Impact of Interpersonal Problems in Borderline Personality Disorder Inpatients on Treatment Outcome and Psychopathology

Abstract

Background: Borderline personality disorder (BPD) is a very common illness; interpersonal problems are one of the core features. The purpose of this study was to investigate the changes in interpersonal problems after transference-focused psychotherapy (TFP)-based disorder-specific treatment and to explore whether the severity of interpersonal problems could serve as a predictor for other variables. Sampling and Methods: A sample of 37 inpatients with BPD was assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I and II) and had to complete a questionnaire including the Inventory of Interpersonal Problems (IIP-C), Inventory of Personality Organization (IPO), Beck Depression Inventory (BDI), Spielberger State and Trait Inventory (STAI), Spielberger State and Trait Anger Inventory (STAXI), and Symptom Checklist-90 (SCL-90-R). After 12 weeks of TFP-based disorder-specific treatment, the patients repeated the same questionnaire; 7 patients had to be excluded from the study, and thus calculations were conducted with 30 patients. Results: After treatment, the patients showed a significant decrease in the IIP total item score and all 8 subscales except the domineering, intrusive, and cold scales. The IIP total item baseline score was correlated with borderline symptomatic and psychopathology [e.g. anxiety, Global Severity Index (GSI)] after 12 weeks as well as with most IIP postsubscales. Conclusions: Although interpersonal problems are considered one of the more stable features of BPD, our results showed a significant improvement after 12 weeks of TFP-based disorder-specific inpatient treatment, especially in the total score and the subscales on the friendly submissive level. The severity of interpersonal problems at baseline was connected to outcome values of other borderline features as well as general psychiatric complaints. It therefore seems important to consider the treatment of interpersonal problems in therapy to be of greater significance.

What interpersonal problems are related to different therapeutic techniques early in treatment?

“…These results help us better understand an important aspect of interpersonal functioning, as previous research shows that higher global interpersonal problem severity predicts worse outcomes at therapy termination (Dammann et al, 2016). Next, therapist explanation of the rationale behind was negatively related to patient level of global interpersonal problems in treatment.…”

“…Such problems, defined as dysfunctional patterns in a person's interpersonal interactions (Horowitz, 1996), have great clinical significance, as they are associated with significant distress, and they are highly comorbid with both Axis I and Axis II disorders (Dammann et al, 2016;Joyce, Ogrodniczuk, & Kealy, 2017 Luyten, & Fonagy, 2018;Penedo, Constantino, Coyne, Westra, & Antony, 2017;Ung et al, 2017). Such problems, defined as dysfunctional patterns in a person's interpersonal interactions (Horowitz, 1996), have great clinical significance, as they are associated with significant distress, and they are highly comorbid with both Axis I and Axis II disorders (Dammann et al, 2016;Joyce, Ogrodniczuk, & Kealy, 2017 Luyten, & Fonagy, 2018;Penedo, Constantino, Coyne, Westra, & Antony, 2017;Ung et al, 2017).…”

“…Similarly, Ung et al (2017) found that eating-disordered patients display a nonassertive and friendly submissive interpersonal style, independent of specific eating disorder diagnosis. Borderline personality disorder is one notable example, as interpersonal problems are considered to be one of the core features of the disorder (Dammann et al, 2016). Borderline personality disorder is one notable example, as interpersonal problems are considered to be one of the core features of the disorder (Dammann et al, 2016).…”

“…In terms of Axis II psychopathology, interpersonal problems are common as well (Joyce et al, 2017). Borderline personality disorder is one notable example, as interpersonal problems are considered to be one of the core features of the disorder (Dammann et al, 2016). Although prior research suggests that interpersonal problems can generally be treated in psychotherapy (McFarquhar et al, 2018), more research is needed to understand what drives patient improvement in interpersonal areas.…”

The association between borderline personality disorder and somatoform disorders: A systematic review and meta-analysis

“…Significant decreases in somatic symptoms were noted as a function of psychotherapy (DBT) for BPD (Brassington & Krawitz, ; Fleischhaker et al., ) and medications (duloxetine, Bellino, Paradiso, Bozzatello, & Bogetto, ; venlaflaxine, Markovitz & Wagner, ), and an herbal compound (yi‐gan san; Miyaoka et al., ). However, insignificant change in somatic symptoms was noted as a function of other treatments for BPD, that is, those that used transference‐focused therapy (Dammann et al., ), topiramate (Loew et al., ), and aripiprazole (Nickel et al., ). Although some studies have suggestive results, these studies have typically utilized unsophisticated methodology (e.g., a single treatment condition and analyses of subjects who completed treatment), small samples, and short courses of treatment and of follow‐up.…”