Factor structure of borderline personality disorder and response to Systems Training for Emotional Predictability and Problem Solving

Differential response to the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program was compared in subgroups identified through latent class analysis (LCA). STEPPS is an evidence‐based group treatment program for patients with borderline personality disorder (BPD). A rea...

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Bibliographic Details
Published in:Personality and mental health 2022-08, Vol.16 (3), p.263-275
Main Authors: Black, Donald W., Blum, Nancee, Allen, Jeff
Format: Article
Language:English
Subjects:
Borderline personality disorder
Clinical trials
Clinical variables
Comorbidity
Dissociation
Emotional intelligence
Group therapy
Impulsivity
Latent class analysis
Personality disorders
Problem solving
Severity
Sociodemographics
Substance abuse
Treatment programs
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Summary:Differential response to the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program was compared in subgroups identified through latent class analysis (LCA). STEPPS is an evidence‐based group treatment program for patients with borderline personality disorder (BPD). A reanalysis of data was conducted using data from a 20‐week randomized controlled trial and 1‐year follow‐up. Subjects (n = 164) with DSM‐IV BPD were assessed for comorbid Axis I and II disorders and selected clinical variables. Severity was assessed using the Zanarini Rating Scale for BPD (ZAN‐BPD) and the Borderline Evaluation of Severity Over Time (BEST). Three‐ and four‐class models were identified with the four‐class model having the better fit. The latter included a high severity (HS) class (26%), an affective instability/substance abuse (AISA) class (16%), an empty/dissociation/identity disturbance (EDID) class (27%), and a low severity (LS) class (30%). High impulsiveness predicted membership in the HS class. Improvement was determined using a linear mixed‐effects model. Those most likely to benefit were those in the HS group characterized by high symptom severity, Axis I and II comorbidity, problem relationships, abandonment fears, and intense anger. This work should help further efforts to match patients with treatments based on sociodemographic, diagnostic, and other illness characteristics.
ISSN:1932-8621
1932-863X
DOI:10.1002/pmh.1538