Predictors of response to Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder: an exploratory study

Black, Donald W.; Allen, Jeff; John, Don St.; Pfohl, Bruce; McCormick, Brett; Blum, Nancee

doi:10.1111/j.1600-0447.2008.01340.x

Cited by 56 publications

(75 citation statements)

References 30 publications

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“…This finding is basically in accordance with several studies in literature (Meares et al, 1999;Giesen-Bloo et al, 2006;Black et al, 2009), indicating that higher pre-treatment severity of BPD predicted greater symptom change with different models of psychotherapies (IPP-Integrative Psychotherapy Practice, Schema-focused therapy, Transference-focused psychotherapy, STEPPS). Some Authors interpreted this result as "a meaningful indication that patients with high symptom severity actually have a great potential 11 for change and are more likely than others to experience improvement" (Black et al, 2009;Barnicot et al, 2012).…”

Section: Discussionsupporting

confidence: 82%

Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: Predictors of response

Bellino

Bozzatello

Bogetto

2015

Psychiatry Research

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HighlightsPredictors of response to combination of fluoxetine and interpersonal therapy in BPD.Severity of BPD and specific core symptoms are predictors of response.Clinical response is not related to general psychopathology.Response is not associated with symtoms of depression and anxiety. Results: Factors significantly and independently related to ∆ CGI-S were the BPDSI total score and the items abandonment, affective instability, and identity. Conclusions:Patients with more severe BPD psychopathology and with a higher degree of core symptoms such as fear of abandonment, affective instability, and identity disturbance have a better chance to improve with combined therapy with fluoxetine and IPT-BPD.

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Section: Discussionsupporting

confidence: 82%

Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: Predictors of response

Bellino

Bozzatello

Bogetto

2015

Psychiatry Research

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“…The most important implication of this study is that the clinical improvement of patients seemed not dependent from the baseline severity of general symptoms, but was more specifically related to the core BPD psychopathology. This finding is in accordance with previous investigations [44][45][46], indicating that higher pre-treatment severity of BPD predicted greater symptom change with different models of psychotherapies (IPP-Integrative Psychotherapy Practice, Schema-focused therapy, Transference-focused psychotherapy, and STEPPS).…”

Section: Controlled Trials Of Ipt-bpd: Efficacy Follow-up and Predicsupporting

confidence: 82%

Interpersonal Psychotherapy Adapted for Borderline Personality Disorder (IPT-BPD): A Review of Available Data and a Proposal of Revision

Bellino¹,

Bozzatello²

2015

J Psychol Psychother

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Interpersonal model of psychotherapy integrates both the relational theory of Harry Stack Sullivan [1] and the attachment theory of John Bowlby [2]. Sullivan asserted that "a person can never be isolated from the complex of interpersonal relations in which the person lives and has his being". This idea was influenced by the integrative psychobiological theories of Adolf Meyer [3] and based on the clinical observation of a primary social group and the immediate involvement of the subject with one or more significant persons. Individual personality is defined by the relations that are established and by the social role that the he plays. According to John Bowlby's attachment theory, secure attachment to the caregiver early in life forms the foundation for later success in interpersonal relationships. Interpersonal therapy was designed on the basis of these theories and is focused on the patient's intimate relationships.Interpersonal psychotherapy (IPT) was proposed in 1984 by Klerman and colleagues [4], who defined the methods and techniques of this psychotherapeutic approach for patients with a diagnosis of major depression. Traditional IPT is a time-limited, diagnosis-focused, life-event-based treatment consisting of 12-16 weekly sessions. The intervention has a distinct medical setting based on the formulation and communication of a diagnosis, and on the transitory attribution of the phenomena of illness to the patient. During IPT sessions the intervention is focused on one of four interpersonal problem areas that patient and therapist together identify and choose: grief, interpersonal role disputes, role transitions, and interpersonal deficits. Interpersonal approach removes responsibility from the patient regarding guilt and frustration for their emotional experience and at the same time defines the symptoms in a syndromic context that is known and therefore curable. Adaptation of IPT to Other Psychiatric Disorders: The Case of Borderline Personality DisorderThe efficacy of IPT in treatment of major depression is wellestablished, and recent meta-analyses have confirmed its efficacy in both monotherapy and in association with pharmacotherapy [5,6]. The promising results that this psychotherapeutic intervention has obtained in its primary indication, unipolar major depression, have led clinicians and investigators to enlarge the application of IPT beyond this clinical population. So, IPT has been studied in several psychiatric disorders: dysthymia [7][8][9][10] AbstractInterpersonal psychotherapy (IPT) was developed by Klerman in 1984 for patients with major depression. IPT is aimed to the resolution of interpersonal difficulties, improving both social functioning and psychiatric symptoms. The promising results that this model of psychotherapy has obtained in unipolar depression have led investigators to enlarge the application of IPT beyond this clinical population. Specific adaptations of IPT have been required to address the different psychopathological and clinical characteristics of each disorder. IPT has...

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“…Dimensional measures of baseline severity, however, were; the superiority of STEPPS over TAU was greater in patients with higher initial severity. In the RCT on the efficacy of STEPPS done by Black et al [38], higher baseline severity was also associated with greater improvement. This, however, was true for both the STEPPS and TAU conditions in that study, and thus may be explained by regression to the mean.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Borderline Personality Problems in a ‘Real-World’ Sample: Moderation by Diagnosis or Severity?

Bos

Wel

Appelo

et al. 2011

Psychother Psychosom

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Background: Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for borderline personality disorder (BPD). Two prior randomized controlled trials (RCTs) have shown the efficacy of this training. In both RCTs, patients with borderline features who did not meet the DSM-IV criteria for BPD were excluded, which were many. We investigated the effectiveness of STEPPS in a sample representative of routine clinical practice and examined whether DSM-IV diagnosis and/or baseline severity were related to differential effectiveness. Methods: Patients whom their practicing clinician diagnosed with BPD were randomized to STEPPS plus adjunctive individual therapy (STEPPS, n = 84) or to treatment as usual (TAU, n = 84). Results: STEPPS recipients showed more improvement on measures of general and BPD-specific psychopathology as well as quality of life than TAU recipients, both at the end of treatment and at a 6-month follow-up. Presence of DSM-IV-diagnosed BPD was not related to differential treatment effectiveness, but dimensional measures of symptom severity were; STEPPS was superior to TAU particularly in patients with higher baseline severity scores. Conclusions: The findings show the effectiveness of STEPPS in a ‘real-world’ sample, and underscore the importance of dimensional versus categorical measures of personality disturbance.

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Predictors of response to Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder: an exploratory study

Cited by 56 publications

References 30 publications

Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: Predictors of response

Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: Predictors of response

Interpersonal Psychotherapy Adapted for Borderline Personality Disorder (IPT-BPD): A Review of Available Data and a Proposal of Revision

Effectiveness of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Borderline Personality Problems in a ‘Real-World’ Sample: Moderation by Diagnosis or Severity?

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