Alcohol Use Disorder, Borderline Personality Disorder
Conditions
Keywords
borderline, alcohol, substance, psychodynamic, psychotherapy, psychoanalytic
Brief summary
The purpose of the study is to determine the feasibility and effectiveness of a modified form of psychodynamic psychotherapy for persons suffering from co-occurring borderline personality disorder and an alcohol use disorder.
Detailed description
Borderline Personality Disorder (BPD) is a condition that can cause significant distress and increased risk of death. Many persons with BPD also have an alcohol use disorder (AUD) and there is evidence that this can worsen the outcome and course of both disorders. A manual-based form of psychodynamic therapy (PT), labeled dynamic deconstructive psychotherapy, has been developed for particularly challenging patients with BPD, especially those with co-occurring substance use disorders. It aims to remediate specific neurocognitive capacities that are responsible for processing of emotional experiences, and so diminishes symptoms of BPD and promotes the development of a coherent and differentiated self-structure. PT has been shown to be helpful for BPD, but has not been tested for people who have BPD with co-occurring substance use disorders. The proposed study is a randomized controlled trial of PT for persons with BPD and co-occurring AUD that will generate some initial data that can be used to determine the need and feasibility for further outcome studies. Participants are randomized to either a study group receiving weekly PT or to a control group receiving usual care. Enrollment is 15 participants in each group. The study group will receive 12-18 months of PT, with naturalistic follow-up. Outcome measures are administered by a research assistant at enrollment, 3 months, 6 months, 9 months, 12 months, and 30 months. The investigators anticipate that the PT group will show trends towards better retention in treatment and greater reduction in parasuicides, alcohol misuse, and institutional care. If so, this would have important and positive implications for the large group of patients who suffer from BPD and co-occurring AUD.
Interventions
BEHAVIORALPsychodynamic Therapy
Dynamic deconstructive psychotherapy is a time-limited (12-18 month) manual-based form of psychodynamic therapy that aims to remediate specific neurocognitive capacities responsible for processing of emotional experiences.
BEHAVIORALOptimized Community Care
individual and group psychotherapy in a private practice, clinic, and/or rehab setting, with an eclectic orientation
Sponsors
State University of New York - Upstate Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Age between 18 and 45 years * Meets diagnostic criteria for borderline personality disorder and for active alcohol abuse or dependence * At least average intelligence
Exclusion criteria
* Meets diagnostic criteria for schizophrenia, or schizoaffective disorder
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| episodes of parasuicide, alcohol intoxication, institutional care | 12 months |
Secondary
| Measure | Time frame |
|---|---|
| depression, dissociation, core symptoms of borderline pd, perceived social support | 12 months |
Countries
United States
Outcome results
None listed