A randomized controlled trial of a Dutch version of systems training for emotional predictability and problem solving for borderline personality disorder
Abstract
Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for persons with borderline personality disorder (BPD) that is relatively easy to implement. We investigated the efficacy of a Dutch version of this treatment (VERS). Seventy-nine DSM-IV BPD patients were randomly assigned to STEPPS plus an adjunctive individual therapy, or to treatment as usual. Assessments took place before and after the intervention, and at a 6-month follow-up. STEPPS recipients showed a significantly greater reduction in general psychiatric and BPD-specific symptomatology than subjects assigned to treatment as usual; these differences remained significant at follow-up. STEPPS also led to greater improvement in quality of life, especially at follow-up. No differences in impulsive or parasuicidal behavior were observed. Effect sizes for the differences between the treatments were moderate to large. The results suggest that the brief STEPPS program combined with limited individual therapy can improve BPD-treatment in a number of ways.
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For parasuicidality, there was a statistically non-significant effect indicating more such pathology in the STEPPS + IT group.
“For the outcome of parasuicidality, there was statistically non-significant effect indicating more such pathology in the STEPPS + IT group.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
STEPPS plus limited individual therapy had statistically non-significant favourable effects on BPD severity (moderate), impulsivity (small), and interpersonal problems (small).
“Statistically non-significant, favourable effects were found for the reduction of BPD severity (moderate in size), impulsivity (small effect), and interpersonal problems (small effect).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
STEPPS plus limited individual therapy had a statistically significant moderate beneficial effect on general psychopathology.
“There was a statistically significant, moderate effect indicating beneficial effects of STEPPS in terms of general psychopathology.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
Bos 2010 had low risk of an allegiance effect.
“Allegiance effect improbable?Low risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
Bos 2010 had low risk of bias for treatment adherence.
“Treatment adherence?Low risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
Bos 2010 had high risk of attention bias because more attention was paid to the experimental group.
“Attention bias: equal amounts of attention to all groups (obligatory treatment components)?High risk More attention paid to EG.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
Bos 2010 had high risk of bias for blinding of outcome assessment because interviews were conducted by research assistants not blind to treatment group assignment.
“High risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Bos 2010
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- Authors
- Bos, E. H., van Wel, E. B., Appelo, M. T., & Verbraak, M. J. P. M.
- Affiliations
- Lentis (NL)
- Radboud University Nijmegen (NL)
- Corresponding author
- Bos, Elisabeth H.
- Appelo, Martin T.
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2010-04
- Volume
- 198
- Issue
- 4
- Pages
- 299-304
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2140493471
- Cited by
- 85
- References
- 7
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 3 · 2017: 11 · 2016: 8 · 2015: 5 · 2014: 8 · 2013: 3 · 2012: 4
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, STEPPS, group therapy, Dutch adaptation, treatment efficacy, symptom relief, quality of life, impulsive behavior, parasuicide
- MeSH terms
- Borderline Personality Disorder, Combined Modality Therapy, Cross-Cultural Comparison, Family Therapy, Female, Humans, Male, Netherlands, Personality Inventory, Psychometrics, Psychotherapy, Group, Social Support, Systems Theory
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