The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder With Co-Occurring Emotional Disorders: A Pilot Study

Abstract

Background: Borderline personality disorder (BPD), which is highlighted by emotional dysregulation and high rates of comorbid emotional disorders, is one of the most challenging clinical conditions for mental health services in different communities. The Unified protocol for the transdiagnostic treatment of emotional disorders (UP) was designed to target common vulnerabilities across emotional co-occurring disorders. Objectives: The aim of the present study was to examine the preliminary efficacy of the UP in treatment of Iranian patients with BPD and comorbid emotional disorders. Methods: By the purposeful sampling method, 6 participants (5 females and 1 male) with borderline personality disorder (BPD) and major depressive disorder (MDD), which met the inclusion criteria, participated in a multiple baseline experimental single case study. Each participant completed the borderline personality inventory (BPI) and difficulties in emotion regulation scale (DERS) during 3 baseline, 8 treatment modules, and 1 follow up assessment session. The unified protocol was carried out for 16 to 20 weekly sessions. Optical analysis and reliable change index (RCI) were used for determination of statistical significance. Remission rate was also applied to measure clinical significance. Results: Results showed that the unified protocol (UP) was effective on reduction of BPD and depressive symptoms as well as increase of emotion regulation skills. Conclusions: The efficacy of UP was statistically and clinically significant in most of the participants. Results from this study provide preliminary evidence for the efficacy of the UP in the treatment of BPD with co-occurring unipolar depressive disorders in Iran, and provide additional support for the transdiagnostic approach in the treatment of emotional disorders.

Psychosocial and pharmacological interventions for personality disorders in low- and middle-income countries: A systematic review

“…For limitations, many identified small samples sizes [19,20,23,[26][27][28] and durations of follow-up [22,23,26,29], lack of randomization, lack of a control group, or study methodology was identified as a limitation in three of the studies [20,22,30]. Three studies mentioned their lack of long-term follow up as a limitation [31][32][33] The treatment group had lower scores on the BPDSI and 3 subscales of the GHQ-28, and higher scores on 5 subscales of the PRQC one month after the end of treatment.…”

“…DBT and schema therapy, they had no female participants [26]. Multiple studies reported limited generalizability of the sample population, with Orduna et al explaining that their sample was a highly motivated group, which is less generalizable to the greater personality disorder population [19,33]. Although self-report scales were the primary outcome measures in most studies, only one study acknowledged this as a limitation [34].…”

Aplicación grupal del protocolo unificado para el tratamiento transdiagnóstico de los trastornos emocionales en una muestra universitaria

“…En su metaanálisis, Aldao et al (2010) evidencian que en personas con problemas de ansiedad y depresión existe un déficit común en las estrategias de regulación de emociones negativas (como la aceptación, la reevaluación y la solución de problemas). Más allá de los trastornos relacionados con la ansiedad y la depresión, existen propuestas para añadir otros trastornos que presentan similitudes con los trastornos emocionales, como el trastorno límite de personalidad (Mohammadi et al, 2018) y el trastorno de estrés postraumático (O'Donnell et al, 2021).…”