Category: Transdiagnostic

Symposium

Impact of Borderline Personality Pathology on Treatment Outcomes Among Adolescents in Residential Treatment

Friday, November 17
12:00 PM - 1:30 PM
Location: Aqua 310, Level 3, Aqua Level

Keywords: Emotion Regulation | Adolescents | Borderline Personality Disorder
Presentation Type: Symposium

Despite growing research on the impact of borderline personality (BP) pathology on treatment outcomes for mood, anxiety, and trauma-related disorders among adults, no studies have examined the impact of BP pathology on response to treatment for emotional and behavioral disorders among adolescents. Moreover, no studies have examined mediators of the relation of BP pathology to symptom changes during treatment. This study examined the impact of BP pathology on treatment outcomes among adolescents in residential treatment, as well as the mediating role of change in emotion regulation in the relation between baseline BP pathology and improvements in psychiatric symptoms during treatment.


Participants were 141 adolescents (51% female; 53% Black/African-American; 39% White; mean age = 14 years) admitted to a psychiatric residential treatment facility. Participants completed questionnaires assessing BP pathology, emotion regulation, and depression, anxiety, and PTSD symptoms. BP pathology was assessed upon admission to the facility; other psychiatric symptoms and emotion regulation were assessed at both admission and discharge (mean time between assessments = 121±59 days).


BP pathology was significantly positively associated with both baseline and post-treatment levels of emotion regulation and psychiatric symptom severity. Further, although BP pathology was not directly associated with the magnitude of change in psychiatric symptoms from baseline to post-treatment, it was associated with greater improvement in emotion regulation during treatment. Finally, results revealed significant indirect effects of BP pathology on improvements in all measured psychiatric symptoms through improvements in emotion regulation. Notably, however, findings that the direction of these indirect effects changed from negative to positive when accounting for baseline levels of emotion regulation and psychiatric symptoms highlight the complexity of the relation of BP pathology to treatment response, suggesting that although adolescents with BP pathology can benefit from residential treatment, the extent of these benefits may not be commensurate with their baseline clinical severity.  

Kim L. Gratz

Professor and Chair
University of Toledo

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