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Quaderni di Psicoterapia Cognitiva - Open Access

Studies and researches

No. 52 (2023)

Summary of scientific evidence and guidelines for the psychological treatment of Borderline and Antisocial Personality Disorders

DOI
https://doi.org/10.3280/qpc52-2023oa16173
Submitted
luglio 6, 2023
Published
2023-07-17

Abstract

In the last years, the dimensional classification of Personality Disorders and the development of manualized treatments have contributed to a new conceptualization of these disorders. Therefore, it is necessary to implement evidence-based clinical treatments and good practices, through the application of international guidelines for the treatment of personality disorders. This paper aims to analyze the main guidelines from recent literature regarding the treatment of Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD) and to identify which are the recommended treatments with greater efficacy. For this reason, two of the most authoritative sources of international guidelines were examined: National Institute for Health and Care Excellence (NICE) and the American Psychiatric Association (APA). Furthermore, given the need to provide updated scientific evidence, in addition to the guidelines, recent reviews and meta-analyses on the treatment of disorders in question were considered. In conclusion, the literature suggests that clinicians pay greater attention to the dimensional aspect of personality disorders within the psychotherapeutic intervention because it allows the use of specific traits and domains for setting up a more targeted intervention.

References

  1. Alexander, J.F., Waldron, H.B., Robbins, M.S. & Neeb, A.A. (2013). Functional family therapy for adolescent behavior problems. Washington, DC: American Psychological Association.
  2. American Psychiatric Association Practice Guidelines (2001). Practice guideline for the treatment of patients with borderline personality disorder. American Psychiatric Association. The American journal of psychiatry, 158(10 Suppl): 1-52. DOI: 10.1176/appi.ajp.158.1.1.
  3. American Psychiatric Association. (2013). The Personality Inventory for DSM-5 (PID-5) – Adult. Edizione italiana a cura di A. Fossati & S. Borroni. Milano: Raffaello Cortina (2015).
  4. Bateman, A. & Fonagy, P. (2004). Psychotherapy for Borderline Personality Disorder: Mentalisation Based Treatment. Oxford: Oxford University Press.
  5. Bateman, A. & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford: Oxford University Press.
  6. Carcione, A., Dimaggio, G., Conti, L., Nicolò, G., Fiore, D., Procacci, M. & Semerari, A. (2010). Metacognition Assessment Scale (MAS) V. 4.0. Manual. Roma: Terzo Centro di Psicoterapia Cognitiva. Manoscritto non pubblicato.
  7. Carcione, A., Riccardi, I., Bilotta, E., Leone, L., Pedone, R., Conti, L., Colle, L., Fiore, D., Nicolò, G., Pellecchia, G., Procacci, M. & Semerari, A. (2019). Metacognition as a predictor of improvements in personality disorders. Frontiers in Psychology, 10: 170. DOI: 10.3389/Fpsyg.2019.00170.
  8. Carcione, A. & Semerari, A. (2021). Commentary on the Presentation of the Metacognitive Interpersonal Therapy (MIT) model (pp. 171-175). In: Ruggiero, G.M., Caselli, G. & Sassaroli, S. (eds.), CBT case formulation as therapeutic Process. Cham: Springer.
  9. Carcione, A., Semerari, A. & Nicolò, G. (2021). Complex cases of personality disorders. Metacognitive interpersonal therapy. Cham: Springer.
  10. Caretti, V., Scarpa, F., Ciappi, S., Castelletti, L., Catanesi, R., Carabellese, F.F., Ferracuti, S., Nava, F.A., Nicolò, G., Paterniti, R., Rivellini, G. & Schimmenti, A. (2019). HCR-20 v3 – Assessing risk for violence. Checklist per la valutazione del rischio di recidiva di un crimine violento. Firenze: Hogrefe.
  11. Caretti, V., Manzi, G.S., Schimmenti, A. & Seragusa, L. (2011). PCL-R. Hare Psychopathy Checklist-Revised. Firenze: Giunti.
  12. Clarkin, J.F., Yeomans, F.E. & Kernberg, O.F. (1999). Psychotherapy for Borderline Personality. New York: John Wiley & Sons.
  13. Dimaggio, G., Semerari, A., Carcione, A., Nicolò, G. & Procacci, M. (2007). Psychotherapy of personality disorders: Metacognition, states of mind, and interpersonal cycles. New York: Routledge.
  14. Elias, M.J. & Clabby, J.F. (1992). Building Social Problem-Solving Skills: Guidelines from a School-Based Program. Jossey Bass Publishing.
  15. First, M.B., Gibbon, M., Spitzer, R.L., Williams, J.B.W. & Benjamin, L.S. (1997). Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Press.
  16. Fisher, P.A. & Chamberlain, P. (2000). Multidimensional treatment foster care: A program for intensive parenting, family support, and skill building. Journal of Emotional and Behavioral Disorders, 8: 155-164. DOI: 10.1177/106342660000800303.
  17. Gibbon, S., Khalifa, N.R., Cheung, N.H., Völlm, B.A. & McCarthy, L. (2020). Psychological interventions for antisocial personality disorder. The Cochrane database of systematic reviews, 9(9): CD007668. DOI: 10.1002/14651858.CD007668.pub3.
  18. Glenn, A.L., Johnson, A.K. & Raine, A. (2013). Antisocial personality disorder: a current review. Current psychiatry reports, 15(12): 427. DOI: 10.1007/s11920-013-0427-7.
  19. Gratz, K.L. & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1): 41-54. DOI: 10.1023/B:JOBA.0000007455.08539.94.
  20. Hatzigeorgiadis, A. (2006). Instructional and Motivational Self-Talk: An Investigation on Perceived Self-Talk Functions. Hellenic Journal of Psychology, 3: 164-175.
  21. Hawkins, K.R., Apolzan, J.W., Staiano, A.E., Shanley, J.R. & Martin, C.K. (2019). Efficacy of a Home-Based Parent Training-Focused Weight Management Intervention for Preschool Children: The DRIVE Randomized Controlled Pilot Trial. Journal of Nutrition Education and Behavior, 51(6): 740-748. DOI: 10.1016/j.jneb.2019.04.002.
  22. Iobst, E.A., Alderfer, M.A., Sahler, O.J., Askins, M.A., Fairclough, D.L., Katz, E.R., Butler, R.W., Dolgin, M.J. & Noll, R.B. (2009). Problem solving and maternal distress at the time of a child’s diagnosis of cancer in two-parent versus lone-parent households. Journal of pediatric psychology, 34(8): 817-821. DOI: 10.1093/jpepsy/jsn140.
  23. Kazdin, A.E. (2010). Problem-solving skills training and parent management training for oppositiona defiant disorder and conduct disorder (pp. 211-226). In: Weisz, J.R. & Kazdin, A.E. (eds.), Evidence-based psychotherapies for children and adolescents. New York: Guilford Press.
  24. Kazdin, A.E., Siegel, T.C. & Bass, D. (1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60(5): 733-747. DOI: 10.1037//0022-006x.60.5.733.
  25. Lang, P.J., Bradley, M.M. & Cuthbert, B.N. (2008). International Affective Picture System (IAPS): Instruction manual and affective ratings, Technical Report A-8. The Center for Research in Psychophysiology, University of Florida.
  26. Linehan, M.M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
  27. Linehan, M.M. (1993b). Skills training manual for treating borderline personality disorder. New York: Guilford Press.
  28. Loranger, A.W., Sartorius, N., Andreoli, A., Berger, P., Buchheim, P., Channabasavanna, S.M., Coid, B., Dahl, A., Diekstra, R.F., Ferguson, B. et al. (1994). The International Personality Disorder Examination. The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Archives of general psychiatry, 51(3): 215-224. DOI: 10.1001/archpsyc.1994.03950030051005.
  29. Mann, A.H., Jenkins, R., Cutting, J.C. & Cowen, P.J. (1981). The development and use of standardized assessment of abnormal personality. Psychological medicine, 11(4): 839-847. DOI: 10.1017/s0033291700041337.
  30. NICE Clinical guideline (2009). Borderline personality disorder: recognition and management, disponibile su: www.nice.org.uk/guidance/cg78.
  31. NICE Clinical guideline. (2013). Antisocial personality disorder: prevention and management, disponibile su: www.nice.org.uk/guidance/cg77.
  32. NICE Quality standard. (2015) Personality disorders: borderline and antisocial, disponibile su: www.nice.org.uk/guidance/qs88.
  33. Oud, M., Arntz, A., Hermens, M.L., Verhoef, R. & Kendall, T. (2018). Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis. The Australian and New Zealand journal of psychiatry, 52(10): 949-961. DOI: 10.1177/0004867418791257.
  34. Pfohl, B., Blum, N.S. & Zimmerman, M. (1997). Structured interview for DSM-IV personality: SIDP-IV. American Washington, DC: Psychiatric Press.
  35. Plebani, M. & Trenti, T. (2002). Praticare il Governo Clinico: qualità, efficacia e professionalità in Medicina. Torino: Centro Scientifico Editore.
  36. Rossi, R., Corbo, D., Magni, L.R., Pievani, M., Nicolò, G., Semerari, A., Quattrini, G., Riccardi, I., Colle, L., Conti, L., Gasparotti, R., Macis, A., Ferrari, C., Carcione, A. & CLIMAMITHE study group (2023). Metacognitive interpersonal therapy in borderline personality disorder: Clinical and neuroimaging outcomes from the CLIMAMITHE study-A randomized clinical trial. Personality disorders. DOI: 10.1037/per0000621.
  37. Sanders, M.R., Markie-Dadds, C., Tully, L.A. & Bor, W. (2000). The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68(4): 624-640. DOI: 10.1037/0022-006X.68.4.624.
  38. Sanders, M.R., Kirby, J.N., Tellegen, C.L. & Day, J.J. (2014). The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support. Clinical psychology review, 34(4): 337-357. DOI: 10.1016/j.cpr.2014.04.003.
  39. Semerari, A., Carcione, A., Dimaggio, G., Falcone, M., Nicolo, G., Procacci, M. & Alleva, G. (2003). How to evaluate metacognitive functioning in psychotherapy? The metacognition assessment scale and its applications. Clinical Psychology & Psychotherapy, 10(4): 238-261. DOI: 10.1002/cpp.362.
  40. Semerari, A., Cucchi, M., Dimaggio, G., Cavadini, D., Carcione, A., Battelli, V., Nicolò, G., Pedone, R., Siccardi, T., D’Angerio, S., Ronchi, P., Maffei, C. & Smeraldi, E. (2012). The development of the Metacognition assessment interview: Instrument description, factor structure and reliability in a non-clinical sample. Psychiatry Research, 200(2-3): 890-895. DOI: 10.1016/j.psychres.2012.07.015.
  41. Storebø, O.J., Stoffers-Winterling, J.M., Völlm, B.A., Kongerslev, M.T., Mattivi, J.T., Jørgensen, M.S., Faltinsen, E., Todorovac, A., Sales, C.P., Callesen, H.E., Lieb, K. & Simonsen, E. (2020) Psychological therapies for people with borderline personality disorder. The Cochrane database of systematic reviews, 5(5): CD012955. DOI: 10.1002/14651858.CD012955.pub2.
  42. Tyrer, P. & Alexander, J. (1979). Classification of Personality Disorder. The British Journal of Psychiatry, 135(2): 163-167. DOI: 10.1192/bjp.135.2.163.
  43. Vita, A., De Peri, L. & Sacchetti, E. (2011). Antipsychotics, Antidepressants, Anticonvulsants, and Placebo on the Symptom Dimensions of Borderline Personality Disorder: A Meta-Analysis of Randomized Controlled and Open-Label Trials. Journal of clinical psychopharmacology, 31(5): 613-624. DOI: 10.1097/JCP.0b013e31822c1636.
  44. Webster-Stratton, C. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66(5): 715-730. DOI: 10.1037//0022-006x.66.5.715.
  45. Young, J.E., Klosko, J.S. & Weishaar, M.E. (2003). Schema Therapy: A Practitioner’s Guide. New York: Guilford Press.
  46. Zanarini, M.C., Frankenburga, F.R., Chaunceyab, D.L. & Gunderson, J.G. (1987). The diagnostic interview for personality disorders: Interrater and test-retest reliability. Comprehensive psychiatry, 28(6): 467-480. DOI: 10.1016/0010-440x(87)90012-5.

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