Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-17T11:23:26.328Z Has data issue: false hasContentIssue false
  • English
  • Français

Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

Published online by Cambridge University Press:  19 February 2018

Louise McCusker ,
Marie-Louise Turner ,
Georgina Pike  and
Helen Startup
Louise McCusker*
Affiliation:
Sussex Partnership NHS Foundation Trust, Lighthouse Recovery Support, 60 Sackville Gardens, Hove BN3 4GH
Marie-Louise Turner
Affiliation:
Sussex Partnership NHS Foundation Trust, Lighthouse Recovery Support, 60 Sackville Gardens, Hove BN3 4GH
Georgina Pike
Affiliation:
Sussex Partnership NHS Foundation Trust, Lighthouse Recovery Support, 60 Sackville Gardens, Hove BN3 4GH
Helen Startup
Affiliation:
Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove BN3 7HY University of Sussex, Falmer, Brighton BN1 9RH
*
Correspondence to Louise McCusker, Sussex Partnership NHS Foundation Trust, Lighthouse Recovery Support, 60 Sackville Gardens, Hove BN3 4GH, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group. Aims: This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure. Method: Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis. Results: Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes. Conclusion: This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

Keywords

borderline personality disorderchangeoutcome measures
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 5 , September 2018 , pp. 528 - 540
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ajayi, S., Bowyer, T., Hicks, A., Larsen, J., Mailey, P., Sayers, R. and Smith, R. (2009). Getting Back into the World: Reflections on Lived Experiences of Recovery. London: Rethink Recovery Series, volume 2.Google Scholar
Akiskal, H. S. (2004). Demystifying borderline personality: critique of the concept and unorthodox reflections on its natural kinship with the bipolar spectrum. Acta Psychiatrica Scandinavica, 110, 401–407.Google Scholar
Biskin, R. (2015). The lifetime course of borderline personality disorder. Canadian Journal of Psychiatry, 60, 303–308.Google Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.Google Scholar
Britten, N. (1999). Qualitative interviews in healthcare. In Pope, C. and Mays, N. (eds), Qualitative Research in Health Care, 2nd edition, pp. 11–19. London: BMJ Books.Google Scholar
Castillo, H., Ramon, S. and Morant, N. (2013). A recovery journey for people with personality disorder. Journal of Social Psychiatry, 59, 264–277.Google Scholar
Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C. and Cuijpers, P. (2017). Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis. JAMA Psychiatry, 74, 319–328.Google Scholar
Droscher, H. K., Startup, H., Petfield, L. S., Horsman, J. and Cartwright-Hatton, S. (2014). Psychological therapies with a group component for people experiencing Borderline Personality Disorder: a systematic review. Unpublished manuscript, University of Sussex.Google Scholar
Elliott, R., Fischer, C. T. and Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38, 215–229.Google Scholar
Gill, P., Stewart, K., Treasure, K. and Chadwick, B. (2008). Methods of data collection in qualitative research: interviews and focus groups. British Dental Journal, 204, 291–295.Google Scholar
IsHak, W., Elbau, I., Ismail, A., Delaloye, S., Ha, K., Bolotaulo, N., Nashawati, R., Cassmassi, B. and Wang, C. (2013). Quality of life in borderline personality disorder. Harvard Review of Psychiatry, 21, 138–150.Google Scholar
Juett, G., McKay, J. and Hill, N. (2012). Measuring outcomes in personality disorder services. Clinical Psychology Forum, 237, 21–25.Google Scholar
Katsakou, C., Marougka, S., Barnicot, K., Savill, M., White, H., Lockwood, K. and Priebe, S. (2012). Recovery in borderline personality disorder (BPD): a qualitative study of service users’ perspectives. PLoS One, 7, 1–8.Google Scholar
Kliem, S., Kroger, C. and Kosfelder, J. (2010). Dialectical behavioural therapy for borderline personality disorder: a meta-analysis using mixed-effects modelling. Journal of Consulting and Clinical Psychology, 8, 936–951.Google Scholar
Leichsenring, F., Leibing, E., Kruse, J., New, A. S. and Leweke, F. (2011). Borderline personality disorder. The Lancet, 377, 74–84.Google Scholar
Lieb, K., Zanharini, M., Schmahl, C., Linehan, M. and Bohus, M. (2004). Borderline personality disorder. The Lancet, 364, 453–461.Google Scholar
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50, 370–396.Google Scholar
May, R. (2000). Routes to recovery from psychosis: the roots of a clinical psychologist. Clinical Psychology Forum, 146, 6–10.Google Scholar
Millon, T., Grossman, S. and Millon, C. (2015). MCMI-IV: Millon Clinical Multiaxial Inventory Manual, 1st edition. Bloomington, MN: NCS Pearson, Inc.Google Scholar
National Institute for Clinical Excellence (NICE) (2009). Borderline Personality Disorder: Treatment and Management. NICE clinical guideline 78. Retrieved from: www.nice.org.uk/CG78Google Scholar
Simons, J. and Gaher, R. (2005). The distress tolerance scale: development and validation of a self-report measure. Motivation and Emotion, 29, 83–102.Google Scholar
Slade, M., Amering, M. and Oades, L. (2008). Recovery: an international perspective. Epidemiolofia e Psychatria Sociale, 17, 128–137.Google Scholar
Slotema, C. W., Niemantsverdriet, M. B. A., Blom, J. D., van der Gaag, M., Hoek, H. W. and Sommer, I. E. C. (2017). Suicidality and hospitalisation in patients with borderline personality disorder who experience auditory verbal hallucinations. Journal of the European Psychiatric Association, 41, 47–52.Google Scholar
Soloff, P., Lynch, K., Kelley, T., Malone, K. and Mann, J. (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study. American Journal of Psychiatry, 157, 601–608.Google Scholar
Stewart, D. W. and Shamdasani, P. M. (1990). Focus Groups. Theory and Practice. London: Sage Publications.Google Scholar
Thornicroft, G. and Tansella, M. (2005). Growing recognition of the importance of service user involvement in mental health service planning and evaluation. Epidemiologia e Psichiatria Sociale, 14, 1–3.Google Scholar
Willig, C. (1999). Beyond appearances: a critical realist approach to social constructionism. In Nightingale, D. J. and Cromby, J. (eds), Social Constructionist Psychology: A Critical Analysis of Theory and Practice, pp. 37–51. Buckingham, UK: Open University Press.Google Scholar
Yeomans, F., Gutfreund, J., Selzer, M., Clarkin, J., Hull, J. and Smith, T. (1994). Factors related to drop-outs by borderline patients. Journal of Psychotherapy Research and Practise, 3, 16–24.Google Scholar
Zanarini, M. C. (2003). Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. Journal of Personality Disorder, 17, 233–242.Google Scholar
Zimmerman, M. and Mattia, I. J. (1999). Differences between clinical and research practices in diagnosing borderline personality disorder. American Journal of Psychiatry, 156, 1570–1574.Google Scholar
Submit a response

Comments

No Comments have been published for this article.