Unified Protocol vs Mentalization-Based Therapy for Adolescents With Borderline Personality Disorder: A Randomized Controlled Trial
Abstract
BACKGROUND
Despite several treatments, e.g., mentalization-based therapy (MBT) and Unified Protocol (UP), being adapted to treat adolescents with borderline personality disorder (BPD), there exists a dearth of literature regarding their relative efficacy. In this study modified forms of MBT and UP - MBT-A and UP-A respectively-were compared in their ability to reduce borderline symptoms in a sample of 91 Iranian adolescents (two-thirds female) with a BPD diagnosis.
METHODS
Individuals randomly allocated to one of two treatment groups, MBT-A (N = 45) or UP-A (N = 46) were followed up across 36 months following treatment. A MIXED ANCOVA was applied to compare the effectiveness of these interventions in reducing severity of borderline symptoms (the primary outcome), impulsivity, self-harm, emotion dysregulation and anger (secondary outcomes). The trial was retrospectively registered at IRCT20231106059970N1.
RESULTS
Both primary outcomes and secondary outcomes decreased significantly following both MBT-A and UP-A. In comparison with MBT-A, UP-A was more effective in reducing emotional dysregulation, but levels of remission declined progressively up to 36 months of follow-up following both treatments.
CONCLUSIONS
UP-A appears to be more effective than MBT-A in reducing emotional dysregulation in adolescents with BPD, despite being a shorter and less intensive treatment. An important caveat is that the treatment induced changes were largely limited to the emotion dysregulation…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 91 participants or records.
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