Logo image
Back
Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up
Journal article   Open access   Peer reviewed

Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up

Nancee Blum, Don St John, Bruce Pfohl, Scott Stuart, Brett McCormick, Jeff Allen, Stephan Arndt and Donald W Black
The American journal of psychiatry, Vol.165(4), pp.468-478
04/2008
DOI: 10.1176/appi.ajp.2007.07071079
PMCID: PMC3608469
PMID: 18281407

View Online

Abstract

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a 20-week manual-based group treatment program for outpatients with borderline personality disorder that combines cognitive behavioral elements and skills training with a systems component. The authors compared STEPPS plus treatment as usual with treatment as usual alone in a randomized controlled trial. Subjects with borderline personality disorder were randomly assigned to STEPPS plus treatment as usual or treatment as usual alone. Total score on the Zanarini Rating Scale for Borderline Personality Disorder was the primary outcome measure. Secondary outcomes included measures of global functioning, depression, impulsivity, and social functioning; suicide attempts and self-harm acts; and crisis utilization. Subjects were followed 1 year posttreatment. A linear mixed-effects model was used in the analysis. Data pertaining to 124 subjects (STEPPS plus treatment as usual [N=65]; treatment as usual alone [N=59]) were analyzed. Subjects assigned to STEPPS plus treatment as usual experienced greater improvement in the Zanarini Rating Scale for Borderline Personality Disorder total score and subscales assessing affective, cognitive, interpersonal, and impulsive domains. STEPPS plus treatment as usual also led to greater improvements in impulsivity, negative affectivity, mood, and global functioning. These differences yielded moderate to large effect sizes. There were no differences between groups for suicide attempts, self-harm acts, or hospitalizations. Most gains attributed to STEPPS were maintained during follow-up. Fewer STEPPS plus treatment as usual subjects had emergency department visits during treatment and follow-up. The discontinuation rate was high in both groups. STEPPS, an adjunctive group treatment, can deliver clinically meaningful improvements in borderline personality disorder-related symptoms and behaviors, enhance global functioning, and relieve depression.
 Manuals as Topic Psychiatric Status Rating Scales - statistics & numerical data Borderline Personality Disorder - prevention & control Follow-Up Studies Outcome Assessment (Health Care) Borderline Personality Disorder - psychology Psychotherapy, Group - methods Humans Problem Solving Male Treatment Outcome Ambulatory Care Emotions Time Factors Psychotherapy - methods Placebos Adult Cognitive Therapy Female Borderline Personality Disorder - therapy Patient Education as Topic

Details

Metrics

40 Record Views
Logo image