Psychodynamic Therapy For Co-occurring Borderline Personality Disorder and Alcohol Use Disorder
Psychodynamic Therapy for Patients With Borderline Personality Disorder and Alcohol Abuse
Study Overview
Status
Intervention / Treatment
Detailed Description
Borderline Personality Disorder (BPD) is a condition that can cause significant distress and increased risk of death. Many persons with BPD also have an alcohol use disorder (AUD) and there is evidence that this can worsen the outcome and course of both disorders.
A manual-based form of psychodynamic therapy (PT), labeled dynamic deconstructive psychotherapy, has been developed for particularly challenging patients with BPD, especially those with co-occurring substance use disorders. It aims to remediate specific neurocognitive capacities that are responsible for processing of emotional experiences, and so diminishes symptoms of BPD and promotes the development of a coherent and differentiated self-structure. PT has been shown to be helpful for BPD, but has not been tested for people who have BPD with co-occurring substance use disorders.
The proposed study is a randomized controlled trial of PT for persons with BPD and co-occurring AUD that will generate some initial data that can be used to determine the need and feasibility for further outcome studies. Participants are randomized to either a study group receiving weekly PT or to a control group receiving usual care. Enrollment is 15 participants in each group. The study group will receive 12-18 months of PT, with naturalistic follow-up. Outcome measures are administered by a research assistant at enrollment, 3 months, 6 months, 9 months, 12 months, and 30 months.
The investigators anticipate that the PT group will show trends towards better retention in treatment and greater reduction in parasuicides, alcohol misuse, and institutional care. If so, this would have important and positive implications for the large group of patients who suffer from BPD and co-occurring AUD.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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New York
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Syracuse, New York, United States, 13210
- SUNY Upstate Medical University, University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age between 18 and 45 years
- Meets diagnostic criteria for borderline personality disorder and for active alcohol abuse or dependence
- At least average intelligence
Exclusion Criteria:
- Meets diagnostic criteria for schizophrenia, or schizoaffective disorder
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: dynamic deconstructive psychotherapy
weekly individual psychotherapy of 50 minute duration lasting 12-18 months
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Dynamic deconstructive psychotherapy is a time-limited (12-18 month) manual-based form of psychodynamic therapy that aims to remediate specific neurocognitive capacities responsible for processing of emotional experiences.
Other Names:
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Active Comparator: optimized community care
eclectic weekly individual and group psychotherapy, as well as drug and alcohol rehabilitation
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individual and group psychotherapy in a private practice, clinic, and/or rehab setting, with an eclectic orientation
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
episodes of parasuicide, alcohol intoxication, institutional care
Time Frame: 12 months
|
12 months
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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depression, dissociation, core symptoms of borderline pd, perceived social support
Time Frame: 12 months
|
12 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Robert J. Gregory, M.D., State University of New York - Upstate Medical University
Publications and helpful links
General Publications
- Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2.
- Gregory RJ. Thematic stages of recovery in the treatment of borderline personality disorder. Am J Psychother. 2004;58(3):335-48. doi: 10.1176/appi.psychotherapy.2004.58.3.335.
- Gregory RJ. Borderline attributions. Am J Psychother. 2007;61(2):131-47. doi: 10.1176/appi.psychotherapy.2007.61.2.131.
- Gregory RJ. The deconstructive experience. Am J Psychother. 2005;59(4):295-305. doi: 10.1176/appi.psychotherapy.2005.59.4.295.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SUNY UMU IRB 4968
- 130230-44
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