Department of Personality Disorders, GGZ Oost Brabant, Oss and Helmond, The Netherlands.
Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Clin Psychol Psychother. 2024 Sep-Oct;31(5):e3061. doi: 10.1002/cpp.3061.
Mentalization-based treatment (MBT) is an evidence based treatment for patients diagnosed with borderline personality disorder (BPD). Although MBT is effective, on average, for individuals with BPD, there are large individual differences in treatment outcomes. Research on predictors of the treatment effect of MBT, such as intelligence, is needed to determine which treatment is most effective for which 'category' of BPD patients, providing more knowledge about optimal indications.
The study aimed to investigate whether intelligence is associated with MBT outcomes in patients with BPD and exploratively studying the difference between two variants of MBT.
A pre-post intervention design was used to examine the effects of MBT on BPD severity. Personal and social recovery were measured as secondary outcome measures. The association between intelligence and the degree of recovery was examined.
No significant correlation was found between intelligence level and treatment efficacy. In addition, a negative correlation between IQ and personal and social recovery was found, indicating that, as IQ increased, the level of recovery decreased. Secondary subanalyses showed the treatment effect of MBT was large and significant in reducing BPD symptoms (Cohen's d = 1.5) and that there was no significant difference between the 2-day MBT and 3-day MBT programmes in terms of a decrease in BPD severity. However, a significant medium positive correlational relationship was found between intelligence and a decrease in BPD severity level for the 3-day MBT, which was not found for the 2-day MBT programme. This indicates that in the 3-day MBT programme, the higher the IQ, the higher the decrease in BPD severity level.
This study is the first to examine the association between intelligence and the outcome of MBT in BPD patients. It shows that patients with a wide range of intelligence (72-124) can equally benefit from MBT and that effectiveness of MBT was not influenced negatively by lower intelligence. Secondary subanalyses showed that this was particularly evident when the intervention was delivered within the context of a 2-day MBT programme. Nevertheless, further randomized studies are required to ascertain the relationship between IQ and treatment effectiveness, as well as other predictors of MBT outcomes.
心理化治疗（MBT）是一种针对诊断为边缘型人格障碍（BPD）患者的循证治疗方法。尽管 MBT 对 BPD 个体平均有效，但治疗效果存在很大的个体差异。需要研究 MBT 治疗效果的预测因素，如智力，以确定哪种治疗方法对哪种“类别”的 BPD 患者最有效，从而提供更多关于最佳适应症的知识。
本研究旨在探讨智力是否与 BPD 患者的 MBT 治疗结果相关，并探索两种 MBT 变体之间的差异。
采用前后干预设计，检查 MBT 对 BPD 严重程度的影响。个人和社会康复作为次要结果指标进行测量。检查智力与康复程度之间的关联。
未发现智力水平与治疗效果之间存在显著相关性。此外，还发现智商与个人和社会康复之间呈负相关，表明随着智商的增加，康复水平下降。次要的亚分析表明，MBT 治疗可显著降低 BPD 症状（Cohen's d=1.5），且 2 天 MBT 与 3 天 MBT 方案在降低 BPD 严重程度方面无显著差异。然而，在 3 天 MBT 方案中，发现智力与 BPD 严重程度水平的降低之间存在显著的正相关关系，但在 2 天 MBT 方案中未发现这种关系。这表明，在 3 天 MBT 方案中，智商越高，BPD 严重程度水平的降低幅度越大。
本研究首次检查了智力与 BPD 患者 MBT 治疗结果之间的关系。结果表明，智力范围广泛（72-124）的患者均可从 MBT 中同等受益，且较低的智力不会对 MBT 的有效性产生负面影响。次要亚分析表明，当干预在 2 天 MBT 方案的背景下进行时，这一点尤其明显。然而，需要进一步的随机研究来确定智商与治疗效果之间的关系，以及 MBT 治疗结果的其他预测因素。
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