Borderline Personality Disorder, Personality Disorders
Conditions
Keywords
Psychotherapy, psychotherapy process, therapeutic alliance, psychotherapeutic change, psychophysiology
Brief summary
Specialized treatment of personality disorders (PD) in youth has been neglected for a long time, because these disorders were not diagnosed before the age of 18. Since 2013 the age threshold has been dropped in the Diagnostic and Statistical Manual (DSM)-5, and such change is also announced for the International Classification of Diseases (ICD)-11. There is broad consensus from both scientific evidence and clinical experience that specialized early interventions in adolescents with PD are urgently needed. In the last decades a number of specialized psychotherapeutic treatment programs have been developed. Despite their conceptual differences, many of the treatment models have shown significant effects in the treatment of PD in adults. However, the treatment of adolescents with PD remains difficult and further enhancement and development of treatments is needed. Given the different therapeutic approaches available, the present project aims to go beyond the comparison of integral therapeutic models in the classical outcome study design. While outcome research is important to build on the evidence of the effectiveness of an intervention, it contributes little to its understanding and refinement. The aim of the present multi-center project is to compare two therapeutic methods used in routine care: * Adolescent Identity Treatment (AIT) * Dialectic Behavioral Treatment for Adolescents (DBT-A) Treatments will be performed at different study centers and compared using the same measures of outcome. The main outcome will be psychosocial functioning. Additionally, the psychotherapy process will be investigated to explore specific and unspecific mechanisms of the therapeutic process, its outcome and mediators.
Interventions
BEHAVIORALAdolescent Identity Treatment
Integrative Approach for the treatment of adolescents with Personality Disorder. Manual was published in 2013.
BEHAVIORALDBT-A
Dialectic Behavioral Treatment for Adolescents is the most commonly used Approach for the Treatment of adolescents with Boderline Personality Disorder
Sponsors
Klaus Schmeck
Heidelberg University
Pontificia Universidad Catolica de Chile
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
13 Years to 19 Years
Healthy volunteers
No
Inclusion criteria
* Identity Diffusion (AIDA T-score \> 60) * borderline Criteria (SKID-II)
Exclusion criteria
* intelligence quotient (IQ) \< 80 * psychotic disorder * pervasive developmental disorders * heavy and persistent substance abuse * major somatic or neurological disease * hospital treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Children's Global Assessment Scale (CGAS) | Baseline, 12 months after Baseline | Psychosocial functioning. Rated considering the results of the Columbia Impairment Scale - parent and patient versions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| School functioning | Baseline, 12 months after Baseline | School Functioning Rating (SFR) |
| Change in Psychopathology | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) |
| Change in Severity of Psychopathology | Baseline, 12 months after Baseline | Clinical Global Impression Scale |
| Change in Depression | Baseline, 12 months after Baseline | Beck Depression Inventory (BDI) |
| Change in Psychopathological Symptoms | Baseline, 12 months after Baseline | Strengths & Difficulties Questionnaires (SDQ) |
| Change in Personality Functioning | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Levels of Personality Functioning - Questionnaire for Adolescents (LoPF-QA) |
| Change in Identity | Baseline, 12 months after Baseline | Assessment of Identity Development in Adolescence (AIDA) |
| Change in Personality Disorder Symptoms | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders (DSM) (SCID)-II |
| Psychosocial functioning | Baseline, 12 months after Baseline | Columbia Impairment Scale (CIS) (Patient and Parent versions) |
| Change in Mentalizing Capacity | Baseline, 12 months after Baseline | Movie for the Assessment of Social Cognition (MASC) |
| Change in Quality of Life | Baseline, 12 months after Baseline | Health-related Quality of Life Screening Instrument for Children and Adolescents (KIDSCREEN) |
| Change in Parental Stress | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Eltern-Belastungs-Inventar (EBI) |
| Self-injurious Behavior | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Self- Injurious Thoughts and Behaviors Interview |
| Borderline-specific Personality Pathology | Baseline, 12 months after Baseline (only Basel and Heidelberg) | Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) |
| Borderline-specific Symptoms | Baseline, 12 months after Baseline (only Basel and Santiago) | Borderline Symptom List 23 (BSL-23) |
| Change in Psychophysiological Measures (Only Basel and Heidelberg) | Baseline, 12 months after Baseline | Regression analysis will be used to evaluate change; Parameters: Heart Rate Variability and Electrodermal Activity (Basel only) |
| Change in Hair Cortisol Level (only Basel and Heidelberg) | Baseline, 12 months after Baseline | — |
| Change in Interpersonal Problems | Baseline, 12 months after Baseline (only Santiago) | Inventory of Interpersonal Problems (IIP-64) |
Countries
Chile, Germany, Switzerland
Outcome results
None listed