Khasho D A, van Alphen S P J, Heijnen-Kohl S M J, Ouwens M A, Arntz A, Videler A C
GGz Breburg, Postbus 770, 5000 AT, Tilburg, the Netherlands.
Mondriaan, Postbus 4436, 6401 CX, Heerlen, the Netherlands.
Contemp Clin Trials Commun. 2019 Jan 24;14:100330. doi: 10.1016/j.conctc.2019.100330. eCollection 2019 Jun.
The treatment of borderline personality disorder (BPD) has been examined extensively in adults up to the age of fifty in the past quarter of a century, but there is still a world to discover in treating BPD in older adults. The aim of the study is to investigate the effectiveness of schema therapy in older adults with BPD.
METHODS/DESIGN: A multiple baseline design is used in which participants are randomly assigned to baseline length. The primary outcome measure is assessed weekly and consists of the credibility of negative core beliefs. Secondary outcome measures are quality of life, psychological distress, early maladaptive schemas, schema modes, severity of BPD symptoms and meeting the criteria for BPD. Ten older adults (age > 60 years) with BPD are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions.
To our knowledge, this is the first empirical study of the effectiveness of psychotherapeutic treatment for BPD in older adults. Because of the different manifestation of BPD in later life, besides section II DSM-5 criteria, the alternative, dimensional model for personality disorders of DSM-5 is used to assess BPD in older adults.
The Netherlands National Trial Register NTR7107. Registered 11 March 2018.
在过去的四分之一世纪里，对50岁及以下成年人的边缘性人格障碍（BPD）治疗进行了广泛研究，但在老年成年人BPD治疗方面仍有许多有待探索之处。本研究的目的是调查图式疗法对老年BPD患者的有效性。
方法/设计：采用多基线设计，参与者被随机分配到不同的基线时长。主要结局指标每周评估一次，包括消极核心信念的可信度。次要结局指标包括生活质量、心理困扰、早期适应不良图式、图式模式、BPD症状严重程度以及是否符合BPD标准。10名年龄大于60岁的老年BPD患者接受图式疗法治疗，为期一年，每周一次治疗 sessions。在这个治疗阶段之前是一个为期4至8周的基线阶段。治疗后，有一个为期6个月的随访阶段，每月进行强化治疗。
据我们所知，这是第一项关于老年成年人BPD心理治疗有效性的实证研究。由于BPD在晚年的表现不同，除了DSM-5标准第二部分外，还使用DSM-5人格障碍的替代维度模型来评估老年成年人的BPD。
荷兰国家试验注册NTR7107。2018年3月11日注册。
