Psychodynamic Therapy For Co-occurring Borderline Personality Disorder and Alcohol Use Disorder
Condition: Borderline Personality Disorder; Alcohol Use Disorder
MeSH terms: Alcoholism; Alcohol Drinking; Personality Disorders; Borderline Personality Disorder
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of the study is to determine the feasibility and effectiveness of a modified form
      of psychodynamic psychotherapy for persons suffering from co-occurring borderline personality
      disorder and an alcohol use disorder.
    

Detailed description: 
      Borderline Personality Disorder (BPD) is a condition that can cause significant distress and
      increased risk of death. Many persons with BPD also have an alcohol use disorder (AUD) and
      there is evidence that this can worsen the outcome and course of both disorders.

      A manual-based form of psychodynamic therapy (PT), labeled dynamic deconstructive
      psychotherapy, has been developed for particularly challenging patients with BPD, especially
      those with co-occurring substance use disorders. It aims to remediate specific neurocognitive
      capacities that are responsible for processing of emotional experiences, and so diminishes
      symptoms of BPD and promotes the development of a coherent and differentiated self-structure.
      PT has been shown to be helpful for BPD, but has not been tested for people who have BPD with
      co-occurring substance use disorders.

      The proposed study is a randomized controlled trial of PT for persons with BPD and
      co-occurring AUD that will generate some initial data that can be used to determine the need
      and feasibility for further outcome studies. Participants are randomized to either a study
      group receiving weekly PT or to a control group receiving usual care. Enrollment is 15
      participants in each group. The study group will receive 12-18 months of PT, with
      naturalistic follow-up. Outcome measures are administered by a research assistant at
      enrollment, 3 months, 6 months, 9 months, 12 months, and 30 months.

      The investigators anticipate that the PT group will show trends towards better retention in
      treatment and greater reduction in parasuicides, alcohol misuse, and institutional care. If
      so, this would have important and positive implications for the large group of patients who
      suffer from BPD and co-occurring AUD.
    

Intervention name(s): Psychodynamic Therapy; Optimized Community Care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Dynamic deconstructive psychotherapy is a time-limited (12-18 month) manual-based form of psychodynamic therapy that aims to remediate specific neurocognitive capacities responsible for processing of emotional experiences.; individual and group psychotherapy in a private practice, clinic, and/or rehab setting, with an eclectic orientation
Other intervention name(s): Dynamic Deconstructive Psychotherapy; Treatment as Usual
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: borderline; alcohol; substance; psychodynamic; psychotherapy; psychoanalytic