1
|
Ekiz E, van Alphen SPJ, Ouwens MA, Van de Paar J, Videler AC. Systems Training for Emotional Predictability and Problem Solving for borderline personality disorder: A systematic review. Personal Ment Health 2023; 17:20-39. [PMID: 35729869 DOI: 10.1002/pmh.1558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/06/2022] [Accepted: 06/10/2022] [Indexed: 11/11/2022]
Abstract
Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed.
Collapse
Affiliation(s)
- Erol Ekiz
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Sebastiaan P J van Alphen
- Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Mental Health Center, Heerlen-Maastricht, The Netherlands.,Personality and Psychopathology Research Group (PEPS), Department of Psychology (PE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Machteld A Ouwens
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jamie Van de Paar
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands
| | - Arjan C Videler
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
2
|
Chuang SP, Wu JYW, Wang CS. Resilience and Quality of Life in People with Mental Illness: A Systematic Review and Meta-Analysis. Neuropsychiatr Dis Treat 2023; 19:507-514. [PMID: 36910331 PMCID: PMC9994666 DOI: 10.2147/ndt.s392332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/08/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose Resilience is viewed as an individual' positive adaptation and experiences of adversity. The maintenance and recovery of mental health in people with mental disorder is considered a sign of coping with adverse conditions. The purpose of the present meta-analysis was to examine the association between resilience and quality of life in individuals with mental disorders. Methods Studies were included if research reported measures of association with resilience, as assessed using self-reported resilience scale and quality of life. A systematic literature search was conducted in PubMed and PsycINFO. Results Eight studies involving a total of 1439 patients were included in the meta-analysis. Assuming a random-effects model, the weighted mean Pearson correlation between resilience and quality of life was r = 0.551 (95% confidence interval [0.370; 0.691], p < 0.001). This association was moderate, although the heterogeneity among individual effect sizes was substantial (I2 = 93.35%). Conclusion Despite substantial heterogeneity across included studies, the findings suggest a strong association between resilience and quality of life in people with mental disorders. In clinical practice, the promotion of resilience is important to enhance the quality of life among people with mental illness.
Collapse
Affiliation(s)
- Shu Ping Chuang
- Department of Psychiatry, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | | | - Chien Shu Wang
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| |
Collapse
|
3
|
Psychopathological Determinants of Quality of Life in People with Borderline Personality Disorder. J Clin Med 2022; 12:jcm12010030. [PMID: 36614831 PMCID: PMC9820836 DOI: 10.3390/jcm12010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Subjective quality of life (SQOL) in people with borderline personality disorder (BPD) is a marker of disease burden; a crucial treatment outcome; an indicator of psychosocial functioning; and a measure of interventions' effectiveness. Given the dearth of consolidated data, the current study examined psychopathological determinants of global and domain-specific SQOL in people with BPD. METHODS Hierarchical regression models were employed to examine in BPD patients (n = 150) the relationships of the number of BPD diagnostic criteria; the co-occurrence of other personality disorders (PDs); depression; state and trait anxiety; suicidality; self-harming; alcohol and substance use disorders with SQOL indices, namely physical health, psychological health, social relationships, environment, overall QOL and overall health. SQOL was estimated using the WHOQOL-BREF instrument. RESULTS Co-existing symptomatology such as depression, state and trait anxiety, and personality pathology, namely the co-occurrence of other PDs, exhibited significant associations with global and domain-specific SQOL, albeit depression was the strongest determinant of the most SQOL domains. In contrast, the number of BPD diagnostic criteria and central illness features such as suicidality, self-harming behaviour, and impulsivity manifested through alcohol and substance use did not exhibit significant associations with any SQOL dimension. CONCLUSIONS Comprehensive assessment of depressive symptoms should be regularly implemented in BPD services to facilitate early detection and treatment, thereby ensuring patients' SQOL. Accordingly, tackling anxiety and other PDs co-occurrence through appropriate interventions can facilitate more effectively SQOL improvement. Our findings can be explained by the hypothesis that co-existing psychopathology such as depression, anxiety and co-occurrence of other PDs in BPD patients represent illness severity indices rather than comorbid disorders, and might fully mediate the effect of BPD traits on SQOL. Future mediation analysis is required to elucidate this hypothesis.
Collapse
|
4
|
Marco JH, Fernandez-Felipe I, García-Alandete J, Fonseca-Baeza S, Baños RM, Garcia-Palacios A, Pérez Rodríguez S, Guillén V. Multicultural Quality of Life Index in Relatives of People With Borderline Personality Disorder. Front Psychiatry 2022; 13:897692. [PMID: 35782442 PMCID: PMC9247397 DOI: 10.3389/fpsyt.2022.897692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/29/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The aim of the present study was to confirm the original factor structure of the Multicultural Quality of Life Index (MQLI) and analyze its psychometric properties in a sample of caregivers of people with borderline personality disorder (BPD). METHODS The MQLI was administered to 233 relatives of people with BPD. Participants completed the MQLI, the Depression, Anxiety and Stress Scale (DASS-21), and the Connor-Davidson Resilience Scale (CD-RISC). RESULTS Factor analysis of the relatives indicated that the MQLI generated a one-factor solution. The MQLI showed good internal consistency, ϖ = 0.91 [95% CI (0.90, 0.93)] and correlated significantly and positively with the CD-RISC (r s = 0.576) and negatively with the DASS-21 (r s = -0.583). CONCLUSION Consistent with other studies, the MQLI demonstrated feasibility, strong internal consistency, and good convergent and discriminant validity, which means it is a psychometrically robust measure for the assessment of quality of life in relatives of people with BPD. Along with other validation studies, this measure will be a useful tool for assessing quality of life in relatives of people with mental disorders.
Collapse
Affiliation(s)
- Jose Heliodoro Marco
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.,CiberObn Pathophysiology of Obesity and Nutrition (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Fernandez-Felipe
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - Joaquín García-Alandete
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Sara Fonseca-Baeza
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Rosa M Baños
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.,CiberObn Pathophysiology of Obesity and Nutrition (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| | - Azucena Garcia-Palacios
- CiberObn Pathophysiology of Obesity and Nutrition (CB06/03), Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Verónica Guillén
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.,CiberObn Pathophysiology of Obesity and Nutrition (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
5
|
Positive Psychology in Times of Pandemic-Time Perspective as a Moderator of the Relationship between Resilience and Meaning in Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413340. [PMID: 34948949 PMCID: PMC8707410 DOI: 10.3390/ijerph182413340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022]
Abstract
Resilience and meaning in life are significant indicators of psychological well-being and health, which are particularly important in the context of the COVID-19 pandemic. Therefore, they have been explored by a growing number of scientists. There has been a research gap, however, that fails to show that time perspectives also have a significant impact on the perception and building of different life aspects. The current study investigated the associations between resilience, time perspectives and meaning in life and examined the moderating role of time perspective in the relationship between resilience and meaning in life. METHODS Participants of this cross-sectional study were 363 adults aged 18-70. Resilience Measurement Scale (SPP-25), the Zimbardo Time Perspective Inventory (ZTPI), and the Purpose in Life Questionnaire (PIL) were used. RESULTS The findings confirmed a positive relationship between resilience, meaning in life, and positive time perspectives (Present Hedonistic and Future) and a negative link with Past Negative and Present Fatalistic perspectives. The linear regression analyses showed that Past Negative and Past Positive perspectives significantly moderated the relationship between resilience and meaning in life. The moderating effect was also confirmed in the case of past time perspectives only. CONCLUSIONS The findings indicate the relevance of positive resources, such as resilience and positive perception of the past, in keeping the meaning in life. Understanding the effect of psychological strengths in the context of the pandemic time can be a key to providing intervention and therapeutic services fostering mental health and well-being.
Collapse
|