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Clinical Social Work Journal

, Volume 46, Issue 3, pp 174–186 | Cite as

A Review of the Effectiveness and Mechanisms of Change for Three Psychological Interventions for Borderline Personality Disorder

  • G. Byrne
  • J. Egan
Original Paper

Abstract

The therapeutic uncertainty common in much of the early literature on borderline personality disorder (BPD) has given way to a growing research base with findings indicating the effectiveness of a number of psychological treatments. This article will review three major evidence-based treatments for BPD: dialectical behavior therapy, schema-focused therapy and mentalization-based treatment. While not a panacea, these treatments have provided, to differing degrees, a reasonable level of evidence indicating therapeutic effectiveness. The evidence base for each of these models is discussed as well as possible mechanisms of change. The article highlights similarities between the differing modalities as well as the features that distinguish the models. The article contends that increasing mentalization skills may be a common underlying factor in all treatments for individual with BPD. The authors conclude by discussing the difficulties and potential benefits of treatment integration.

Keywords

Borderline personality disorder Dialectical behavior therapy Mentalization-based therapy Schema-focused therapy 

Notes

Funding

This study was not funded.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest to disclose.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

As this article is a review no informed consent was ascertained.

References

  1. Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S., & Midgley, N. (2013). Psychodynamic psychotherapy for children and adolescents: A meta-analysis of short-term psychodynamic models. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 863–875.  https://doi.org/10.1016/j.aac.2013.05.014 PubMedGoogle Scholar
  2. Alexander, K. (2006). BPD recovery and peer support. Presentation at National Education Alliance on Mental Illness. Arlington, VA: Expert BPD Focus Group.Google Scholar
  3. Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. London: American Psychiatric Publishing.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Washington, DC; American Psychiatric Association, p. 5Google Scholar
  5. Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.  https://doi.org/10.1093/clipsy.bpg015.Google Scholar
  6. Bales, D., van Beck, N., Smits, M., Willemsen, S., Busschbach, J., et al. (2012). Treatment outcome of 18-month, day hospital mentalization-based treatment (MBT) in patients with severe borderline personality disorders in the Netherlands. Journal of Personality Disorders, 26, 568–582.  https://doi.org/10.1521/pedi.2012.26.4.568.PubMedGoogle Scholar
  7. Bales, D. L., Timman, R., Andrea, H., Busschbach, J. J. V., Verheul, R., & Kamphuis, J. H. (2014). Effectiveness of day hospital mentalization-based treatment for patients with severe borderline personality disorder: A matched control study. Clinical Psychology and Psychotherapy, 22, 409–417.  https://doi.org/10.1002/cpp.1914.PubMedGoogle Scholar
  8. Bamelis, L. L. M., Evers, S. M. A. A., Spinhoven, P., & Arntz, A. (2014). Results of a multicentered randomized controlled trial on the clinical effectiveness of schema therapy for personality disorders. The American Journal of Psychiatry, 171, 305–322.  https://doi.org/10.1176/appi.ajp.2013.12040518.PubMedGoogle Scholar
  9. Bateman, A., O’Connell, J., Lorenzini, N., Gardner, T., & Fonagy, P. (2016). A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder. BMC Psychiatry, 16, 304.  https://doi.org/10.1186/s12888-016-1000-9.PubMedPubMedCentralGoogle Scholar
  10. Bateman, A. W., & Fonagy, P. (1999). Effectiveness of partial hospitalisation in the treatment of borderline personality disorder: a randomised controlled trial. American Journal of Psychiatry, 156, 1563–1569.  https://doi.org/10.1176/ajp.156.101563.PubMedGoogle Scholar
  11. Bateman, A. W., & Fonagy, P. (2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: An 18-month follow-up. American Journal of Psychiatry, 158, 36–42.  https://doi.org/10.1176/appi.ajp.1581.36.PubMedGoogle Scholar
  12. Bateman, A. W., & Fonagy, P. (2004). Mentalization-based treatment of BPD. Journal of Personality Disorders, 18, 36–51.  https://doi.org/10.1521/pedi.18.1.36.32772.PubMedGoogle Scholar
  13. Bateman, A. W., & Fonagy, P. (2008a). Comorbid antisocial and borderline personality disorders: Mentalization-based treatment. Journal of Clinical Psychology, 64, 187–194.  https://doi.org/10.1002/jclp.20451.Google Scholar
  14. Bateman, A. W., & Fonagy, P. (2008b). 8-year follow-up of patients treated for borderline personality disorder: Mentalization-based treatment versus treatment as usual. American Journal of Psychiatry, 165, 631–638.  https://doi.org/10.1176/appi.ajp.2007.07040636.PubMedGoogle Scholar
  15. Bateman, A. W., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry, 166, 1355–1364.  https://doi.org/10.1176/appi.ajp.2009.09040539.PubMedGoogle Scholar
  16. Bateman, A. W., & Fonagy, P. (2013). Mentalization-based treatments. Psychoanalytical Inquiry: A Topical Journal for Mental Health Professionals, 33, 595–613.  https://doi.org/10.1080/07351690.2013.835170.Google Scholar
  17. Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorders. The Lancet, 385, 735–743.  https://doi.org/10.1016/S0140-6736(14)61394-5.Google Scholar
  18. Bateman, A. W., & Krawitz, R. (2013). Borderline personality disorder: An evidence-based guide for generalist mental health professionals. Oxford: Oxford University Press.Google Scholar
  19. Bateman, A. W., Ryle, A., Fonagy, P., & Kerr, I. B. (2007). Psychotherapy for borderline personality disorder: Mentalization based therapy and cognitive analytic therapy compared. International Review of Psychiatry, 19, 51–62.  https://doi.org/10.1080/09540260601109422.PubMedGoogle Scholar
  20. Binks, C., Fenton, M., McCarthy, L., Lee, T., Adams, C. E., & Duggan, C. (2006). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Review, 1, CD005652.  https://doi.org/10.1002/14651858.CD005652.Google Scholar
  21. Blennerhassett, R. C., & O’Raghallaigh, J. W. (2005). Dialectical behavior therapy in the treatment of borderline personality disorder. British Journal of Psychiatry, 186, 278–280.  https://doi.org/10.1192/bjp.186.4.278.PubMedGoogle Scholar
  22. Bliss, S., & McCardle, M. (2014). An exploration of common elements in dialectical behavior therapy, mentalization based treatment and transference focused psychotherapy in the treatment of borderline personality disorder. Clinical Social Work Journal, 42, 61–69.  https://doi.org/10.1007/s10615-013-0456-z.Google Scholar
  23. Bohus, M., Haaf, B., Simms, T., Limberger, M. F., Schmahl, C., Unckel, C., Lieb, K., & Linehan, M. M. (2004). Effectiveness of inpatient dialectical behavior therapy for borderline personality disorder: A controlled trial. Behavior Research and Therapy, 42, 875–887.  https://doi.org/10.1016/S0005-7967(03)00174-8.Google Scholar
  24. Brazier, J., Tumur, I., Holmes, M., Ferriter, M., Parry, G., Dent-Brown, K., & Paisley, S. (2006). Psychological therapies including dialectical behavior therapy for borderline personality disorder: A systematic review and preliminary economic evaluation. Health Technology Assessment, 10, 1–117.PubMedGoogle Scholar
  25. Byrne, G., Bogue, J., Egan, R., & Lonergan, E. (2016). “Identifying and describing emotions” Measuring the effectiveness of a brief, Alexithymia-specific, intervention for a sex offender population. Sexual Abuse, 28, 599–619.PubMedGoogle Scholar
  26. Chanen, A. M., & McCutcheon, L. (2013). Prevention and early intervention for borderline personality disorder: Current status and recent evidence. The British Journal of Psychiatry, 202, 24–29.  https://doi.org/10.1192/bjp.bp.112.119180.Google Scholar
  27. Chapman, A. L., & Dixon-Gordon, K. L. (2015). Mentalization as a common process in treatments for borderline personality disorder: Commentary on the special issue on mentalization in borderline personality disorder. Personality Disorders: Theory, Research and Treatment, 6, 393–394.  https://doi.org/10.1037/per0000151.Google Scholar
  28. Chapman, A. L., Turner, B. J., & Dixon-Gordon, K. L. (2011). To integrate or not to integrate dialectical behavior therapy with other therapy approaches? Clinical Social Work Journal, 39, 170–179.  https://doi.org/10.1007/s10615-010-0283-4.Google Scholar
  29. Chiesa, M., Fonagy, P., & Holmes, J. (2006). Six year follow-up of three treatment programs to personality disorder. Journal of Personality Disorders, 20, 493–509.  https://doi.org/10.1521/pedi.2006.20.5.493.PubMedGoogle Scholar
  30. Choi-Kain, L. W., Albert, E. B., & Gunderson, J. G. (2016). Evidence-based treatments for borderline personality disorder: Implementation, integration, and stepped care. Harvard Review of Psychiatry, 24, 342–356.  https://doi.org/10.1097/HRP.0000000000000113.PubMedGoogle Scholar
  31. Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What works in the treatment of borderline personality disorder. Current Behavioral Neuroscience Reports, 4, 21–30.  https://doi.org/10.1007/s40473-017-0103-z.PubMedPubMedCentralGoogle Scholar
  32. Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization: Ontogeny, assessment, and application in the treatment of borderline personality disorder. American Journal of Psychiatry, 165, 1127–1135.  https://doi.org/10.1176/appi.ajp.2008.07081360.PubMedGoogle Scholar
  33. Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. The American Journal of Psychiatry, 164, 922–928.  https://doi.org/10.1176/appi.ajp.164.6.922.PubMedGoogle Scholar
  34. de Groot, E. R., Verheul, R., & Trijsburg, R. W. (2008). An integrative perspective on psychotherapeutic treatments for borderline personality disorder. Journal of Personality Disorders, 22, 332–352.  https://doi.org/10.1521/pedi.2008.22.4.332.PubMedGoogle Scholar
  35. Dimaggio, G. (2015). Awareness of maladaptive interpersonal schemas as a core element of change in psychotherapy for personality disorders. Journal of Psychotherapy Integration, 25, 39–44.  https://doi.org/10.1037/a0038770.Google Scholar
  36. Edel, M. A., Raaff, V., Dimaggio, G., Buchheim, A., & Brüne, M. (2017). Exploring the effectiveness of combined mentalization-based group therapy and dialectical behavior therapy for inpatients with borderline personality disorder: A pilot study. British Journal of Clinical Psychology, 56, 1–15.PubMedGoogle Scholar
  37. Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: A randomised controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40, 317–328.  https://doi.org/10.1016/j.jbtep.2009.01.002.PubMedGoogle Scholar
  38. Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016). Emotion regulation in schema therapy and dialectical behavior therapy. Frontiers in Psychology, 7, 1372.  https://doi.org/10.3389/fpsyg.2016.01373.Google Scholar
  39. Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry, 14, 137–150.  https://doi.org/10.1002/wps.20235.PubMedPubMedCentralGoogle Scholar
  40. Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51, 372–380.  https://doi.org/10.1037/a0036505.PubMedGoogle Scholar
  41. Fonagy, P., & Bateman, A. (2006). Progress in the treatment of borderline personality disorder. British Journal of Psychiatry, 188, 1–3.  https://doi.org/10.1192/bjp.bp.105.01.2088.PubMedGoogle Scholar
  42. Fonagy, P., & Sharp, C. (2015). Vulnerabilities of the mentalization-based models ofvulnerability: A rejoinder to commentaries on the special issue on mentalization in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 6, 399–400.  https://doi.org/10.1037/per0000154.Google Scholar
  43. Giesen-Bloo, J., Dyck, R., Spinhoven, P., Tilburg, W., Dirksen, C., van Asselt, T. et al (2006). Outpatient psychotherapy for borderline personality disorder: Randomised trial of schema-focused therapy vs. transference-focused psychotherapy. Archives of General Psychiatry, 63, 649–658.  https://doi.org/10.1001/archpsyc.63.6.649.PubMedGoogle Scholar
  44. Goldman, G. A., & Gregory, R. J. (2010). Relationships between techniques and outcomes for borderline personality disorder. American Journal of Psychotherapy, 64, 359–371.PubMedGoogle Scholar
  45. Goodman, G. (2013). Is mentalization a common process factor in transferencefocused psychotherapy and dialectical behavior therapy sessions? Journal of Psychotherapy Integration, 23, 179–192.  https://doi.org/10.1037/a0032354.Google Scholar
  46. Grant, B. F., Chou, S. P., & Goldstein, R. B. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from Wave 2 National Epidemiological Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 533–545.PubMedGoogle Scholar
  47. Gunderson, J. G. (2009). Borderline personality disorder: Ontogeny of a diagnosis. American Journal of Psychiatry, 166, 530–539.  https://doi.org/10.1176/appi/ajp.2009.08121825.PubMedGoogle Scholar
  48. Gunderson, J. G. (2014). Handbook of good psychiatric management for borderline personality disorder. Washington DC: American Psychiatric Publications.Google Scholar
  49. Hayes, S. C., Masuda, A., Bisset, R., Lumona, J., & Guerrero, L. F. (2005). DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies. Behavior Therapy, 35, 35–54.  https://doi.org/10.1016/S0005-7894(04)800030-0.Google Scholar
  50. Hutsebaut, J., Bales, D. L., Busschbach, J. J. V., & Verheul, R. (2012). The implementation of mentalization-based treatment for adolescents: A case study from an organizational team and therapist perspective. International Journal of Mental Health Systems, 6, 10.  https://doi.org/10.1186/1752-4458-6-10.PubMedPubMedCentralGoogle Scholar
  51. Ingenhoven, T., Lafay, P., Passchier, J., & Duivenvoorden, H. (2010). Effectiveness of pharmacotherapy for severe personality disorders: Meta-analyses of randomized controlled trials. Journal of Clinical Psychiatry, 71, 14–25.  https://doi.org/10.4088/JCP.08r04526gre.PubMedGoogle Scholar
  52. Jacob, G. A., & Arntz, A. (2013). Schema therapy for personality disorders: A review. International Journal of Cognitive Therapy, 6, 171–185.  https://doi.org/10.1521/ijct.2013.6.2.171.Google Scholar
  53. Jørgensen, C. R., Freund, C., Møye, R., Jordet, H., Andersen, D., & Kjøbye, M. (2013). Outcome of mentalization-based and supportive psychotherapy in patients with borderline personality disorder: A randomized trial. Acta Psychiatrica Scandinavica, 127, 305–317.  https://doi.org/10.1111/j.1600-0447.2012.01923.x.PubMedGoogle Scholar
  54. Kellogg, S. H., & Young, J. E. (2006). Schema therapy for borderline personality disorder. Journal of Clinical Psychology, 62, 445–458.PubMedGoogle Scholar
  55. Kleindienst, N., Limberger, M. F., Schmal, C., Steil, R., Ebner-Priemer, U. W., & Bohus, M. (2008). Do improvements after inpatient dialectical behavior therapy persist in the long term? A naturalistic follow-up in patients with borderline personality disorder. Journal of Nervous and Mental Disease, 196, 847–851.  https://doi.org/10.1097/NMD.0ob13e3181818b481d.PubMedGoogle Scholar
  56. Kliem, S., Kroger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modelling. Journal of Consulting and Clinical Psychology, 78, 936–951.  https://doi.org/10.1037/a0021015.PubMedGoogle Scholar
  57. Kramer, U., Pascual-Leone, A., Berthoud, L., Roten, Y., Marquet, P., Kolly, S., et al. (2016). Assertive anger mediates effects of dialectical behavior-informed skills training for borderline personality disorder: A randomized controlled trial. Clinical Psychology & Psychotherapy, 23, 189–202.  https://doi.org/10.1002/cpp.1956.Google Scholar
  58. Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorder: A meta-analysis. American Journal of Psychiatry, 160, 1223–1232.  https://doi.org/10.1001/jama.300.13.1551.PubMedGoogle Scholar
  59. Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. Lancet, 377(10), 74–84.  https://doi.org/10.1016/50140-6736.61422-5.PubMedGoogle Scholar
  60. Lenz, A. S., Conte, D., Hollenbaugh, G. K. M., & Callendar, K. (2016). Emotional regulation and interpersonal effectiveness as mechanisms of change for treatment outcomes within a DBT program for adolescents. Counselling Outcome Research and Evaluation, 7, 73–85.Google Scholar
  61. Levy, K. N., Meehan, K. B., Kelly, K. M., Reynoso, J. S., Weber, M., Clarkin, J. F., & Kernberg, O. F. (2006). Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 74, 1027–1040.PubMedGoogle Scholar
  62. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.Google Scholar
  63. Linehan, M. M. (2014). DBT skills training manual. New York: Guilford Press.Google Scholar
  64. Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment for chronically parasucidial borderline patients. Archives of General Psychiatry, 48, 1060–1064.PubMedGoogle Scholar
  65. Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72, 475–482.  https://doi.org/10.1001/jamapsychiatry.2014.3039.PubMedGoogle Scholar
  66. Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. The American Journal on Addictions, 8, 279–292.  https://doi.org/10.1080/105504999305686.PubMedGoogle Scholar
  67. Livesley, W. J. (2007). An integrated approach to the treatment of personality disorder. Journal of Mental Health, 16, 131–148.  https://doi.org/10.1080/09638230601182086.Google Scholar
  68. Luborsky, L., Singer, B., & Luborsky, L. (1975). Comparative studies of psychotherapy. Archives of General Psychiatry, 32, 995–1008.  https://doi.org/10.1001/archpsyc.1975.01760260059004.PubMedGoogle Scholar
  69. Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62, 459–480.  https://doi.org/10.1002/jclp.20243.PubMedGoogle Scholar
  70. McMain, S., Links, P. S., Guimond, T., Wnuk, S., Eynan, R., Bergmans, Y., & Warwar, S. (2013). An exploratory study of the relationship between changes in emotion and cognitive processes and treatment outcome in borderline personality disorder. Psychotherapy Research, 23(6), 658–673.  https://doi.org/10.1080/10503307.2013.838653.PubMedGoogle Scholar
  71. McMain, S., & Pos, A. B. (2007). Advances in psychotherapy of personality disorders: A research update. Current Psychiatry Reports, 9, 46–52.  https://doi.org/10.1007/s11920-007-0009-7.PubMedGoogle Scholar
  72. Montgomery-Graham, S. (2016). DBT and schema therapy for borderline personality disorder: Mentalization as a common factor. Journal of Contemporary Psychotherapy, 46, 53–60.  https://doi.org/10.1007/s10879-015-9309-0.Google Scholar
  73. Neacsiu, A. D., Rizvi, S. L., & Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behavior Research and Therapy, 48, 832–839.  https://doi.org/10.1016/j.brat.2010.05.017.Google Scholar
  74. Nixon, M. K., Cloutier, P. F., & Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy for Child and Adolescent Psychiatry, 41, 1333–1341.Google Scholar
  75. Nordahl, H. M., & Nysӕter, T. F. P. E. (2005). Schema therapy for patients with borderline personality disorder: A single case series. Journal of Behavior Therapy and Experimental Psychiatry, 36, 254–265.  https://doi.org/10.1016/jbtep.2005.05.007.PubMedGoogle Scholar
  76. Nose, M., Cipriani, A., Biancosino, B., Grassi, L., & Barbui, C. (2006). Efficacy of pharmacotherapy against core traits of borderline personality disorder: Meta-analysis of randomized controlled trials. International Clinical Psychopharmacology, 21, 345–353.  https://doi.org/10.1097/01.yic.0000224784.90911.66.PubMedGoogle Scholar
  77. O’Toole, S. K., Diddy, E., & Kent, M. (2012). Mindfulness and emotional well-being in women with borderline personality disorder. Mindfulness, 3, 117–123.Google Scholar
  78. Oldham, J. M. (2006). Borderline personality disorder and suicidality. American Journal of Psychiatry, 163, 20–26.  https://doi.org/10.1176/appi.ajp.163.1.20.PubMedGoogle Scholar
  79. Oldham, J. M. (2015). A framework for all seasons: Commentary on the special issue on mentalization in borderline personality disorder. Personality Disorders; Theory, Research and Treatment, 6, 397–398.  https://doi.org/10.1037/per0000153.Google Scholar
  80. Ost, L. G. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behavior and Research Therapy, 46, 296–321.  https://doi.org/10.1016/j.brat.2007.12.005.Google Scholar
  81. Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2013). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, 24, 213–223.  https://doi.org/10.1177/1049731513503047.Google Scholar
  82. Pearce, S. (2007). Knowledge of the effectiveness of treatments for borderline personality disorder is not yet sufficient to justify the lack of a control condition. Archives of General Psychiatry, 24, 609.  https://doi.org/10.1001/archpsyc.64.6.609-b.Google Scholar
  83. Perroud, N., Nicastro, R., Jermann, F., & Huguelet, P. (2012). Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: Preliminary results. International Journal of Psychiatry in Clinical Practice, 16, 189–196.  https://doi.org/10.3109/13651501.2012.674531.PubMedGoogle Scholar
  84. Perry, J. C., Banon, E., & Ianni, F. (1999). Effectiveness of psychotherapy for personality disorders. American Journal of Psychiatry, 156, 1312–1321.PubMedGoogle Scholar
  85. Poulsen, S., Lunn, S., Daniel, S. I. F., Folke, S., Mathiesen, B. B., Katznelson, H., et al. (2014). A randomized controlled trial of psychoanalytical psychotherapy or cognitive-behavioral therapy for bulimia. American Journal of Psychiatry, 171, 109–116.  https://doi.org/10.1176/appi.ajp.2013.12121511.PubMedGoogle Scholar
  86. Reiss, N., Lieb, K., Arntz, A., Shaw, I. A., & Farrell, J. (2014). Responding to the treatment challenge of patients with severe BPD: Results of three pilot studies of inpatient schema therapy. Behavioral and Cognitive Psychotherapy, 42, 355–367.  https://doi.org/10.1017/S1352465813000027.Google Scholar
  87. Rizvi, S. L., & Ritschel, L. A. (2014). Mastering the art of chain analysis in dialectical behavior therapy. Cognitive and Behavioral Practice, 21, 335–349.  https://doi.org/10.1016/j.cbpra.2013.09.002.Google Scholar
  88. Scheel, K. R. (2000). The empirical basis of dialectical behavior therapy. Summary, critique, and implications. Clinical Psychology: Science and Practice, 7, 68–86.  https://doi.org/10.1093/clinpsy.7.1.68.Google Scholar
  89. Schmidt, N., Joiner, T., Young, J., & Telch, M. (1995). The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research, 19, 295–321.  https://doi.org/10.1007/bf02230402.Google Scholar
  90. Sempértegui, G. A., Karreman, A., Arntz, A., & Bekker, M. H. J. (2013). Schema therapy for borderline personality disorder: A comprehensive review of its empirical foundations, effectiveness and implementation possibilities. Clinical Psychology Review, 33, 426–447.  https://doi.org/10.1016/j.cpr.2012..11.006.PubMedGoogle Scholar
  91. Sharp, C., & Fonagy, P. (2015). Practitioner review: Borderline personality disorder in adolescence: Recent conceptualization, intervention, and implications for clinical practice. The Journal of Child Psychology and Psychiatry, 56, 1266–1288.  https://doi.org/10.1111/jcpp.12449.PubMedGoogle Scholar
  92. Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65, 98–109.  https://doi.org/10.1037/a0018378.PubMedGoogle Scholar
  93. Sinnaeve, R., van den Bosch, L. M. C., & van Steenbergen-Weijenburg, K. M. (2015). Change in interpersonal functioning during psychological interventions for borderline personality disorder: A systematic review of measures and efficacy. Personality and Mental Health, 9, 173–194.  https://doi.org/10.1002/pmh.1296.PubMedGoogle Scholar
  94. Spinhoven, P., Giesen-Bloo, J., van Dyck, R., Kooiman, K., & Arnoud, A. (2007). The therapeutic alliance in schema-focused therapy and transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 75, 104–115.  https://doi.org/10.1037/0022-006X.75.1.104.PubMedGoogle Scholar
  95. Stoffers, J., Vollm, B. A., Rucker, G., Timmer, A., Huband, N., & Lieb, K. (2010). Pharmacology interventions for borderline personality disorder. Cochrane Database of Systemic Review, 6, CD005653.  https://doi.org/10.1002/14651858.CD005653.Google Scholar
  96. Stoffers, J. M., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2012). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, CD005652(8), 1–186.  https://doi.org/10.1002/14651858.CD005652.pub2.Google Scholar
  97. Swenson, C. R., & Choi-Kain, L. W. (2015). Mentalization and dialectical behavior therapy. American Journal of Psychotherapy, 69, 199–217.PubMedGoogle Scholar
  98. Taylor, C. D. J., Bee, P., & Haddock, G. (2016). Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychology and Psychotherapy: Theory, Research and Practice.  https://doi.org/10.1111/papt.12112.Google Scholar
  99. The National Institute for Health and Clinical Excellence. (2009). Borderline personality disorders: Treatment and management. National Clinical practice Guidelines, 78.Google Scholar
  100. Van Asselt, A. D., Dirksen, C. D., Arntz, A., Giesen-Bloo, J. H., van Dyck, R., Spinhoven, P., et al. (2008). Outpatient psychotherapy for borderline personality disorder: Cost-effectiveness of schema-focused therapy vs. transference-focused psychotherapy. British Journal of Psychiatry, 192, 450–457.  https://doi.org/10.1192/bjp.bp.106.033597.PubMedGoogle Scholar
  101. Verheul, R., & Herbrink, M. (2007). The efficacy of various modalities of psychotherapy for personality disorders: A systematic review of the evidence and clinical recommendations. International Review of Psychiatry, 19, 25–38.  https://doi.org/10.1080/09540260601095399.PubMedGoogle Scholar
  102. Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijen, T., & Van Den Brink, W. (2003). Dialectical behavior therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. British Journal of Psychiatry, 182, 135–140.  https://doi.org/10.1192/bjp.182.2.135.PubMedGoogle Scholar
  103. Vermote, R., Lowyck, B., Luyten, P., Vertommen, H., Corveleyn, J., Verhaest, Y., et al. (2010). Process and outcome in psychodynamic hospitalization-based treatment for patients with a personality disorder. The Journal of Nervous and Mental Disease, 198, 110–115.  https://doi.org/10.1097/NMD.0b013e3181cc0d59.PubMedGoogle Scholar
  104. Widiger, T. A., Clark, L. A., & Livesley, W. J. (2009). An integrative dimensional classification of personality disorder. Psychological Assessment, 21, 243–255.  https://doi.org/10.1037/a0016606.PubMedGoogle Scholar
  105. Young, J. E., & Brown, G. (1990). Young schema questionnaire-long version. New York: New York Cognitive Therapy Centre of New York.Google Scholar
  106. Young, J. E., Klosko, J., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: Guildford.Google Scholar
  107. Zanarini, M. (2009). Psychotherapy of borderline personality disorder. Acta Psychiatrica Scandinavica, 120, 373–377.  https://doi.org/10.1111/j.1600-0447.2009.01448.x.PubMedGoogle Scholar
  108. Zanarini, M. C., Frankenberg, F. R., Hennen, J., & Silk, M. D. (2003). The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry, 160, 274–283.  https://doi.org/10.1176/appi.ajp.160.2.74.PubMedGoogle Scholar
  109. Zanarini, M. C., Frankenberg, F. R., Reich, D. B., Silk, K. R., James, M. D., Hudson, M. D., et al. (2007). The subsyndromal phenomenology of borderline personality disorder: A 10-year follow-up study. American Journal of Psychiatry, 164, 929–935.  https://doi.org/10.1176/appi.ajp.164.6.929.PubMedGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of PsychologyNational University of IrelandGalwayIreland

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