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Cited by 71Personality Disorders and PsychopathologyDigital Mental Health InterventionsMental Health Research Topics

Randomized Controlled Trial of Web-Based Psychoeducation for Women With Borderline Personality Disorder

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Zanarini, Mary C., Conkey, Lindsey C., Temes, Christina M., Fitzmaurice, Garrett M.·2018·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.16m11153PMC PMC5764827
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Abstract

OBJECTIVE: To determine if internet-based psychoeducation for borderline personality disorder is effective in reducing symptom severity and improving psychosocial functioning. METHODS: Eighty women who met DSM-IV criteria for borderline personality disorder were randomly assigned either to the internet-based psychoeducation treatment group (n = 40) or to the internet-based control group with no psychoeducation (n = 40). Recruitment was conducted from July 2013 to March 2015. Subjects participated in 15 assessment periods that were divided into an acute phase (weeks 1-12) and a maintenance phase (months 6, 9, and 12). Main outcomes were assessed using the Zanarini Rating Scale for Borderline Personality Disorder. RESULTS: In the acute phase, women in the treatment group were found to have a significant decline in their scores on all 10 outcomes studied, while women in the control group had a significant decline on 7 of these outcomes. Two between-group differences were found to be significant-those in the treatment group reported a significantly greater decline in their impulsivity (z = -1.98, P = .048) and a significantly greater increase in their psychosocial functioning (z = -1.97, P = .049) than those in the control group. In the maintenance phase, those in the treatment group were found to have a significant decline in their scores on 9 of the 10 outcomes studied, while those in the control group had a significant decline in 3 of these outcomes. In terms of between-group differences, those in the treatment group reported a significantly greater decline in all 5 studied areas of borderline psychopathology: affective symptoms (z = -2.31, P = .021), cognitive symptoms (z = -3.20, P = .001), impulsivity (z = -2.44, P = .015), interpersonal difficulties (z = -2.15, P = .032), and overall borderline personality disorder symptoms (z = -2.11, P = .035). CONCLUSIONS: Taken together, these results suggest that internet-based psychoeducation is an effective form of early treatment for reducing the symptom severity of borderline personality disorder for periods up to 1 year. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01719731.

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  • The availability of long-term psychological interventions for personality disorders is limited by their high intensity and cost.

    “Although previous research has demonstrated the clinical effectiveness of some long-term psychological interventions (e.g. mentalisation-based therapy and dialectical behavioural therapy) for people with some types of personality disorder, the availability is limited by their high intensity and cost.4,5”

    From Recovery-focused self-help intervention using vodcasts for patients with personality disorder: Feasibility randomised controlled trial (2024) · cites this paper as [4]

    The Introduction reports evidence that dialectical behavioral therapy and mentalization-based treatment are effective for borderline personality disorder. It also says trained personnel and cost prevented other centers from adopting an earlier psychoeducation program, but it does not establish that the intensity and cost of long-term psychological interventions limit their availability. (LLM, conf=0.85)

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  • Previous research has demonstrated the clinical effectiveness of some long-term psychological interventions (e.g., mentalisation-based therapy and dialectical behavioural therapy) for people with some types of personality disorder.

    “Although previous research has demonstrated the clinical effectiveness of some long-term psychological interventions (e.g. mentalisation-based therapy and dialectical behavioural therapy) for people with some types of personality disorder, the availability is limited by their high intensity and cost.4,5”

    From Recovery-focused self-help intervention using vodcasts for patients with personality disorder: Feasibility randomised controlled trial (2024) · cites this paper as [4]

    The Introduction reports that trials found dialectical behavioral therapy and mentalization-based treatment effective in reducing symptoms of borderline personality disorder. It does not establish that these interventions were long-term, so that qualifier is unsupported by our copy. No page number is available. (LLM, conf=0.82)

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Research works printed but not linked: 4

  1. [4]Widiger TA Frances AJ Epidemiology, diagnosis, and comorbidity of borderline personality disorder, in Review of Psychiatry 8 Tasman A Hales RE Frances A Washington, DC American Psychiatric Press 1989 8 24
  2. [6]Skodol AE Gunderson JG McGlashan TH Dyck IR Stout RL Bender DS Grilo CM Shea MT Zanarini MC Morey LC Sanislow CA Oldham JM Functional impairment in schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders Am J Psychiatry 2002 159 2 276 83 11823271
  3. [12]Stone MH The fate of borderline patients New York, New York Guilford Press 1990
  4. [32]Schulz SC Camlin KL Berry S Friedman L Risperidone for borderline personality disorder: A double-blind study In proceedings of the 39th Annual Meeting of the American College of Neuropsychopharmacology Nashville, TN, ACNP 1999

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Authors
Zanarini, M. C., Conkey, L. C., Temes, C. M., & Fitzmaurice, G. M.
Affiliations
  • Harvard University (US)
  • McLean Hospital (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2018-06-27
Volume
79
Issue
3
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.16m11153
PMC
PMC5764827
OpenAlex
W2735770272
Cited by
71
References
49
Citations by year
2026: 7 · 2025: 6 · 2024: 13 · 2023: 5 · 2022: 11 · 2021: 5 · 2020: 10 · 2019: 10 · 2018: 4
FWCI
8.14
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R34MH095818)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
borderline personality disorder, women, symptom severity, impulsivity, psychosocial functioning, interpersonal problems, affective symptoms, cognitive symptoms, early treatment, maintenance phase
MeSH terms
Adult, Borderline Personality Disorder, Female, Humans, Patient Education as Topic, Psychotherapy, Severity of Illness Index, Outcome Assessment, Health Care, Telemedicine, Internet, Young Adult

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