Borderline personality disorder: STEPPS improves symptoms

QUESTION

Question:

How effective is the STEPPS programme for people with a borderline personality disorder?

Patients:

165 people with DSM-IV borderline personality disorder (≥18 years; 83% female). Main exclusions: psychotic or primary neurological disorder; cognitive impairment; substance abuse or dependence; recent suicidal thoughts or self-harm behaviour.

Setting:

Outpatient setting, Iowa, USA; recruitment 2002–2006.

Intervention:

Systems Training for Emotional Predictability and Problem Solving (STEPPS) plus usual care or usual care alone (including medication, individual psychotherapy and case management). STEPPS is a manual-based group treatment programme involving psychoeducation, and emotion and behaviour management skills training, delivered in once weekly 2-hour sessions over 20 weeks, which includes education for a friend or relative.

Outcomes:

Primary outcome: symptoms (Zanarini Rating Scale for Borderline Personality Disorder Affective (ZRS-BPD), a scale which assesses cognitive disturbance, disturbed relationships, and impulsivity). Secondary outcomes: thoughts, feelings and behaviour (Borderline Evaluation of Severity Over Time scale (BESOT)); positive and negative disposition (Positive and Negative Affect Schedule (PANAS)); Beck Depression Inventory (BDI); Symptom Checklist-90-Revised (SCL90R); …