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

Acta Psychiatr Scand. 2009 Jul;120(1):53-61. doi: 10.1111/j.1600-0447.2008.01340.x. Epub 2009 Jan 12.

Abstract

Objective: Few predictors of treatment outcome or early discontinuation have been identified in persons with borderline personality disorder (BPD).

Aim: The aim of the study was to examine the relationship between baseline clinical variables and treatment response and early discontinuation in a randomized controlled trial of System Training for Emotional Predictability and Problem Solving, a new cognitive group treatment.

Method: Improvement was rated using the Zanarini Rating Scale for BPD, the Clinical Global Impression Scale, the Global Assessment Scale and the Beck Depression Inventory. Subjects were assessed during the 20 week trial and a 1-year follow-up.

Results: Higher baseline severity was associated with greater improvement in global functioning and BPD-related symptoms. Higher impulsivity was predictive of early discontinuation. Optimal improvement was associated with attending > or = 15 sessions.

Conclusion: Subjects likely to improve have the more severe BPD symptoms at baseline, while high levels of impulsivity are associated with early discontinuation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / psychology
  • Borderline Personality Disorder / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Emotions*
  • Family Therapy / methods*
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Humans
  • Impulsive Behavior / diagnosis
  • Impulsive Behavior / psychology
  • Impulsive Behavior / therapy
  • Interpersonal Relations
  • Interview, Psychological
  • Iowa
  • Male
  • Patient Dropouts
  • Personality Inventory
  • Problem Solving*
  • Psychotherapy, Group / methods*
  • Systems Theory*
  • Treatment Outcome
  • Young Adult