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Effectiveness of Psychological Treatments for Borderline Personality Disorder and Predictors of Treatment Outcomes: A Multivariate Multilevel Meta-Analysis of Data from All Design Types.
Rameckers, Sophie A; Verhoef, Rogier E J; Grasman, Raoul P P P; Cox, Wouter R; van Emmerik, Arnold A P; Engelmoer, Izabella M; Arntz, Arnoud.
Afiliación
  • Rameckers SA; Department of Clinical Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
  • Verhoef REJ; Department of Developmental Psychology, University of Utrecht, 3584 CS Utrecht, The Netherlands.
  • Grasman RPPP; Department of Psychological Methods, University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
  • Cox WR; Department of Clinical Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
  • van Emmerik AAP; Department of Clinical Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
  • Engelmoer IM; Institute for Personality Disorders and Behavioral Problems, de Viersprong Amsterdam, 1115 HG Duivendrecht, The Netherlands.
  • Arntz A; Department of Clinical Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
J Clin Med ; 10(23)2021 Nov 29.
Article en En | MEDLINE | ID: mdl-34884324
We examined the effectiveness of psychotherapies for adult Borderline Personality Disorder (BPD) in a multilevel meta-analysis, including all trial types (PROSPERO ID: CRD42020111351). We tested several predictors, including trial- and outcome type (continuous or dichotomous), setting, BPD symptom domain and mean age. We included 87 studies (N = 5881) from searches between 2013 and 2019 in four databases. We controlled for differing treatment lengths and a logarithmic relationship between treatment duration and effectiveness. Sensitivity analyses were conducted by excluding outliers and by prioritizing total scale scores when both subscale and total scores were reported. Schema Therapy, Mentalization-Based Treatment and reduced Dialectical Behavior Therapy were associated with higher effect sizes than average, and treatment-as-usual with lower effect sizes. General severity and affective instability showed the strongest improvement, dissociation, anger, impulsivity and suicidality/self-injury the least. Treatment effectiveness decreased as the age of participants increased. Dichotomous outcomes were associated to larger effects, and analyses based on last observation carried forward to smaller effects. Compared to the average, the highest reductions were found for certain specialized psychotherapies. All BPD domains improved, though not equally. These findings have a high generalizability. However, causal conclusions cannot be drawn, although the design type did not influence the results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: J Clin Med Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza
Texto completo
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Imprimir
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PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: J Clin Med Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza