Borderline Personality Disorder: Psychotherapy vs. Control

Kim Setkowski

, Christina Palantza

, Wouter van Ballegooijen

, Renske Gilissen

, Matthijs Oud

, Ioana Cristea

, Hisashi Noma

, Toshi Furukawa

, Arnoud Arntz

, Anton van Balkom

, Pim Cuijpers

General Description

The borderline-psyctr dataset is a meta-analytic research domain MARD) which is part of the Metapsy project. The dataset contains study information and effect size data of randomized trials on psychotherapy interventions for borderline personality disorder (BPD). The date of the last search update is provided here. More details about this database can be accessed in the published network meta-analysis.

This dataset includes psychotherapies for BPD vs. control comparisons. Effect sizes are provided for two types of outcomes at post-test: 1) overall BPD severity (based on any validated clinician or self-rated instrument for BPD severity) and 2) suicidal behaviour (combined rate of suicide attempts and death by suicide). When more than one BPD instrument is reported in the included trials, effect size dependency is handled by selecting one instrument per study (based on frequency).

The dataset follows the Metapsy data standard.

Affiliated Institutions

Vrije Universiteit Amsterdam

Online Meta-Analysis Tool

A simplified version of this database can be analyzed at metapsy.org/database/borderline.

Metadata

metapsyData Shorthand: borderline-psyctr
Number of Studies: 34
Latest Version: 23.0.1
Last updated: November 22, 2023
Last search: January 1, 2023
Search String (Latest Version): ↗
Data Repository (Latest Version): ↗
Preregistration (Research Domain): ↗
License: ODC-By v1.0 ↗
Database DOI:

Version 23.0.1 (November 22, 2023):
Version 23.0.0 (November 22, 2023):

Variable Description

Variable	Description
`study`	Author and year of publication
`condition_arm1`	Type of psychological intervention (cbt= Cognitive Behavior Therapy, ipt= interpersonal psychotherapy, pdp= psychodynamic psychotherapy, dbt= dialectical behavior therapy, tfp= transferrence-focused therapy, st= schema therapy, mbt= mentalisation based therapy, mixed= mixed approaches/therapeutic techniques)
`condition_arm2`	Type of comparator (TAU= treatment as usual, GT= generic treatments for BPD, CTBE= community treatment by experts, or an active psychological intervention mentioned in condition_arm1)
`multi_arm1`	In multiarm trials, this variable provides a specification of the type of treatment used in the first arm. This variable is set to NA (missing) when the study was not a multiarm trial.
`multi_arm2`	In multiarm trials, this variable provides a specification of the type of treatment used in the second arm. This variable is set to NA (missing) when the study was not a multiarm trial.
`.g`	metapsyTools generated variable: Calculated effect size (Hedges' g).
`.g_se`	metapsyTools generated variable: Standard error of Hedges' g.
`outcome_type`	This variable encodes the type of outcome that builds the basis of the comparison (msd= mean, standard deviation, number of participants reported in each group; dich= dichotomous outcomes reported as events/non events, e.g., response, remission; change= change scores based on mean change (and sd) from baseline; other stats= Other statistics: exact p-value, t-statistic for between-groups differences in means at post-test)
`instrument`	This variable describes the standardized instrument through which the relevant outcome was measured.
`outcome_domain`	exact outcome type (e.g. BPD severity, suicidal behavior)
`rating`	This variable encodes if the measured outcome was self-reported ("self-report") or clinician-rated ("clinician"). This variable has not been extracted for this database.
`time`	The measurement point at which the outcome was obtained (e.g. post-treatment or follow-up).
`time_weeks`	The measurement point at which the outcome was obtained, in weeks after randomization (set to NA if this information was not available).
`mean_arm1`	Mean arm 1
`mean_arm2`	Mean arm 2
`sd_arm1`	Standard deviation arm 1
`sd_arm2`	Standard deviation arm 2
`n_arm1`	Number of participants arm 1
`n_arm2`	Number of participants arm 2
`baseline_m_arm1`	Baseline mean arm 1
`baseline_sd_arm1`	Baseline standard deviation arm 1
`baseline_n_arm1`	Number of participants at baseline arm 1
`baseline_m_arm2`	Baseline mean arm 2
`baseline_sd_arm2`	Baseline standard deviation arm 2
`baseline_n_arm2`	Number of participants at baseline arm 2
`dich`	Exact definition of the dichotomous outcome as provided in the publication
`dich_type`	Type of dichotomous outcome, e.g., remission, response, other dich outcomes
`event_arm1`	Number of events for dichotomous outcomes in the first trial arm
`event_arm2`	Number of events for dichotomous outcomes in the second trial arm
`totaln_arm1`	Total number of randomized participants arm 1 (event data)
`totaln_arm2`	Total number of randomized participants arm 2 (event data)
`Other_stats`	This variable encodes if the outcome type is "other statistics"
`mean_change_arm1`	Mean change from baseline arm 1
`mean_change_arm2`	Mean change from baseline arm 2
`sd_change_arm1`	Standard deviation for the change from baseline arm 1
`sd_change_arm2`	Standard deviation for the change from baseline arm 2
`n_change_arm1`	Number of participants arm 1 (change scores)
`n_change_arm2`	Number of participants arm 2 (change scores)
`.log_rr`	metapsyTools generated variable: log-risk ratio, comparing events in the first arm to events in the second arm.
`.log_rr_se`	metapsyTools generated variable: The standard error of the log-risk ratio
`year`	year of publication
`comorbid_mental`	This variable shows if all the participants are recruited based on meeting criteria for a comorbid mental health disorder or having elevated symptoms (above cut-off) at baseline (y= yes, n= no)
`comorbid_mental_type`	This variable encodes if there is a comorbid mental health disorder for all the participants
`format`	This variable shows the format of intervention (group, individual, or both which is called "other" in this database)
`format_details`	This variable encodes if the intervention format is "other"
`modality`	This variable shows that if the intervention delivery was face to face or a modality was used as an adjunct to an existing treatment (telephone-based sessions added to face-to-face sessions): ftf= face-to-face, tel= telephone
`n_sessions_ig`	Average number of sessions that intervention group received. If average is not available, we take the planned number of sessions. Only full numbers are given (no decimals).
`country`	The country where the study was conducted which is categorized in different categories (us= USA; uk= UK; eu= any country in Europe; can= Canada; au= Australia and New Zealand; eas= East Asia including China plus Hong Kong and Macau, Japan, North Korea, South Korea, Taiwan, Mongolia; other= any other countries; NR= not reported)
`age_group`	Age group of participants (child= mean age is lower than 13; adol= adolescents, mean age is between 13 and 18; yadul= young adults, studies in college students and studies with a mean age between 18 and 24; adul= adults; old= Older adults: all studies indicating that they work with older adults and with a mean age of 55 or higher; olderold= Older old: all studies with a mean age of 75 or higher)
`mean_age`	Average age for the overall sample
`percent_women`	% of women at baseline for the overall sample
`recruitment`	Where participants were recruited from (com= community: If (a part of) the participants are recruited through announcements in newspapers, radio, tv, social media, flyers, etc., and participate as volunteers in the study, the study is rated as “community recruitment”; clin= clinical: Participants are exclusively recruited from patient samples with mental disorders for which they have sought treatment. They can be recruited from primary care or outpatient centers; oth= Other: Other recruitment methods which are not community or clinical recruitment.
`diagnosis`	All the participants in this database should be diagnosed with BPD based on a clinical diagnosis or other methods
`target_group`	This variable shows if the target group of a trial was adul= adults, old= older adults, stud= student population, child= childre, adol= adolescents, yadul= young adults, med= general medical disorder
`RoB_D1`	Domain 1: Bias arising from the randomization process (high risk, low risk, some concerns)
`RoB_D2`	Domain 2: Deviations from the intended interventions (high risk, low risk, some concerns)
`RoB_D3`	Domain 3: Missing outcome data (high risk, low risk, some concerns)
`RoB_D4`	Domain 4: Inappropriate measurement of the outcome (high risk, low risk, some concerns)
`RoB_D5`	Domain 5: Selection of the reported results (high risk, low risk, some concerns)
`overall_RoB`	Overall risk of bias rating (high risk, low risk, some concerns)
`full_ref`	full reference of the trial
`.id`	metapsyTools generated variable for each trial

Study References

0: Amianto, F., Ferrero, A., Pierò, A., Cairo, E., Rocca, G., Simonelli, B., ... & Fassino, S. (2011). Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study. BMC psychiatry, 11(1), 1-14.
1: Amianto, F., Ferrero, A., Pierò, A., Cairo, E., Rocca, G., Simonelli, B., ... & Fassino, S. (2011). Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study. BMC psychiatry, 11(1), 1-14.
2: Andreoli, A., Burnand, Y., Cochennec, M. F., Ohlendorf, P., Frambati, L., Gaudry-Maire, D., ... & Frances, A. (2016). Disappointed love and suicide: a randomized controlled trial of “abandonment psychotherapy” among borderline patients. Journal of personality disorders, 30(2), 271-287.
3: Arntz A, Jacob GA, Lee CW, et al. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(4):287–299. doi:10.1001/jamapsychiatry.2022.0010
4: Arntz A, Jacob GA, Lee CW, et al. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(4):287–299. doi:10.1001/jamapsychiatry.2022.0010
5: Arntz A, Jacob GA, Lee CW, et al. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(4):287–299. doi:10.1001/jamapsychiatry.2022.0010
6: Arntz A, Jacob GA, Lee CW, et al. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(4):287–299. doi:10.1001/jamapsychiatry.2022.0010
7: Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American journal of Psychiatry, 166(12), 1355-1364.
8: Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American journal of Psychiatry, 166(12), 1355-1364.
9: Bellino, S., Rinaldi, C., & Bogetto, F. (2010). Adaptation of interpersonal psychotherapy to borderline personality disorder: a comparison of combined therapy and single pharmacotherapy. The Canadian Journal of Psychiatry, 55(2), 74-81.
10: Bozzatello, P., & Bellino, S. (2020). Interpersonal psychotherapy as a single treatment for borderline personality disorder: a pilot randomized-controlled study. Frontiers in Psychiatry, 11, 578910.
11: Bozzatello, P., & Bellino, S. (2020). Interpersonal psychotherapy as a single treatment for borderline personality disorder: a pilot randomized-controlled study. Frontiers in Psychiatry, 11, 578910.
12: Carlyle, D., Green, R., Inder, M., Porter, R., Crowe, M., Mulder, R., & Frampton, C. (2020). A randomized-controlled trial of mentalization-based treatment compared with structured case management for borderline personality disorder in a mainstream public health service. Frontiers in Psychiatry, 11, 561916.
13: Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian & New Zealand Journal of Psychiatry, 44(2), 162-173.
14: Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian & New Zealand Journal of Psychiatry, 44(2), 162-173.
15: Cottraux, J., Note, I. D., Boutitie, F., Milliery, M., Genouihlac, V., Yao, S. N., ... & Gueyffier, F. (2009). Cognitive therapy versus Rogerian supportive therapy in borderline personality disorder. Psychotherapy and psychosomatics, 78(5), 307-316.
16: Cottraux, J., Note, I. D., Boutitie, F., Milliery, M., Genouihlac, V., Yao, S. N., ... & Gueyffier, F. (2009). Cognitive therapy versus Rogerian supportive therapy in borderline personality disorder. Psychotherapy and psychosomatics, 78(5), 307-316.
17: Crawford, M. J., Thana, L., Parker, J., Turner, O., Carney, A., McMurran, M., ... & Spong, A. (2020). Structured psychological support for people with personality disorder: feasibility randomised controlled trial of a low-intensity intervention. BJPsych Open, 6(2), e25.
18: Davidson, K., Norrie, J., Tyrer, P., Gumley, A., Tata, P., Murray, H., & Palmer, S. (2006). The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. Journal of personality disorders, 20(5), 450-465.
19: Davidson, K., Norrie, J., Tyrer, P., Gumley, A., Tata, P., Murray, H., & Palmer, S. (2006). The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. Journal of personality disorders, 20(5), 450-465.
20: Dixon-Gordon, K. L., Chapman, A. L., & Turner, B. J. (2015). A preliminary pilot study comparing dialectical behavior therapy emotion regulation skills with interpersonal effectiveness skills and a control group treatment. Journal of Experimental Psychopathology, 6(4), 369-388.
21: Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., ... & Buchheim, P. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. The British Journal of Psychiatry, 196(5), 389-395.
22: Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., ... & Buchheim, P. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. The British Journal of Psychiatry, 196(5), 389-395.
23: Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of behavior therapy and experimental psychiatry, 40(2), 317-328.
24: Feigenbaum, J. D., Fonagy, P., Pilling, S., Jones, A., Wildgoose, A., & Bebbington, P. E. (2012). A real‐world study of the effectiveness of DBT in the UK National Health Service. British Journal of Clinical Psychology, 51(2), 121-141.
25: Feigenbaum, J. D., Fonagy, P., Pilling, S., Jones, A., Wildgoose, A., & Bebbington, P. E. (2012). A real‐world study of the effectiveness of DBT in the UK National Health Service. British Journal of Clinical Psychology, 51(2), 121-141.
26: Gregory, R. J., Chlebowski, S., Kang, D., Remen, A. L., Soderberg, M. G., Stepkovitch, J., & Virk, S. (2008). A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder. Psychotherapy: Theory, Research, Practice, Training, 45(1), 28.
27: Gregory, R. J., Chlebowski, S., Kang, D., Remen, A. L., Soderberg, M. G., Stepkovitch, J., & Virk, S. (2008). A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder. Psychotherapy: Theory, Research, Practice, Training, 45(1), 28.
28: Herpertz, S. C., Matzke, B., Hillmann, K., Neukel, C., Mancke, F., Jaentsch, B., ... & Dempfle, A. (2021). A mechanism-based group-psychotherapy approach to aggressive behaviour in borderline personality disorder: findings from a cluster-randomised controlled trial. BJPsych open, 7(1), e17.
29: Herpertz, S. C., Matzke, B., Hillmann, K., Neukel, C., Mancke, F., Jaentsch, B., ... & Dempfle, A. (2021). A mechanism-based group-psychotherapy approach to aggressive behaviour in borderline personality disorder: findings from a cluster-randomised controlled trial. BJPsych open, 7(1), e17.
30: Hilden, H. M., Rosenström, T., Karila, I., Elokorpi, A., Torpo, M., Arajärvi, R., & Isometsä, E. (2021). Effectiveness of brief schema group therapy for borderline personality disorder symptoms: a randomized pilot study. Nordic journal of psychiatry, 75(3), 176-185.
31: Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., ... & Bastian, L. A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior therapy, 32(2), 371-390.
32: Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., ... & Bastian, L. A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior therapy, 32(2), 371-390.
33: Kredlow, M. A., Szuhany, K. L., Lo, S., Xie, H., Gottlieb, J. D., Rosenberg, S. D., & Mueser, K. T. (2017). Cognitive behavioral therapy for posttraumatic stress disorder in individuals with severe mental illness and borderline personality disorder. Psychiatry Research, 249, 86-93.
34: Laurenssen, E. M., Luyten, P., Kikkert, M. J., Westra, D., Peen, J., Soons, M. B., ... & Dekker, J. J. (2018). Day hospital mentalization-based treatment v. specialist treatment as usual in patients with borderline personality disorder: randomized controlled trial. Psychological medicine, 48(15), 2522-2529.
35: Leppänen, V., Hakko, H., Sintonen, H., & Lindeman, S. (2016). Comparing effectiveness of treatments for borderline personality disorder in communal mental health care: The Oulu BPD Study. Community mental health journal, 52, 216-227.
36: Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of general psychiatry, 48(12), 1060-1064.
37: Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., ... & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of general psychiatry, 63(7), 757-766.
38: Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., ... & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of general psychiatry, 63(7), 757-766.
39: Majdara, E., Rahimmian, I., Talepassand, S., & Gregory, R. J. (2019). A randomized trial of dynamic deconstructive psychotherapy in Iran for borderline personality disorder. Journal of the American Psychoanalytic Association, 67(5), NP1-NP7.
40: McMain, S. F., Guimond, T., Barnhart, R., Habinski, L., & Streiner, D. L. (2017). A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder. Acta Psychiatrica Scandinavica, 135(2), 138-148.
41: McMain, S. F., Guimond, T., Barnhart, R., Habinski, L., & Streiner, D. L. (2017). A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder. Acta Psychiatrica Scandinavica, 135(2), 138-148.
42: Philips, B., Wennberg, P., Konradsson, P., & Franck, J. (2018). Mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: a randomized controlled feasibility study. European Addiction Research, 24(1), 1-8.
43: Philips, B., Wennberg, P., Konradsson, P., & Franck, J. (2018). Mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: a randomized controlled feasibility study. European Addiction Research, 24(1), 1-8.
44: Pistorello, J., Fruzzetti, A. E., MacLane, C., Gallop, R., & Iverson, K. M. (2012). Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial. Journal of consulting and clinical psychology, 80(6), 982.
45: Pistorello, J., Fruzzetti, A. E., MacLane, C., Gallop, R., & Iverson, K. M. (2012). Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial. Journal of consulting and clinical psychology, 80(6), 982.
46: Priebe, S., Bhatti, N., Barnicot, K., Bremner, S., Gaglia, A., Katsakou, C., ... & Zinkler, M. (2012). Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial. Psychotherapy and psychosomatics, 81(6), 356-365.
47: Reneses, B., Galián, M., Serrano, R., Figuera, D., Fernandez del Moral, A., López-Ibor, J. J., ... & Trujillo, M. (2013). A new time limited psychotherapy for BPD: preliminary results of a randomized and controlled trial. Actas Espanolas de Psiquiatria, 41(3).
48: Reneses, B., Galián, M., Serrano, R., Figuera, D., Fernandez del Moral, A., López-Ibor, J. J., ... & Trujillo, M. (2013). A new time limited psychotherapy for BPD: preliminary results of a randomized and controlled trial. Actas Espanolas de Psiquiatria, 41(3).
49: Stanley, B. (2017). Comparing Treatments for Self-Injury and Suicidal Behavior in People With Borderline Personality Disorder [published data only]. NCT00834834.
50: Turner, R. M. (2000). Naturalistic evaluation of dialectical behavior therapy-oriented treatment for borderline personality disorder. Cognitive and Behavioral Practice, 7(4), 413-419.
51: Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. The British journal of psychiatry, 182(2), 135-140.
52: Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. The British journal of psychiatry, 182(2), 135-140.
53: Weinberg, I., Gunderson, J. G., Hennen, J., & Cutter Jr, C. J. (2006). Manual assisted cognitive treatment for deliberate self-harm in borderline personality disorder patients. Journal of personality disorders, 20(5), 482-492.

Database Flowchart

Studies in the borderline-psyctr dataset were extracted from the larger “psychological interventions for BPD” database. The study flow of this database can be found below.

BPD not primary diagnosis: n=36
Study outcomes: n=21
Follow-up study: n=12
Study Design: n=19
No data available: n=11
Protocol or trial registration: n=12
Secondary analysis: n=17
Setting: n=6
Duplicate: n=10
Language: n=1
No psychotherapy/add-on intervention: n=17
Comparator: n=1
Adolescents: n=8
Low methodological quality: n=2
Study arms classified within a similar node: n=9
No BPD-focused intervention: n=2
Psychotherapy vs Psychotherapy: n=10

Further Information

Published network meta-analysis using the database. ↗

Citation