Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study

Abstract Background Iconic therapy (IT) is a new therapy that uses images to teach skills with the aim of improving the symptoms of borderline personality disorder. Preliminary results are promising, and there is indication that IT may be effective. The purpose of this preliminary study was to test...

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Main Authors: Silvia Hurtado-Santiago, José Guzmán-Parra, Fermín Mayoral, Rosa M. Bersabé
Format: Article
Language:English
Published: BMC 2022-03-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-022-03862-x
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author Silvia Hurtado-Santiago
José Guzmán-Parra
Fermín Mayoral
Rosa M. Bersabé
author_facet Silvia Hurtado-Santiago
José Guzmán-Parra
Fermín Mayoral
Rosa M. Bersabé
author_sort Silvia Hurtado-Santiago
collection DOAJ
description Abstract Background Iconic therapy (IT) is a new therapy that uses images to teach skills with the aim of improving the symptoms of borderline personality disorder. Preliminary results are promising, and there is indication that IT may be effective. The purpose of this preliminary study was to test the effectiveness of IT compared to a psychological supportive intervention (SI). Methods The study was carried out at the University Regional Hospital of Malaga. Young patients (N = 40; 15–30 years) with suicidal or parasuicidal behavior and borderline personality traits were randomized into IT (N = 20) or SI (N = 20). The main outcome variable was a change in the symptoms of borderline personality disorder (BSL-23) at the end of treatment. The secondary outcome variables were suicidal ideation and behavior, self-harm, the need for medication, the number of visits to mental health professionals, maladaptive behavior, satisfaction with therapy and perceived improvement, both at the end of the intensive treatment and at the 12-month follow-up. Results As expected, the two therapies produced a reduction in BPD symptoms at 10 weeks post-treatment and at the 12-month follow-up. Contrary to expectation, there were no statistically significant differences in the effectiveness of the two therapies (p > 0.05). However, at the 12-month follow-up, the effect sizes for the difference between the effectiveness of the two therapy groups on BSL-23 scores (d = 0.33) and on maladjustment to daily life (d = 0.39) was found to exceed the commonly used convention for a small effect (d = 0.20). Besides, participants in the IT group showed greater satisfaction with therapy than those who received SI. The mean difference between groups was statistically significant after the 10-week treatment period (p < .01), with a large effect size (d = 1.11). Nevertheless, this difference was not maintained at the 12-month follow-up (p > .05), although the effect size for this analysis (d = 0.34) was found to exceed a small effect. Conclusions This preliminary study did not find a statistically significant difference in the effectiveness of the two therapies, probably due to the small sample of participants, but there are some indicators (effect sizes) suggesting that perhaps IT may be superior for reducing BPD symptoms and maladjustment in daily life. Future studies with larger samples and comparisons with established treatments for borderline personality disorder are necessary to confirm that IT effects are significant and persistent in the long term. Trial registration ClinicalTrials.gov identifier: NCT03011190 . First posted 05/01/2017. Last update posted 15/05/2018.
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spelling doaj.art-0e2ccd37bde8420dbd2aabf241ece9a92022-12-22T03:13:56ZengBMCBMC Psychiatry1471-244X2022-03-0122111110.1186/s12888-022-03862-xIconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary studySilvia Hurtado-Santiago0José Guzmán-Parra1Fermín Mayoral2Rosa M. Bersabé3San Juan de Dios Psychiatric CentreUniversity Regional Hospital of Málaga. Mental Health Unit. Biomedical Research Institute of Málaga (IBIMAUniversity Regional Hospital of Málaga. Mental Health Unit. Biomedical Research Institute of Málaga (IBIMAPsychobiology and Methodology of the Behavioral Sciences Department, University of MálagaAbstract Background Iconic therapy (IT) is a new therapy that uses images to teach skills with the aim of improving the symptoms of borderline personality disorder. Preliminary results are promising, and there is indication that IT may be effective. The purpose of this preliminary study was to test the effectiveness of IT compared to a psychological supportive intervention (SI). Methods The study was carried out at the University Regional Hospital of Malaga. Young patients (N = 40; 15–30 years) with suicidal or parasuicidal behavior and borderline personality traits were randomized into IT (N = 20) or SI (N = 20). The main outcome variable was a change in the symptoms of borderline personality disorder (BSL-23) at the end of treatment. The secondary outcome variables were suicidal ideation and behavior, self-harm, the need for medication, the number of visits to mental health professionals, maladaptive behavior, satisfaction with therapy and perceived improvement, both at the end of the intensive treatment and at the 12-month follow-up. Results As expected, the two therapies produced a reduction in BPD symptoms at 10 weeks post-treatment and at the 12-month follow-up. Contrary to expectation, there were no statistically significant differences in the effectiveness of the two therapies (p > 0.05). However, at the 12-month follow-up, the effect sizes for the difference between the effectiveness of the two therapy groups on BSL-23 scores (d = 0.33) and on maladjustment to daily life (d = 0.39) was found to exceed the commonly used convention for a small effect (d = 0.20). Besides, participants in the IT group showed greater satisfaction with therapy than those who received SI. The mean difference between groups was statistically significant after the 10-week treatment period (p < .01), with a large effect size (d = 1.11). Nevertheless, this difference was not maintained at the 12-month follow-up (p > .05), although the effect size for this analysis (d = 0.34) was found to exceed a small effect. Conclusions This preliminary study did not find a statistically significant difference in the effectiveness of the two therapies, probably due to the small sample of participants, but there are some indicators (effect sizes) suggesting that perhaps IT may be superior for reducing BPD symptoms and maladjustment in daily life. Future studies with larger samples and comparisons with established treatments for borderline personality disorder are necessary to confirm that IT effects are significant and persistent in the long term. Trial registration ClinicalTrials.gov identifier: NCT03011190 . First posted 05/01/2017. Last update posted 15/05/2018.https://doi.org/10.1186/s12888-022-03862-xIconic therapyBorderline personality disorderPsychological therapySuicideClinical trial
spellingShingle Silvia Hurtado-Santiago
José Guzmán-Parra
Fermín Mayoral
Rosa M. Bersabé
Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
BMC Psychiatry
Iconic therapy
Borderline personality disorder
Psychological therapy
Suicide
Clinical trial
title Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
title_full Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
title_fullStr Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
title_full_unstemmed Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
title_short Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study
title_sort iconic therapy for the reduction of borderline personality disorder symptoms among suicidal youth a preliminary study
topic Iconic therapy
Borderline personality disorder
Psychological therapy
Suicide
Clinical trial
url https://doi.org/10.1186/s12888-022-03862-x
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AT ferminmayoral iconictherapyforthereductionofborderlinepersonalitydisordersymptomsamongsuicidalyouthapreliminarystudy
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