Borderline Personality Disorder
Conditions
Brief summary
The BRIDGE project: A feasibility randomised controlled trial of brief, intensive assessment and integrated formulation for young people (age 14-24) early in the course of borderline personality disorder.
Detailed description
This project is the first step in testing a new intervention programme, called BRIDGE (Brief, Intensive Assessment and Integrated Formulation), for young people early in the course of Borderline Personality Disorder (BPD). The BRIDGE Project will help us find out whether we can do a much bigger study in the future that will tell us whether BRIDGE works well. BPD is characterised by long standing difficulty in managing emotional responses, personal relationships, impulse control and self-image. Research shows that individuals with BPD may experience discrimination and resulting stigmatisation by both the public and health care professionals. Many adolescents and young people with complex needs and high suicide risk are left under-diagnosed and untreated. As a result, young people with BPD are frequently not in education or training and experience challenging relationships with friends and families. The overall aim of the study is to assess the possibility of providing a treatment programme for young people with BPD symptoms in the general population, who may or may not be accessing any mental health services. First, we need to see whether young people are comfortable with random allocation to BRIDGE (AND service as usual) or Service-as-usual (ALONE) (a bit like tossing a coin). Second, we need to find out whether enough young people want to be involved. Third, whether we can find out the information we need about them and can follow up enough young people later. The proposed study will try to find these things out, so that we can design a future, bigger, study to find out whether BRIDGE is good value for young people with BPD.
Interventions
BEHAVIORALBRIDGE Intervention
Intensive clinical assessment; \>16 sessions of Cognitive Analytic Therapy (CAT); Development of a shared formulation
BEHAVIORALService as Usual
Likely to range from social services, mental-health services, forensic services to no intervention
Sponsors
University of Glasgow
NHS Greater Glasgow and Clyde
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Randomized
Eligibility
Sex/Gender
ALL
Age
14 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
* Cut off score of 11 out of 15 on the self-reported SCID-II BPD questionnaire AND subthreshold (3 or 4 out of 9 domains) or threshold (5 and above out of 9 domains) criteria on the SCID-II DSM-V (BPD Module) * Age 14-25
Exclusion criteria
* Currently receiving psychological/counselling /psychotherapeutic treatment for BPD * Has received psychological/counselling/psychotherapeutic intervention for over 8 sessions in the last 3 months * Severe or profound intellectual disability, that would preclude full engagement in talking therapy * Receiving Intensive psychiatric treatment at the time of study entry, for conditions such as acute psychosis or severe eating disorder * Non-English speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recruitment & Retention rates | Continuous over 3 year study period | The number of participants recruited for randomisation and the number retained to follow-up (12 & 24wks post randomisation). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of trial processes and interventions | Continuous over 3 year study period | Explored through qualitative interviews |
| Process Evaluation | Continuous over 3 year study period | Theory of change and logic modelling will be explored to capture the process behind intervention effects. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Vocational and Educational Functioning | Baseline and Follow-up (12 and 24weeks post randomisation) | Measure of functioning in domains of work and education |
| Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) DSM-V | Screening/Pre-randomisation | Clinical interview using the SCID-II DSM-V |
| KIDSCREEN-10 Index | Screening/Pre-randomisation | Health Questionnaire for Children and Young People |
| KIDDIE Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) | within 2 weeks of randomisation (baseline) | Questionnaire for affective disorders and schizophrenia |
| Adverse Childhood Experiences Scale | within 2 weeks of randomisation (baseline) | Questionnaire for Adverse Childhood Experiences |
| EuroQol-5D-5L (EQ-5D-5L) | Baseline and Follow-up (12 and 24weeks post randomisation) | Quality of Life questionnaire |
| Adult ADHD Self-Report Scale (ASRS) | within 2 weeks of randomisation (baseline) | Questionnaire for ADHD symptoms in adulthood |
| Borderline Symptoms List (BSL) | Baseline and Follow-up (12 and 24weeks post randomisation) | Questionnaire for symptoms of Borderline Personality Disorder (BPD) |
| Sheehan's Disability Scale (SDS) | Baseline and Follow-up (12 and 24weeks post randomisation) | Assessment of functional impairment |
| Difficulties in Emotional Regulation Scale-Short Form (DERS-SF) | Baseline and Follow-up (12 and 24weeks post randomisation) | Questionnaire to assess emotion regulation |
| Patient Health Questionnaire-9 (PHQ-9) | Baseline and Follow-up (12 and 24weeks post randomisation) | General health questionnaire |
| The Autism Symptom Self Report for Adolescents (ASSERT) Scale | within 2 weeks of randomisation (baseline) | Questionnaire for symptoms of Autism |
| Suicidal Ideation Scale | Baseline and Follow-up (12 and 24weeks post randomisation) | Questionnaire for suicidal ideation |
| Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) PQ-BPD | Screening; Pre-randomisation | 15 Item Questionnaire for Borderline Personality Disorder |
Countries
United Kingdom
Outcome results
None listed