Gold Card SA is a four-session structured psychological intervention offered soon after an acute crisis presentation to people with symptoms characteristic of borderline personality disorder. This ...study describes individual and system-level outcomes from a large-scale health-care improvement initiative to implement Gold Card SA across South Australia. An uncontrolled pre-post study design was utilized examining service user (
= 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model.
ObjectivesChildren of parents diagnosed with borderline personality disorder (BPD) are at greater risk of psychopathology compared to children of healthy controls and parents diagnosed with another ...mental illness. Parental and child psychopathology are likely to be related via multiple pathways. The current study explored relationships between parental borderline symptom severity, parental empathy, parenting style, and child psychopathology.MethodsParents diagnosed with BPD were recruited to participate in an anonymous online survey. Sixty-four parents completed questionnaires assessing borderline symptom severity, parental empathy, and parenting style. Parental reports of child psychopathology were obtained for 64 children (aged 4–17) utilising the Strengths and Difficulties Questionnaire. Spearman’s rank correlation coefficients were calculated to investigate the relationships between variables. Two three-path serial mediation models were tested.ResultsParental borderline symptom severity was negatively associated with parental empathy, and positively associated with maladaptive parenting styles. Parental borderline symptom severity was related to child psychopathology via two indirect pathways 1) authoritarian parenting style and 2) through parental empathy’s relationship with authoritarian parenting.ConclusionsFuture research is recommended to develop and evaluate parenting programme for parents experiencing borderline symptoms and their school-aged children.KEY POINTSWhat is already known about this topic:While many people with borderline symptoms are capable parents, difficulties in some domains of parenting have been identified.The extant literature has a heavy focus on the perinatal period while studies of school-aged children of parents with borderline symptoms are limited.Evidence regarding the effectiveness of interventions specific to this population of parents and children remains a gap in the literature.What this topic adds:Borderline symptom severity was related to child psychopathology via parental empathy’s association with authoritarian parenting.Children of parents who experience severe borderline symptoms may benefit from screening for internalising and externalising symptoms to aid early intervention.Interventions for this specific cohort of parents and children may consider parental psychopathology, parental empathy and maladaptive parenting styles as treatment targets.
This study evaluated the acceptance, feasibility and safety of a short-term group program for adults (18 years and older) and youth (16 to 18 years) with borderline personality disorder (BPD) ...symptoms. Termed
, the content and development were informed by common treatment factors identified from evidence-based therapies for BPD.
Two-hundred and eight people consented to participate in the research trial and completed baseline measures. Intervention participants rated the acceptability and subjective experience of the group. Attrition rates informed feasibility, and serious adverse events were tracked to identify potential harms.
Participant post-group ratings of the group's acceptability and subjective experience were above average across both adult and youth populations. Attrition rate after commencement of group was 38% for adults and 27% among youth. The incidence rate of emergency department presentations was reduced by 41% in the 6 months post-group, relative to 6 months pre-group.
The current study provides preliminary support for the acceptability and feasibility of a short-term group therapy program for people with a diagnosis of BPD. Road Maps may be a useful intermediate intervention in a broader model of stepped care. Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au/ACTRN12622000849796.aspx, (ACTRN12622000849796).
There is a notable lack of literature evaluating peer support for people with a diagnosis of borderline personality disorder (BPD). Peer‐led groups have been shown to positively impact outcomes ...related to empowerment, hope, and self‐efficacy beliefs for consumers diagnosed with serious mental illness and may also be a helpful option for those experiencing personality disorder symptoms. We outline the coproduction of a peer group for people with a lived experience of BPD and a qualitative analysis of feedback post‐group participation. Twenty‐two consumers participated in post‐group interviews and described their experiences of peer support. Interview transcripts were coded, and three main themes were identified: growth and change, connection and feeling understood, and creating safety. The findings suggested that participation in a coproduced peer support group for people with a diagnosis of BPD facilitated positive personal transformation as well as opportunities to develop connection through shared experiences in a safe environment grounded in mutuality. These themes were particularly powerful for participants because they countered previous experiences of not feeling safe, understood, or equal when seeking treatment. These findings support the acceptability of implementing a coproduced group for people diagnosed with BPD in a community mental health setting.
A parental diagnosis of borderline personality disorder has been associated with high levels of parenting distress and greater risk of psychopathology and psychosocial issues among their children. ...The aim of the present study was to investigate the experience of parents who have a diagnosis of borderline personality disorder and their perceptions regarding access to appropriate parenting supports and resources.
Eleven mothers and one father with a past and/or present diagnosis of borderline personality disorder participated in focus groups in which they were asked questions about their experiences of parenting and service provision. Participants were aged between 29 and 59 years (M = 40.17; standard deviation = 9.53), and the majority identified themselves as Caucasian (83%). The study design was qualitative, and thematic analysis was utilised to identify common themes.
Thematic analysis identified four key themes of parenting challenges, parenting rewards, barriers to accessing support, and recommendations for improving parenting experience. Seventeen subthemes were also identified and are represented graphically.
Parents with a diagnosis of borderline personality disorder find parenting both a challenging and rewarding experience. While a number of themes identified by parents with a diagnosis of borderline personality disorder are similar to those reported by parents with other forms of severe mental illness (i.e., rewards, stigma, fear of custody loss, and negative service provision experiences), there was also evidence of specific themes relating to the symptoms of borderline personality disorder and parenting. Recommendations are provided for improving services for these parents.
Borderline personality disorder (BPD) is a pervasive and debilitating mental health condition. Current literature suggests that children of families where a parent has a diagnosis of BPD may be ...particularly vulnerable to experiencing psychological and psychosocial difficulties. However, there is a limited understanding of the mechanisms by which difficulties may be transmitted from parent to child. Furthermore, fear of stigma and intervention from child protection services may be barriers to these parents engaging in research about their parenting experiences. An alternative source of information can be sourced from clinicians who work with these families in clinical contexts. This study aimed to explore mental health clinicians' perceptions of parenting problems that may be experienced by individuals with a diagnosis of BPD and clinicians' views on available parenting resources, supports or interventions for this cohort of families. Mental health clinicians were asked to provide their opinions via a voluntary and anonymous online survey. A total of 106 clinicians, trained in various disciplines and working in varied clinical contexts, participated from across four countries (Australia, USA, Canada and New Zealand). Thematic analysis revealed six themes relating to parenting problems within this population. These included disruption to empathic responsiveness, difficulties maintaining stable and/or safe environments, difficulty managing interpersonal boundaries, parenting skill deficits and poor parenting self-efficacy. An additional theme, capacity for adaptive parenting, was also identified. Finally, themes relating to effective and ineffective parenting resources, supports and interventions were discussed and recommendations were made for the development of future parenting interventions.
