Predictors of treatment completion and outcomes for individuals with borderline personality disorder
Notice bibliographique
Résumé
Background: Borderline personality disorder (BPD) is a pervasive mental disorder characterized by emotional instability, unstable interpersonal relationships, and impulsive behaviours.The disorder is associated with heightened sensitivity to chronic pain, a high prevalence of co-occurring mood, anxiety and substance use disorders, and severe functional impairment in several domains.Specialized treatments have demonstrated superiority to treatment as usual but there is still a proportion of individuals who dropout of treatment early.Objectives: The objective of this study was to examine factors predictive of treatment completion and outcomes among individuals entering specialized treatment for BPD.Baseline measures were also compared at intake between individuals with and without a drug or alcohol problem to determine if substance abuse was associated with greater psychiatric symptom severity.Outcome variables examined at 3-and 6-month follow-up included treatment completion, severity of psychological symptoms, substance use, and depressive symptoms.Methods: This study was conducted at the Personality Disorders Clinic at the Allan Memorial Institute of the McGill University Health Centre in Montreal.Information was collected from 65 patients that met DSM-IV criteria for BPD and were enrolled in a 3-month outpatient treatment program.Patients' baseline psychological distress, lifetime Axis I comorbidity, subjective experiences of pain, objective measures of physiological sensitivity, employment, medical, and family/social functioning, and severity of substance problems were examined.Results: At baseline, substance abuse was associated with greater psychiatric symptom severity, mood disturbance, impulsivity, and number of lifetime Axis I comorbidities.However, problem substance use did not predict treatment dropout or outcomes of psychopathology or iii functional improvement at follow-ups.Treatment completers were less likely to have had substance abuse, recent suicide attempt, or severe depressive symptoms at 3 months compared to non-completers.Psychiatric severity and depressive symptoms decreased over time, but impairment in medical, employment, and family/social functioning did not improve by 6-month follow-up.Regression analysis indicated the most significant predictor of moderate to severe depressive symptoms at 3 months was a lifetime history of sexual abuse.Conclusions: Together these findings suggest that physiological sensitivity, comorbid psychiatric disorders, and severity of substance use do not predict treatment dropout or improvements in psychopathology and psychosocial functioning.Nonetheless, the association of substance abuse with psychiatric severity, impulsivity, mood disturbance, and lifetime comorbidities provide insight into the effects of drug and alcohol problems on the presentation of BPD.The relationship between treatment dropout and greater psychological distress highlight the importance of treatment retention on psychopathology outcomes.Sexual abuse history and functional impairment should be targeted in future interventions to improve outcomes for individuals with BPD.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».