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Vol. 78, No. 5, 2009
Issue release date: August 2009
Psychother Psychosom 2009;78:307–316
(DOI:10.1159/000229769)

Cognitive Therapy versus Rogerian Supportive Therapy in Borderline Personality Disorder

Two-Year Follow-Up of a Controlled Pilot Study

Cottraux J. · Note I.D. · Boutitie F. · Milliery M. · Genouihlac V. · Yao S.N. · Note B. · Mollard E. · Bonasse F. · Gaillard S. · Djamoussian D. · de Mey Guillard C. · Culem A. · Gueyffier F.
aAnxiety Disorder Unit, Hospices Civils de Lyon, Hôpital Neurologique, bService de Biostatistique, Hospices Civils de Lyon, UMR 5558, and cClinical Investigation Centre, Inserm, CIC201, 69677 CHU de Lyon, Lyon, and dAssistance Publique de Marseille, Behaviour Therapy Unit, CHU de Marseille, Marseille, France

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Abstract

Background: To date, there have been no studies comparing cognitive therapy (CT) with Rogerian supportive therapy (RST) in borderline personality disorder. Method: Sixty-five DSM-IV borderline personality disorder outpatients were recruited at 2 centres: Lyon and Marseille. Thirty-three patients were randomly allocated to CT and 32 to RST. The therapists were the same in both groups. Both treatments shared the same duration (1 year) and amount of therapy. Assessment by independent evaluators utilised the Clinical Global Impression (CGI) Scale, the Hamilton Depression Scale, Beck Depression Inventory, Beck Anxiety Inventory, Hopelessness Scale, Young Schema Questionnaire II, Eysenck Impulsivity Venturesomeness Empathy (IVE) Inventory, a self-harming behaviours checklist and scales measuring quality of life and the therapeutic relationship. The response criterion was a score of 3 or less on the CGI, associated with a Hopelessness Scale score of <8. Results: No patient committed suicide during the trial. Fifty-one patients were evaluated at week 24, 38 at week 52 and 21 at week 104. Cognitive therapy retained the patients in therapy for a longer time. The response criterion found no significant between-group differences at any measurement point in the completers. However, at week 24, CT was better than RST on the Hopelessness Scale, IVE scale and regarding the therapeutic relationship. At week 104, the CGI improvement (patient and evaluator) was significantly better in CT than in RST. High baseline depression and impulsivity predicted dropouts. Conclusions: CT retained the patients in therapy longer, showed earlier positive effects on hopelessness and impulsivity, and demonstrated better long-term outcomes on global measures of improvement.



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References

  1. Linehan M, Armstrong H, Suarez A, Almon D, Heard H: Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991;48:1060–1064.
  2. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, Korslund KE, Tutek DA, Reynolds SK, Lindenboim N: Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006;63:757–766.
  3. Davidson K, Norrie J, Tyrer P, Gumley A, Tata P, Norrie J, Murray H, Seivewright H: The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. J Personal Disord 2006;20:450–465.
  4. Giesen-Bloo J, Van Dyck R, Spinhoven P, Van Tilburg W, Dirksen C, Van Asselt T, Kremers I, Nadort M, Arntz A: Outpatient psychotherapy for borderline personality disorder randomized trial of schema-focused therapy vs. transference-focused psychotherapy. Arch Gen Psychiatry 2006;63:649–658.
  5. Blum N, St. John D, Pfohl B, Stuart S, McCormick B, Allen J, Arndt S, Black DW: Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up. Am J Psychiatry 2008;165:468–478.
  6. Teusch L, Böhme H, Finke J, Gastpar M: Effects of client-centered psychotherapy for personality disorders alone and in combination with psychopharmacological treatment: an empirical follow-up study. Psychother Psychosom 2001;70:328–336.
  7. American Psychiatric Association: Diagnostic Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  8. Beck AT, Freeman A, Davis DD: Cognitive Therapy of Personality Disorders (revised 2004). New York, Guilford Press, 1990.
  9. Layden MA, Newman CF, Freeman A, Morse SB: Cognitive Therapy of Borderline Personality Disorder. Boston, Allyn & Bacon, 1993.
  10. Young J: Cognitive Therapy for Personality Disorders: A Schema-Focused Approach. Sarasota, Professional Resource Exchange, 1994.
  11. Cottraux J, Blackburn IM: Psychothérapies Cognitives des Troubles de la Personnalité (revised 2006). Paris, Masson, 1995.
  12. Rogers C: Client-Centered Therapy. Boston, Houghton Miflin, 1951.
  13. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC: The Mini International Neuropsychiatric Interview (M.I.N.I): the development of and validation of a structural psychiatric interview for DSM-4 and ICD-1O. J Clin Psychiatry 1998;59(suppl 20):22–33.

    External Resources

  14. Zanarini MC, Gunderson JG, Frankenburg FR, Chauncey DL: The revised diagnostic interview for borderlines: discriminating BPD from other axis II disorders. J Personal Disord 1989;3:10–18.
  15. Chaine F, Guelfi JD, Monier C, Brun A, Seunevel F: Diagnostic clinique et évaluation standardisée de la personnalité borderline: rapport préliminaire. Encéphale 1995;21:247–256.
  16. Cottraux J, Note I, Yao SN, de Mey-Guillard C, Bonasse F, Djamoussian D, Mollard E, Note B, Chen Y: Randomized controlled comparison of cognitive behavior therapy with Rogerian supportive therapy in chronic post-traumatic stress disorder: a 2-year follow-up. Psychother Psychosom 2008;77:101–110.
  17. Cottraux J: La répétition des scénarios de vie. Paris, Odile Jacob, 2001.
  18. Beck J: Cognitive Therapy. Basics and Beyond. New York, The Guilford Press, 1995.
  19. Young J, Klosko J, Weishaar M: Schema Therapy: A Practitioner’s Guide. New York, Guilford Press, 2003.
  20. ECDEU Assessment Manual for Psychopharmacology.Washington, NIMH, 1976, pp 217–222.
  21. Hamilton M: Diagnosis and rating of anxiety (special publication). Br J Psychiatry 1969;3:76–79.
  22. Bouvard M, Cottraux J: Protocoles et échelles d’évaluation en psychiatrie et psychologie. Paris, Masson, 1996.
  23. Beck AT, Brown G, Berchick RJ, Stewart BL, Steer RA: Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients. Am J Psychiatry 1990;147:190–195.
  24. Bouvard M, Charles S, Guerin J, Aimard G, Cottraux J: Etude de l’échelle de désespoir de Beck (Hopelesness scale): validation et analyse factorielle. Encéphale 1992;18:237–240.
  25. Beck AT, Epstein N, Brown G, Steer RA: An inventory for measuring clinical anxiety. J Consult Clin Psychol 1988;56:893–897.
  26. Freeston MH, Ladouceur R, Thibodeau N, Gagnon F, Rhéaume J: L’inventaire d’anxiété de Beck: propriétés psychométriques d’une traduction française. Encéphale 1994;20:83–88.
  27. Lachenal-ChevalletK: Validation du questionnaire des schémas précoces inadaptés de Young et étude exploratoire de l’échelle des croyances LIR de Cottraux; note de recherche pour le DEA (Dimensions cognitives et modélisation), Université Lyon II, 2002.
  28. Lachenal-Chevallet K, Mauchand P, Cottraux J, Bouvard M, Martin R: Factor analysis of the schema questionnaire-short form in a nonclinical sample. J Cog Psychother 2006;20:217–224.
  29. Eysenck SBG: The I7: development of a measure of impulsivity and its relationship to the super factors of personality; in McCown WG, Johnson JL, Sure MB (eds): The Impulsive Client: Theory, Research and Treatment. Washington, American Psychological Association, 1993, pp 141–149.
  30. Bouvard M: Questionnaires et échelles d’évaluation de la personnalité. Paris, Masson, 1999.
  31. Hoogduin CAL, De Haan E, Schaap C: The significance of patient-therapist relationship in the treatment of obsessive-compulsive disorder. Br J Clin Psychol 1989;28:185–186.
  32. Cottraux J, Note ID, Cungi C, Légeron P, Heim F, Chneiweiss L, Bernard G, Bouvard M: A controlled study of cognitive-behaviour therapy with buspirone or placebo in panic disorder with agoraphobia: a one-year follow-up. Br J Psychiatry 1995;167:635–641.
  33. Marks IM, Swinson RP, Başoğlu M, Kuch K, Noshirvani H, O’Sullivan G, Lelliott PT, Kirby M, McNamee G, Sengun S, Wickwire K: Alprazolam and exposure alone or combined in panic disorder with agoraphobia: a controlled study in London and Toronto. Br J Psychiatry 1993;162:776–787.
  34. Linehan MM: Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, Guilford Press, 1993.
  35. Linehan MM, Dimeff LA, Reynolds SK, Comtois K, Shaw-Welch S, Heagerty P, Kivlahan DR: Dialectical behavior therapy versus comprehensive validation plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend 2002;67:13–26.
  36. Bateman A, Fonagy P: Eight-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual. Am J Psychiatry 2008;165:631–638.


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