
The borderline diagnosis I: psychopathology, comorbidity, and personaltity structure
Skodol, A. E., Gunderson, J. G., Pfohl, B., Widiger, T. A., Livesley, W. J., & Siever, L. J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01324-0 · Cited by 769 · see citing works
Self-citationDevelopment and validation of the anger rumination scale
Sukhodolsky, D. G., Golub, A., & Cromwell, E. N. (2001) · Personality and Individual Differences · doi:10.1016/s0191-8869(00)00171-9 · Cited by 711 · see citing works
Mentalization-Based Treatment of BPD
BATEMAN, A. W., & Fonagy, P. (2004) · Journal of Personality Disorders · doi:10.1521/pedi.18.1.36.32772 · Cited by 688 · see citing works
Dialectical behaviour therapy for women with borderline personality disorder
Verheul, R., van den Bosch, L. V. D., Koeter, M., de Ridder, M. D., Stijnen, T., & van den Brink, W. J. (2003) · British Journal of Psychiatry · doi:10.1192/bjp.182.2.135 · Cited by 663 · see citing works
Gratz, K. L., & Gunderson, J. G. (2006) · Behavior Therapy · doi:10.1016/j.beth.2005.03.002 · Cited by 618 · see citing works
Self-citationMcGlashan, T. H., Grilo, C. M., Skodol, A. E., Gunderson, J. G., Shea, M. T., Morey, L. C., Zanarini, M. C., & Stout, R. L. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.102004256.x · Cited by 542 · see citing works
Self-citationBohus, M., Haaf, B., Simms, T., Limberger, M. F., Schmahl, C., Unckel, C., Lieb, K., & Linehan, M. M. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00174-8 · Cited by 526 · see citing works
Interpersonal outcome of cognitive behavioral treatment for chronically suicidal borderline patients
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.12.1771 · Cited by 494 · see citing works
An outcome study of psychotherapy for patients with borderline personality disorder.
(1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.3.358 · Cited by 328 · see citing works
Bohus, M., Haaf, B., Stiglmayr, C., Pohl, U., Böhme, R., & Linehan, M. M. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00103-5 · Cited by 283 · see citing works
The Revised Behavior and Symptom Identification Scale (BASIS-R): Reliability and Validity
Eisen, S. V., Normand, S.-L., Belanger, A. J., Spiro, A., & Esch, D. (2004) · Medical Care · doi:10.1097/00005650-200412000-00010 · Cited by 262 · see citing works
Blum, N., Pfohl, B., John, D. S. S., Monahan, P., & Black, D. (2002) · Comprehensive Psychiatry · doi:10.1053/comp.2002.33497 · Cited by 183 · see citing works
Karterud, S., Pedersen, G., Bjordal, E., Brabrand, J., Friis, S., Haaseth, Ø., Haavaldsen, G., Irion, T., Leirvåg, H., Tørum, E., et al. (2003) · Journal of Personality Disorders · doi:10.1521/pedi.17.3.243.22151 · Cited by 178 · see citing works
An open clinical trial of cognitive therapy for borderline personality disorder.
Brown, G. K., Newman, C., Charlesworth, S., Crits-Christoph, P., & Beck, A. (2004) · Journal of Personality Disorders · doi:10.1521/pedi.18.3.257.35450 · Cited by 100 · see citing works
McQuillan, A., Nicastro, R., Guenot, F., Girard, M., Lissner, C., & Ferrero, F. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.2.193 · Cited by 93 · see citing works
Day Hospital Therapeutic Community Treatment for Patients with Personality Disorders
Karterud, S., Vaglum, S., Friis, S., Irion, T., Johns, S., & Vaglum, P. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199204000-00005 · Cited by 83 · see citing works
Outcomes of Poorly Functioning Patients With Personality Disorders in a Day Treatment Program
Wilberg, T., Karterud, S., Urnes, Ø., Pedersen, G., & Friis, S. (1998) · Psychiatric Services · doi:10.1176/ps.49.11.1462 · Cited by 66 · see citing works
Wilberg, T., Friis, S., Karterud, S., Mehlum, L. I., Urnes, Ø., & Vaglum, P. (1998) · Nordic Journal of Psychiatry · doi:10.1080/08039489850139139 · Cited by 49 · see citing works
Treatment Response of Severe and Nonsevere Personality Disorders in a Therapeutic Community Day Unit
Vaglum, P., Friis, S., Irion, T., Johns, S., Karterud, S., Larsen, F., & Vaglum, S. (1990) · Journal of Personality Disorders · doi:10.1521/pedi.1990.4.2.161 · Cited by 43 · see citing works
A Prospective Psychotherapy Outcome Study
Krawitz, R. (1997) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679709065066 · Cited by 22 · see citing works
Treatment for severe borderline personality disorder in 1987 and 1997 [clinical conference]
Quaytman, M., & Sharfstein, S. S. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.8.1139 · Cited by 14 · see citing works
Flagged first, then by citations
1 of the 31 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Measurement of emotion dysregulation in adolescents
Weinberg, A., & Klonsky, E. D. (2009) · Psychological Assessment · doi:10.1037/a0016669 · Cited by 477 · see citing works
Giromini, L., Velotti, P., de Campora, G., Bonalume, L., & Cesare Zavattini, G. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21876 · Cited by 301 · see citing works
Turner, B. J., Austin, S. B., & Chapman, A. L. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405901103 · Cited by 259 · see citing works
Axelrod, S. R., Perepletchikova, F., Holtzman, K., & Sinha, R. (2011) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2010.535582 · Cited by 254 · see citing works
Alcohol use and alcohol-related consequences: associations with emotion regulation difficulties
Dvorak, R. D., Sargent, E. M., Kilwein, T. M., Stevenson, B. L., Kuvaas, N. J., & Williams, T. J. (2014) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2013.877920 · Cited by 241 · see citing works
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Nick, B., Delany-Brumsey, A., Lynch, T. R., Kosson, D., & Lejuez, C. W. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.07.014 · Cited by 152 · see citing works
Self-citationMeasuring changes in emotion during psychotherapy: Conceptual and methodological issues.
Sloan, D. M., & Kring, A. M. (2007) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2007.00092.x · Cited by 111 · see citing works
A Brazilian Investigation of the 36- and 16-Item Difficulties in Emotion Regulation Scales
Miguel, F. K., Giromini, L., Colombarolli, M. S., Zuanazzi, A. C., & Zennaro, A. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22404 · Cited by 84 · see citing works
The Five Factor Mindfulness Questionnaire in Norway
Dundas, I., Vøllestad, J., Binder, P., & Sivertsen, B. (2013) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12044 · Cited by 77 · see citing works
Gratz, K. L., Levy, R., & Tull, M. T. (2012) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.26.4.365 · Cited by 69 · see citing works
Self-citationDialectical behavior therapy in an intensive outpatient program with a mixed-diagnostic sample
Ritschel, L. A., Cheavens, J. S., & Nelson, J. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20863 · Cited by 52 · see citing works
Huntjens, A., van den Bosch, L. M. C. W., Sizoo, B., Kerkhof, A., Huibers, M. J. H., & van der Gaag, M. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02531-1 · Cited by 50 · see citing works
Advances in psychotherapy of personality disorders: A research update
McMain, S., & Pos, A. E. (2007) · Current Psychiatry Reports · doi:10.1007/s11920-007-0009-7 · Cited by 51 · see citing works
Zimmerman, M., Ward, M., D’Avanzato, C., & Tirpak, J. W. (2021) · Journal of Personality Disorders · doi:10.1521/pedi_2021_35_539 · Cited by 18 · see citing works
Peters, J. R., Mereish, E. H., Krek, M., Chuong, A., Ranney, M. L., SOLOMON, J. M., Spirito, A., & Yen, S. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112664 · Cited by 46 · see citing works
Ertürk, İ. Ş., Kahya, Y., & Gor, N. (2018) · Journal of Aggression, Maltreatment & Trauma · doi:10.1080/10926771.2018.1541493 · Cited by 34 · see citing works
Christopher, M., Jacob, K. L., Neuhaus, E. C., Neary, T. J., & Fiola, L. (2009) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000348362.11548.5f · Cited by 36 · see citing works
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Lenz, A., & Conte, G. S. D. (2018) · Journal of Counseling & Development · doi:10.1002/jcad.12174 · Cited by 24 · see citing works
Emotion dysregulation as a cross-cutting target for inpatient psychiatric intervention
Fowler, J. C., Clapp, J. D., Madan, A., Allen, J. G., Oldham, J. M., & Frueh, B. C. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.07.043 · Cited by 29 · see citing works
Lotzin, A., Romer, G., Schiborr, J., Noga, B., Schulte‐Markwort, M., & Ramsauer, B. S. (2015) · PLoS ONE · doi:10.1371/journal.pone.0144417 · Cited by 24 · see citing works
Winter, D. A., Bradshaw, S. A., Bunn, F., & Wellsted, D. (2013) · Counselling and Psychotherapy Research · doi:10.1080/14733145.2012.761717 · Cited by 27 · see citing works
Borderline Personality Disorder
Gunderson, J. G. (2008) · Social Work in Mental Health · doi:10.1300/j200v06n01_02 · Cited by 20 · see citing works
Self-citationEating disorder behaviors as a form of non-suicidal self-injury
Washburn, J. J., Soto, D., Osorio, C. A., & Slesinger, N. C. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.115002 · Cited by 19 · see citing works
Fowler, J. C., Allen, J. G., Hart, J. M., Szlykh, H., Ellis, T. E., Frueh, B. C., & Oldham, J. M. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-19 · Cited by 15 · see citing works
Effectiveness of Psychosocial Treatments on Suicidality in Personality Disorders
McMain, S. F. (2007) · Canadian journal of psychiatry. Revue canadienne de psychiatrie · doi:10.1177/07067437070526s109 · Cited by 16 · see citing works
Understanding predictors of change in a day treatment setting for non‐suicidal self‐injury
Slesinger, N. C., Hayes, N. A., & Washburn, J. J. (2020) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12295 · Cited by 12 · see citing works
Affective Saturation Index: A Lexical Measure of Affect
Gennaro, A., Carola, V., Ottaviani, C., Pesca, C., Palmieri, A., & Salvatore, S. (2021) · Entropy · doi:10.3390/e23111421 · Cited by 10 · see citing works
Tratamiento integral del Trastorno Límite de Personalidad
López, M. A. T. G., Pérez, M. F. M., & Llop, R. O. (2010) · Revista de la Asociación Española de Neuropsiquiatría · doi:10.4321/s0211-57352010000200005 · Cited by 10 · see citing works
Assessing the effectiveness of intensive outpatient care for Christian missionaries and clergy
Rosik, C. H., Summerford, A., & Tafoya, J. (2009) · Mental Health Religion & Culture · doi:10.1080/13674670903127213 · Cited by 10 · see citing works
Outcomes of Acute Partial Hospital Treatment: Comparison of Two Programs and a Waiting List Control
Lieberman, P. B., Villalba, R., & Farris, S. G. (2017) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000271 · Cited by 9 · see citing works
Lorillard, S., Schmitt, L., & Andreoli, A. (2011) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2010.08.008 · Cited by 8 · see citing works
Predictors of Outcome of Acute Partial Hospitalization
Lieberman, P. B., Gentes, E. L., & Russell, S. A. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001109 · Cited by 6 · see citing works
Savard, C., Chrétien, M., Gamache, D., Maranda, J., & Villeneuve, É. (2019) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000382 · Cited by 3 · see citing works
Psychometric Properties of the Spanish BASIS-24© Mental Health Survey
Eisen, S. V., Seal, P., Glickman, M. E., Cortés, D. E., Gerena, M., Aguilar‐Gaxiola, S., Febo, V., Soto-Espinosa, J., Magaña, C. G., & CANINO, G. J. (2009) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-009-9170-6 · Cited by 4 · see citing works
Steele, S. J., Baskin-sommers, A. R., Hearon, B. A., Gironde, S., & Björgvinsson, Þ. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9726-0 · Cited by 3 · see citing works
The Evaluation of Emotion Regulation in Caregivers Referred to a Parent-Training Program
Wallace, N. M. (2014) · doi:10.33915/etd.6891 · Cited by 3 · see citing works
Decker, S. E., Kroll‐Desrosiers, A., Mattocks, K. M., Aunon, F. M., Galliford, E., DeRycke, E. C., Doran, N., Baird, S. O., Rielage, J. K., Ridley, J., et al. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.107828 · Cited by 2 · see citing works
Brief Therapeutic Approaches for Personality Disorders
Dixon–Gordon, K. L., Conkey, L. C., & Woods, S. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108333931.083 · Cited by 2 · see citing works
Avery, J., Francois, D., Martins, O., Park, S., & Roth, S. D. (2012) · Psychiatric Quarterly · doi:10.1007/s11126-012-9209-3 · Cited by 1 · see citing works
Into the Wild, Out of the Woods: A Systematic Case Study on Facilitating Emotional Change
Gunst, E., Willemsen, J., Desmet, M., Watson, J. C., Loeys, T., & Vanhooren, S. (2019) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x19866977 · Cited by 1 · see citing works
Gunst, E., Desmet, M., Watson, J. C., Willemsen, J., Loeys, T., & Vanhooren, S. (2022) · Journal of Sexual Aggression · doi:10.1080/13552600.2021.2019845 · Cited by 2 · see citing works
The Role of Emotion Regulation in the Expressive Writing Intervention
Mattina, J. M. (2012) · TSpace (University of Toronto) · Cited by 1 · see citing works
Fallon, M. (2014) · UTAS Research Repository · doi:10.25959/23241086
Lindquist, K. A. (2009) · NORA - Norwegian Open Research Archives
Altenburger, E. M. (2016) · OhioLink ETD Center (Ohio Library and Information Network)
An Examination of Productive Processing Activities in the Expressive Writing Intervention
Danson, J. J. (2014) · TSpace (University of Toronto)
Millon, T., & Grossman, S. D. (2007) · Wiley eBooks · doi:10.1002/9781118269893.refs
Decker, S. E., Kroll-Desrosiers, A., Mattocks, K., Aunon, F. M., Galliford, E., Doran, N., Baird, S., Rielage, J. K., Ridley, J., Bannister, J., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1495102
Huntjens, A., van den Bosch, L. M. C., Sizoo, B. B., Kerkhof, A. J. F. M., Huibers, M. J. H., & van der Gaag, M. (2020) · Figshare · doi:10.6084/m9.figshare.11998398
- Authors
- GRATZ, K. L., LACROCE, D. M., & GUNDERSON, J. G.
- Affiliations
- Harvard University (US)
- ORCID
- GRATZ, KIM L.
- Venue
- Journal of Psychiatric Practice
- Published
- 2006-05
- Volume
- 12
- Issue
- 3
- Pages
- 153-159
- ISSN
- 1527-4160 (ISSN-L)
- 1538-1145
- OpenAlex
- W2049676892
- Cited by
- 50
- References
- 31
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 7 · 2013: 2 · 2012: 5
- FWCI
- 4.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- borderline personality disorder, short-term treatment, partial hospitalization, intensive outpatient treatment, emotional dysregulation, mood dysregulation, symptom severity, quality of life, global functioning, treatment response assessment
- MeSH terms
- Adolescent, Adult, Affect, Aftercare, Analysis of Variance, Borderline Personality Disorder, Day Care, Medical, Emotions, Female, Humans, Male, Middle Aged, Progressive Patient Care, Quality of Life, Time Factors, Self-Injurious Behavior, Treatment Outcome
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