Treatment for Borderline Personality Disorder and Secondary Effects on Somatization

Author(s):  
Karen B. Schmaling ◽  
Jessica L. Fales ◽  
Marsha M. Linehan

Borderline personality disorder (BPD) is often accompanied by other diagnoses. Some comorbidities have received a good deal of attention, but others, including somatization, have not. As effective treatments for BPD are identified, the secondary effects of these treatments on BPD comorbidities are of clinical relevance. Secondary data were used from a randomized clinical trial of dialectical behavior therapy (DBT) and community treatment by experts among 101 women with BPD in order to characterize change in somatization with treatment for BPD, and to examine emotional avoidance as a mediator. Somatization decreased significantly over time, which did not differ by treatment condition. DBT had an indirect effect on somatization through less emotional avoidance. These results suggest that the comorbid presence of significant somatization should be evaluated among those with BPD, especially in the context of emotional avoidance; treatments could be enhanced by addressing emotion regulation skills.

Author(s):  
David Saunders ◽  
Erica Robinson ◽  
Sarah Fineberg

This chapter provides a summary of a landmark study on borderline personality disorder. Is dialectical behavior therapy more effective than treatment offered by nonbehavioral psychotherapy experts in reducing suicidal behaviors and treating borderline personality disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


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