Psychological Interventions for Self-harm Behaviour and Suicide Attempts in Borderline Personality Disorder: A Systematic Review

Abstract

Self-harm behaviour and suicide attempts are considered maladaptive coping mechanisms by individuals with a diagnosis of borderline personality disorder (BPD). Numerous studies have demonstrated that individuals with BPD are at a heightened risk for self-harm behaviour and suicide. Therefore, there is a need for intervention efforts aimed at reducing self-harm and suicide attempts in this population by promoting more functional coping strategies. No systematic review has been conducted to explore the effectiveness of such interventions. A systematic review was performed to identify randomized controlled trials of interventions to reduce self-harm and suicide attempts among individuals with BPD, published between 2012 and 2022. PsycARTICLES, PubMed, Web of Science, Science Direct, and Taylor & Francis databases were examined in the review. A total of 6,760 studies were initially screened, only 13 were selected for review based on the inclusion and exclusion criteria. The results indicated that the standard dialectical behaviour therapy protocol, with the addition of psychological intervention components such as skills training, exposure and acceptance, statistically significantly increased recovery. Statistically significant results have been obtained from various psychotherapeutic intervention groups such as schema therapy, cognitive behavioural therapy and emotion regulation therapy However, it was noted that existing protocols might be inadequate in preventing relapse and addressing potential negative outcomes such as premature termination of therapy.

Keywords

• Borderline personality disorder
• self-harm
• suicide
• psychological intervention

Borderline Bireylerde Kendine Zarar Verme Davranışı ve İntihar Girişimine Yönelik Psikolojik Müdahaleler: Sistematik Derleme

Öz

Kendine zarar verme davranışı ve intihar girişimi, borderline kişilik bozukluğu tanılı bireylerin başvurduğu uyumsuz baş etme yöntemleri olarak kabul edilmektedir. Birçok araştırmada bu kişilerde kendine zarar verme davranışı ve intihar riskinin yüksek olduğu ortaya konmuştur. Dolayısıyla bu popülasyonda daha işlevsel baş etme yöntemlerinin kazandırılması, kendine zarar verme davranışının ve intihar girişiminin azaltılması yönünde müdahale çalışmalarına ihtiyaç duyulmaktadır. Bu müdahale çalışmalarının etkileri üzerine herhangi bir siste-matik derlemeye rastlanılmamıştır. Borderline kişilik bozukluğu tanılı bireylerde kendine zarar verme ve intihar girişimini azaltmaya yönelik yapılan 2012-2022 yılları arasında yayınlanmış randomize kontrollü çalışmaları belirlemek için sistematik bir derleme yapılmıştır. Derlemede PsycARTICLES, Pubmed, Web of Science, Science Direct ve Taylor & Francis veri tabanları taranmıştır. Dahil etme ve dışlama kriterlerine göre başlangıçta 6760 çalışma taranmış ve sadece 13 çalışma derleme için seçilmiştir. Derleme sonucunda, standart Diyalektik Davra-nışçı Terapi protokolüne maruz bırakma, beceri eğitimi, kabul gibi psikolojik müdahale bileşenlerinin eklenme-sinin iyileşmeyi istatistiksel olarak anlamlı derecede arttırdığı tespit edilmiştir. Şema Terapi, Bilişsel Davranışçı Terapi, Duygu Düzenleme Terapisi gibi çeşitli psikoterapotik müdahale gruplarından istatistiksel olarak anlamlı sonuçlarelde edildiği tespit edilmiştir. Ancak mevcut protokollerin, nüks önlemede ve terapiyi bırakma gibi olası olumsuz sonuçlarla başa çıkmada yetersiz kalabileceği belirtilmiştir.

Anahtar Kelimeler

• Borderline kişilik bozukluğu
• intihar
• kendine zarar verme davranışı
• psikolojik müdahale

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