Evidence map›Paper›PMID 34314461›Full record

ArticlePloS one2021

Searching in the dark: Shining a light on some predictors of non-response to psychotherapy for borderline personality disorder.

Jane Woodbridge, Samantha Reis, Michelle L Townsend, Lucy Hobby, Brin F S Grenyer

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06106555 (Vilka Faktorer påverkar Behandlingsutfall Vid Dialektisk Beteendeterapi för Borderline Personlighetssyndrom?), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06106555 recruitingnot on this mapstarted 2023, after this paper: background citation

Vilka Faktorer påverkar Behandlingsutfall Vid Dialektisk Beteendeterapi för Borderline Personlighetssyndrom?

TypeobservationalSponsorRegion SkaneRan2023 to 2027Enrolled100ConditionsBorderline Personality Disorder, Non-suicidal Self-injury, Deliberate Self HarmArmsDialectibal Behaviour Therapy
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Jane WoodbridgeIllawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.ORCID 0000-0003-1374-3906
Samantha ReisIllawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.
Michelle L TownsendIllawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.ORCID 0000-0001-8921-781X
Lucy HobbyIllawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.ORCID 0000-0002-9416-0675
Brin F S GrenyerIllawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.
University of Wollongong · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBorderline Personality Disorder (BPD) is a prevalent and serious mental health condition. People can experience recovery or remission after receiving psychotherapy for BPD; however, it is estimated that about 45% of people in well conducted treatment trials do not respond adequately to current psychological treatments.

aimTo further advance psychotherapies for BPD by identifying the factors that contribute to the problem of non-response.

method184 consecutive participants with BPD in community treatment were naturalistically followed up over 12 months and measures of personality and social functioning were examined. Logistic regressions were used to determine which baseline factors were associated with the likelihood of being a non-responder after 12 months of psychotherapy. After 12 months, 48.4% of participants were classed as non-responders due to a lack of reduction in BPD symptoms according to the Reliable Change Index (RCI) method.

resultsAt baseline intake, patients who endorsed an adult preoccupied attachment relationship style and increased anger were more likely to be a non-responder regarding BPD symptoms at 12 months. In addition, those with preoccupied attachment patterns in their adult relationships were more likely to be non-responders regarding general psychological distress at follow up. Higher baseline levels of paranoia and endorsement of a dismissive adult relationship style was associated with being a non-responder in regard to global functioning.

conclusionsConsistent with previous research, almost half of the sample did not achieve reliable change at 12-month follow up. A relationship style characterised by preoccupied insecurity and high anger seemed to be particularly challenging in being able to benefit from psychotherapy. This style may have affected both relationships outside, but also inside therapy, complicating treatment engagement and alliance with the therapist. Early identification and modification of treatment based on challenges from these relationship styles may be one way to improve psychotherapy outcomes for BPD.

Indexed as

PsychotherapyAdolescentAdultAgedBorderline Personality DisorderFemaleHumansLogistic ModelsMaleMiddle AgedPsychological DistressSeverity of Illness IndexTreatment FailureYoung Adult

Identifiers

PMID34314461
PMCPMC8315515
OpenAlexW3185046510

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.