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Transference-focused psychotherapy for borderline personality disorder: Change in reflective function

  • Melitta Fischer-Kern (a1), Stephan Doering (a1), Svenja Taubner (a2), Susanne Hörz (a3), Johannes Zimmermann (a4), Michael Rentrop (a5), Peter Schuster (a1), Peter Buchheim (a5) and Anna Buchheim (a6)...
Summary

Borderline personality disorder is associated with deficits in personality functioning and mentalisation. In a randomised controlled trial 104 people with borderline personality disorder received either transference-focused psychotherapy (TFP) or treatment by experienced community therapists. Among other outcome variables, mentalisation was assessed by means of the Reflective Functioning Scale (RF Scale). Findings revealed only significant improvements in reflective function in the TFP group within 1 year of treatment. The between-group effect was of medium size (d = 0.45). Improvements in reflective function were significantly correlated with improvements in personality organisation.

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Copyright
Corresponding author
Melitta Fischer-Kern, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria 1090. Email: melitta.fischer-kern@meduniwien.ac.at
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Declaration of interest

M.R. has received fees from Janssen-Cilag, Eli Lilly, Pfizer, AstraZeneca, Essex Pharma, and Roche, unrelated to the present work.

Footnotes
References
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1 Clarkin, JF, Yeomans, FE, Kernberg, OF. Psychotherapy for Borderline Personality. Focusing on Object Relations. American Psychiatric Publishing, 2006.
2 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (5th edn) (DSM-5). APA, 2013.
3 Fonagy, P, Gergely, G, Jurist, EJ, Target, M. Affect Regulation, Mentalization, and the Development of the Self. Other Press, 2002.
4 Fonagy, P, Target, M, Steele, H, Steele, M. Reflective-Functioning Manual. Version 5, for Application to Adult Attachment Interviews. Psychoanalysis Unit, University College London, 1998.
5 George, C, Kaplan, N, Main, M. The Adult Attachment Interview. Department of Psychology, University of California at Berkeley, 1985.
6 Giesen-Bloo, J, van Dyck, R, Spinhoven, P, van Tilburg, W, Dirksen, C, van Asselt, T, et al. Outpatient psychotherapy for borderline personality disorder. Randomized trial of schema-focused therapy vs transference-focused psychotherapy. Arch Gen Psychiatry 2006; 63: 649–58.
7 Levy, KN, Meehan, KB, Kelly, KM, Reynoso, JS, Weber, M, Clarkin, JF, et al. Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder. J Consult Clin Psychol 2006; 74: 1027–40.
8 Doering, S, Hörz, S, Rentrop, M, Fischer-Kern, M, Schuster, P, Benecke, C, et al. Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. Br J Psychiatry 2010; 196: 389–95.
9 Clarkin, JF, Caligor, E, Stern, B, Kernberg, OF. Structured Interview of Personality Organization (STIPO). Weill Medical College of Cornell University, 2004.
10 Von Buuren, S, Groothuis-Oudshoorn, K. mice: Multivariate Imputation by Chained Equations in R. J Statistical Software 2011; 45: 167.
11 Fischer-Kern, M, Buchheim, A, Hörz, S, Schuster, P, Doering, S, Kapusta, ND, et al. The relationship between personality organization, reflective functioning, and psychiatric classification in borderline personality disorder. Psychoanal Psychol 2010; 27: 395409.
12 Kernberg, OF. Severe Personality Disorders. Yale University Press, 1984.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Transference-focused psychotherapy for borderline personality disorder: Change in reflective function

  • Melitta Fischer-Kern (a1), Stephan Doering (a1), Svenja Taubner (a2), Susanne Hörz (a3), Johannes Zimmermann (a4), Michael Rentrop (a5), Peter Schuster (a1), Peter Buchheim (a5) and Anna Buchheim (a6)...
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