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A Randomized Controlled Trial Comparing Mentalization-Based Therapy With the Unified Protocol in the Treatment of Psychopathy and Comorbid Borderline + Antisocial Personality Disorders.

التفاصيل البيبلوغرافية
العنوان: A Randomized Controlled Trial Comparing Mentalization-Based Therapy With the Unified Protocol in the Treatment of Psychopathy and Comorbid Borderline + Antisocial Personality Disorders.
المؤلفون: Mohajerin B; Clinical Psychology Department, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran., Shamsi A; School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran., Howard R; Institute of Mental Health, Nottingham, UK.
المصدر: Clinical psychology & psychotherapy [Clin Psychol Psychother] 2024 Jul-Aug; Vol. 31 (4), pp. e3047.
نوع المنشور: Journal Article; Randomized Controlled Trial; Comparative Study
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons Country of Publication: England NLM ID: 9416196 Publication Model: Print Cited Medium: Internet ISSN: 1099-0879 (Electronic) Linking ISSN: 10633995 NLM ISO Abbreviation: Clin Psychol Psychother Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chichester, West Sussex, England : John Wiley & Sons, c1993-
مواضيع طبية MeSH: Borderline Personality Disorder*/therapy , Borderline Personality Disorder*/psychology , Borderline Personality Disorder*/complications , Antisocial Personality Disorder*/therapy , Antisocial Personality Disorder*/psychology , Antisocial Personality Disorder*/complications , Mentalization*, Humans ; Male ; Adult ; Female ; Treatment Outcome ; Comorbidity ; Psychotherapy/methods ; Middle Aged
مستخلص: Background: Those with cooccurring antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are reported to be highly psychopathic and to represent a severe challenge to treatment efforts. In a sample of such individuals, the effects of two treatments, mentalization-based therapy (MBT) and the unified protocol (UP), were investigated on three outcomes: (i) the psychopathy trait domains of meanness, boldness and disinhibition proposed by the triarchic psychopathy model (TPM); (ii) antisocial and borderline symptom severity; and (iii) the severity of their common features including impulsivity, anger expression and self-harm.
Methods: Of 163 individuals with BPD + ASPD screened for eligibility, 55 were randomized to MBT treatment and 53 to UP treatment. Outcomes of treatment were assessed at 6-month intervals to 36 months.
Results: Short-term reductions were seen following both treatments in traits of psychopathy, antisocial and borderline personality symptom severity, anger dysregulation, impulsivity and self-harm, but both treatment groups showed almost complete relapse of symptoms at the 36-month follow-up. UP had more durable effects than MBT.
Conclusions: Despite being a considerably shorter treatment, UP was at least as effective as MBT and in some respects superior. Remission of symptoms was not achieved by either treatment in the long term. Psychopathy and borderline/antisocial comorbidity with which it is associated are to some extent remediable through psychotherapy, but only in the short term.
Clinical Implications: Patients with high levels of impulsivity and disinhibition are likely to relapse following psychotherapy and should be closely monitored after treatment.
(© 2024 John Wiley & Sons Ltd.)
References: Ahmadi, A., R. Molodi, and M. Bahmani. 2019. The Prevalence of Antisocial Symptoms Among Criminal Population (Unpublished Master's Thesis). Kerman, Iran: Islamic Azad University.
American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorder. 5th ed. Arlington, VA: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.744053.
Asghari Moghaddam, M. A., M. Moghaddasin, and P. Dibajnia. 2012. “The Reliability and Criterion Validity of a Persian Version of the State‐Trait Anger Expression Inventory‐2 (STAXI‐2) in a Clinical Sample.” Clinical Psychology & Personality Journal 3, no. 5: 75–94.
Azadfallah, P., and N. Sohrabifard. 2009. “Factor Structure, Reliability and Validity of Impulsivity Behaviors Scale (UPPS‐P).” Psychological Research 3: 65–78.
Barlow, D. H., T. J. Farchione, C. P. Fairholme, et al. 2010. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. Oxford University Press.
Barlow, D. H., and L. J. Long 2023. “The Unified Protocol: Current Status, Future Directions”. https://doi.org/10.1037/cps0000152.
Baskin‐Sommers, A., S. Ruiz, B. Sarcos, and C. Simmons. 2022. “Cognitive–Affective Factors Underlying Disinhibitory Disorders and Legal Implications.” Nature Reviews Psychology 1, no. 3: 145–160. https://doi.org/10.1038/s44159‐022‐00020‐8.
Bateman, A., P. Fonagy, C. Campbell, P. Luyten, and M. Debbané. 2023. Cambridge Guide to Mentalization‐Based Treatment (MBT). Cambridge University Press.
Bateman, A., J. O'Connell, N. Lorenzini, T. Gardner, and P. Fonagy. 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, no. 1: 1–11. https://doi.org/10.1186/s12888‐016‐1000‐9.
Bateman, A. W., and P. Fonagy. 2010. “Mentalization Based Treatment for Borderline Personality Disorder.” World Psychiatry 9: 11–15.
Black, D. W., F. Simsek‐Duran, N. Blum, B. McCormick, and J. Allen. 2016. “Do People With Borderline Personality Disorder Complicated by Antisocial Personality Disorder Benefit From the STEPPS Treatment Program?” Personality and Mental Health 10, no. 3: 205–215. https://doi.org/10.1002/pmh.1326.
Bohus, M., N. Kleindienst, M. F. Limberger, et al. 2009. “The Short Version of the Borderline Symptom List (BSL‐23): Development and Initial Data on Psychometric Properties.” Psychopathology 42, no. 1: 32–39. https://doi.org/10.1159/000173701.
Coid, J. W., M. Yang, S. Ullrich, et al. 2011. “Most Items in Structured Risk Assessment Instruments Do Not Predict Violence.” Journal of Forensic Psychiatry & Psychology 22, no. 1: 3–21. https://doi.org/10.1080/14789949.2010.495990.
Crotty, K., M. Viswanathan, S. Kennedy, et al. 2024. “Psychotherapies for the Treatment of Borderline Personality Disorder: A Systematic Review.” Journal of Consulting and Clinical Psychology 92, no. 5: 275–295. https://doi.org/10.1037/ccp0000833.
First, M. B., J. B. Williams, L. S. Benjamin, and R. L. Spitzer. 2016. SCID‐5‐PD: Structured Clinical Interview for DSM‐5® Personality Disorders. American Psychiatric Association Publishing.
First, M. B., J. B. Williams, R. S. Karg, and R. L. Spitzer. 2016. User's Guide for the SCID‐5‐CV Structured Clinical Interview for DSM‐5® Disorders: Clinical Version. American Psychiatric Publishing, Inc.
Fisher‐Fox, L., C. J. Prestigiacomo, and M. A. Cyders. 2024. “Urgency Theory in the Context of Broader Emotion Theories: A Conceptual Review.” Frontiers in Psychiatry 15: 1403639. https://doi.org/10.3389/fpsyt.2024.1403639.
Gratz, K. L. 2001. “Measurement of Deliberate Self‐Harm: Preliminary Data on the Deliberate Self‐Harm Inventory.” Journal of Psychopathology and Behavioral Assessment 23, no. 4: 253–263. https://doi.org/10.1023/A:1012779403943.
Hahn, A. M., R. M. Simons, and C. K. Hahn. 2016. “Five Factors of Impulsivity: Unique Pathways to Borderline and Antisocial Personality Features and Subsequent Alcohol Problems.” Personality and Individual Differences 99: 313–319. https://doi.org/10.1016/j.paid.2016.05.035.
Howard, R., D. Hasin, and M. Stohl. 2021. “Substance Use Disorders and Criminal Justice Contact Among Those With Co‐Occurring Antisocial and Borderline Personality Disorders: Findings From a Nationally Representative Sample.” Personality and Mental Health 15, no. 1: 40–48. https://doi.org/10.1002/pmh.1491.
Howard, R. C., N. Khalifa, and C. Duggan. 2014. “Antisocial Personality Disorder Comorbid With Borderline Pathology and Psychopathy Is Associated With Severe Violence in a Forensic Sample.” Journal of Forensic Psychiatry & Psychology 25: 658–672. https://doi.org/10.1080/14789949.2014.943797.
Huber, J., S. Jennissen, C. Nikendei, H. Schauenburg, and U. Dinger. 2021. “Agency and Alliance as Change Factors in Psychotherapy.” Journal of Consulting and Clinical Psychology 89, no. 3: 214–226. https://doi.org/10.1037/ccp0000628.
Jørgensen, M. S., L. Møller, S. Bo, et al. 2024. “The Course of Borderline Personality Disorder From Adolescence to Early Adulthood: A 5‐Year Follow‐Up Study.” Comprehensive Psychiatry 132: 152478. https://doi.org/10.1016/j.comppsych.2024.152478.
Kavish, N., J. Miller, and B. Boutwell. 2022. “The Science of Psychopathy and Some Strategies for Moving Forward.” Criminal Behaviour and Mental Health 33, no. 1: 1–8. https://doi.org/10.31234/osf.io/wbn83.
Kleindienst, N., M. Jungkunz, and M. Bohus. 2020. “A Proposed Severity Classification of Borderline Symptoms Using the Borderline Symptom List (BSL‐23).” Borderline Personality Disorder and Emotion Dysregulation 7, no. 1: 1–11. https://doi.org/10.1186/s40479‐020‐00126‐6.
Lilienfeld, S. O., K. C. Sauvigné, S. J. Lynn, R. L. Cautin, R. D. Latzman, and I. D. Waldman. 2015. “Fifty Psychological and Psychiatric Terms to Avoid: A List of Inaccurate, Misleading, Misused, Ambiguous, and Logically Confused Words and Phrases.” Frontiers in Psychology 6, 1100. https://doi.org/10.3389/fpsyg.2015.01100.
López‐Villatoro, J. M., N. Palomares, M. Díaz‐Marsá, and J. L. Carrasco. 2018. “Borderline Personality Disorder With Psychopathic Traits: A Critical Review.” Clinical Medical Reviews and Case Reports 5, no. 227: 2378–3656. https://doi.org/10.23937/2378‐3656/1410227.
Lynam, D. R., G. T. Smith, S. P. Whiteside, and M. A. Cyders. 2006. The UPPS‐P: Assessing Five Personality Pathways to Impulsive Behavior, 10. West Lafayette, IN: Purdue University.
Martin, S., and J. Del‐Monte. 2022. “Just Try It: Preliminary Results of a Six‐Month Therapy for Borderline Personality Disorder.” Personality and Mental Health 16, no. 4: 338–349. https://doi.org/10.1002/pmh.1555.
Mohajerin, B., and R. C. Howard. 2023. “Effects of Two Treatments on Interpersonal, Affective and Lifestyle Features of Psychopathy and Emotion Dysregulation.” Personality & Mental Health 18: 43–59. https://doi.org/10.1002/pmh.1593.
Moore, K. E., M. T. Tull, and K. L. Gratz. 2017. “Borderline Personality Disorder Symptoms and Criminal Justice System Involvement: The Roles of Emotion‐Driven Difficulties Controlling Impulsive Behaviors and Physical Aggression.” Comprehensive Psychiatry 76: 26–35. https://doi.org/10.1016/j.comppsych.2017.03.008.
Namzi, S. 2017. “Evaluation of Personality of Parents With Borderline Children.” Unpublished doctoral dissertation, Hormozgan University of Medical Sciences, Iran.
Newhill, C. E., M. G. Vaughn, and M. DeLisi. 2009. “Psychopathy Scores Reveal Heterogeneity Among Patients With Borderline Personality Disorder.” Journal of Forensic Psychiatry and Psychology 21: 202–220. https://doi.org/10.1080/14789940903281157.
Paap, M., A. Heltne, G. Pedersen, et al. 2022. “More Is More: Evidence for the Incremental Value of the SCID‐II/SCID‐5‐PD Specific Factors Over and Above a General Personality Disorder Factor.” Personality Disorders, Theory, Research, and Treatment 13, no. 2: 108–118. https://doi.org/10.1037/per0000426.
Paivastegar, M. 2012. “Relationship Between Self‐Harm, Attachment and Loneness Among High School Girls.” Quarterly Journal of Psychological Studies 9, no. 3: 29–51.
Patrick, C. J., D. C. Fowles, and R. F. Krueger. 2009. “Triarchic Conceptualization of Psychopathy: Developmental Origins of Disinhibition, Boldness, and Meanness.” Development and Psychopathology 21, no. 3: 913–938. https://doi.org/10.1521/pedi.2011.25.1.75.
Polaschek, D. L., and J. L. Skeem. 2018. “Treatment of Adults and Juveniles With Psychopathy.” In Handbook of Psychopathy, edited by C. J. Patrick, 2nd ed., 710–731. The Guilford Press.
Rafiemanesh, H., A. Rahimi Movaghar, S. Nedjat, A. Noroozi, and K. Yazdani. 2017. “An Overview of the Tools and Screening Tests for Detection of Alcohol Disorders.” Iranian Journal of Epidemiology 13, no. 2: 98–109.
Roberts, B. W., J. Luo, D. A. Briley, P. I. Chow, R. Su, and P. L. Hill. 2017. “A Systematic Review of Personality Trait Change Through Intervention.” Psychological Bulletin 143, no. 2: 117–141. https://doi.org/10.1037/bul0000088.
Robitaille, M. P., D. Checknita, F. Vitaro, R. E. Tremblay, J. Paris, and S. Hodgins. 2017. “A Prospective, Longitudinal, Study of Men With Borderline Personality Disorder With and Without Comorbid Antisocial Personality Disorder.” Borderline Personality Disorder and Emotion Dysregulation 4, no. 1: 1–13. https://doi.org/10.1186/s40479‐017‐0076‐2.
Saunders, J. B., O. G. Aasland, T. F. Babor, J. R. De La Fuente, and M. Grant. 1993. “Development of the Alcohol use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons With Harmful Alcohol Consumption‐II.” Addiction 88, no. 6: 791–804. https://doi.org/10.1111/j.1360‐0443.1993.tb02093.x.
Semel, R. A., T. B. Pinsoneault, L. E. Drislane, and M. Sellbom. 2021. “Operationalizing the Triarchic Model of Psychopathy in Adolescents Using the MMPI‐A‐RF (Restructured Form).” Psychological Assessment 33, no. 4: 311–325. https://doi.org/10.1037/pas0000985.
Shadloo, T., S. Karimian, and B. Shadloo. 2017. A Persian qTranslation of Structured Clinical Interview for DSM‐5 Disorder. Ebnesina Press.
Shamloo, F. 2017. A Persian Translation of Structured Clinical Interview for DSM‐5 Personality Disorders. Ebnesina Press.
Somma, A., S. Borroni, G. Gialdi, et al. 2020. “The Inter‐Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for DSM‐5 Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients.” Journal of Personality Disorders 34, no. Supplement C: 95–123. https://doi.org/10.1521/pedi_2020_34_511.
South, S. C. 2019. “Psychopathy as an Emergent Interpersonal Syndrome: What Is the Function of Fearlessness?” Journal of Personality Disorders 33, no. 5: 633–639. https://doi.org/10.1521/pedi.2019.33.5.633.
Spielberger, C. D. 1999. STAXI‐2: State‐Trait Anger Expression Inventory‐2. Odessa, FL: Psychological Assessment Resources.
Strickland, C. M., C. J. Hopwood, M. A. Bornovalova, E. C. Rojas, R. F. Krueger, and C. J. Patrick. 2019. “Categorical and Dimensional Conceptions of Personality Pathology in DSM‐5: Toward a Model‐Based Synthesis.” Journal of Personality Disorders 33, no. 2: 185–213. https://doi.org/10.1521/pedi_2018_32_339.
Van Til, K., J. D. Miller, N. T. Carter, and D. R. Lynam. 2024. “Exploring the Structure of Fearlessness Using Self‐Report Measures.” Journal of Personality 92: 548–564. https://doi.org/10.1111/jopy.12851.
Varlamov, A., N. Khalifa, P. Liddle, C. Duggan, and R. Howard. 2011. “Cortical Correlates of Impaired Self‐Regulation in Personality Disordered Patients With Traits of Psychopathy.” Journal of Personality Disorders 25, no. 1: 75–88.
Watson, D., and L. A. Clark. 2023. “Comorbidity and Heterogeneity: Two Challenges for Personality Pathology Research.” Personality Disorders, Theory, Research, and Treatment 14, no. 1: 39–49. https://doi.org/10.1037/per0000586.
Wrege, J. S., M. Busmann, A. H. Meyer, S. Euler, U. E. Lang, and M. Walter. 2021. “Impulsiveness in Borderline Personality Disorder Predicts the Long‐Term Outcome of a Psychodynamic Treatment Programme.” Clinical Psychology & Psychotherapy 28, no. 3: 633–641. https://doi.org/10.1002/cpp.2526.
فهرسة مساهمة: Keywords: antisocial personality disorder; borderline personality disorder; comorbidity; mentalization‐based therapy; psychopathy; triarchic model; unified protocol
تواريخ الأحداث: Date Created: 20240822 Date Completed: 20240822 Latest Revision: 20240822
رمز التحديث: 20240822
DOI: 10.1002/cpp.3047
PMID: 39171765
قاعدة البيانات: MEDLINE
الوصف
تدمد:1099-0879
DOI:10.1002/cpp.3047