Personal agency and borderline personality disorder: a longitudinal study of outcomes
Abstract Background Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links between low personal agency and symptoms of borderline personality disorder (BPD). The present research followed pa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04214-5 |
| _version_ | 1811285939964608512 |
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| author | Talia Hashworth Samantha Reis Michelle Townsend Jessica O.’Garr Brin F.S. Grenyer |
| author_facet | Talia Hashworth Samantha Reis Michelle Townsend Jessica O.’Garr Brin F.S. Grenyer |
| author_sort | Talia Hashworth |
| collection | DOAJ |
| description | Abstract Background Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links between low personal agency and symptoms of borderline personality disorder (BPD). The present research followed patients in an outpatient dialectical behavioural therapy (DBT) group from intake to 12 months follow up to examine the impact of personal agency on outcome. Methods Patients (N = 57, age 18–72, 91.5% female) were assessed at intake, after three months of DBT treatment, and 12 months follow up on measures of symptoms and personal agency. Three separate measures were used to assess treatment outcomes: the BPD Checklist, the Personality Inventory for DSM-5 (PID-5), and the Mental Health Inventory (MHI-5). Results Mixed model analyses found BPD symptoms significantly reduced as a result of DBT treatment and were maintained at follow-up. However, 47% of participants continued to meet BPD criteria 12 months later, despite treatment. Regression analyses indicated that low personal agency at intake was associated with higher BPD symptom severity at post-treatment and 12 month follow up. In addition, low personal agency at intake was associated with greater levels of negative affectivity at post-treatment. Personal agency did not relate to levels of depression and anxiety. Conclusions Despite the reductions in BPD symptomology, personal agency did not significantly change over time. Those with lower agency at intake continued to do more poorly at follow up. We speculate that poor outcomes may be contributed to by patients' lack of engagement in recovery due to poor agency and an external locus of control. As such, therapeutic approaches, like DBT, may require additional strategies to appropriately target low personal agency. Further research is needed to understand if other treatment protocols may facilitate positive change in personal agency. |
| first_indexed | 2024-04-13T02:52:11Z |
| format | Article |
| id | doaj.art-5b4d15a5302b44c0afcb11dc2c31108b |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-13T02:52:11Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-5b4d15a5302b44c0afcb11dc2c31108b2022-12-22T03:05:49ZengBMCBMC Psychiatry1471-244X2022-08-012211910.1186/s12888-022-04214-5Personal agency and borderline personality disorder: a longitudinal study of outcomesTalia Hashworth0Samantha Reis1Michelle Townsend2Jessica O.’Garr3Brin F.S. Grenyer4School of Psychology, University of WollongongSchool of Psychology, University of WollongongSchool of Psychology, University of WollongongSouth Coast Private Mental Health HospitalSchool of Psychology, University of WollongongAbstract Background Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links between low personal agency and symptoms of borderline personality disorder (BPD). The present research followed patients in an outpatient dialectical behavioural therapy (DBT) group from intake to 12 months follow up to examine the impact of personal agency on outcome. Methods Patients (N = 57, age 18–72, 91.5% female) were assessed at intake, after three months of DBT treatment, and 12 months follow up on measures of symptoms and personal agency. Three separate measures were used to assess treatment outcomes: the BPD Checklist, the Personality Inventory for DSM-5 (PID-5), and the Mental Health Inventory (MHI-5). Results Mixed model analyses found BPD symptoms significantly reduced as a result of DBT treatment and were maintained at follow-up. However, 47% of participants continued to meet BPD criteria 12 months later, despite treatment. Regression analyses indicated that low personal agency at intake was associated with higher BPD symptom severity at post-treatment and 12 month follow up. In addition, low personal agency at intake was associated with greater levels of negative affectivity at post-treatment. Personal agency did not relate to levels of depression and anxiety. Conclusions Despite the reductions in BPD symptomology, personal agency did not significantly change over time. Those with lower agency at intake continued to do more poorly at follow up. We speculate that poor outcomes may be contributed to by patients' lack of engagement in recovery due to poor agency and an external locus of control. As such, therapeutic approaches, like DBT, may require additional strategies to appropriately target low personal agency. Further research is needed to understand if other treatment protocols may facilitate positive change in personal agency.https://doi.org/10.1186/s12888-022-04214-5Personal agencyLocus of controlBorderline personality disorderDialectical behaviour therapyGroup therapyTreatment outcomes |
| spellingShingle | Talia Hashworth Samantha Reis Michelle Townsend Jessica O.’Garr Brin F.S. Grenyer Personal agency and borderline personality disorder: a longitudinal study of outcomes BMC Psychiatry Personal agency Locus of control Borderline personality disorder Dialectical behaviour therapy Group therapy Treatment outcomes |
| title | Personal agency and borderline personality disorder: a longitudinal study of outcomes |
| title_full | Personal agency and borderline personality disorder: a longitudinal study of outcomes |
| title_fullStr | Personal agency and borderline personality disorder: a longitudinal study of outcomes |
| title_full_unstemmed | Personal agency and borderline personality disorder: a longitudinal study of outcomes |
| title_short | Personal agency and borderline personality disorder: a longitudinal study of outcomes |
| title_sort | personal agency and borderline personality disorder a longitudinal study of outcomes |
| topic | Personal agency Locus of control Borderline personality disorder Dialectical behaviour therapy Group therapy Treatment outcomes |
| url | https://doi.org/10.1186/s12888-022-04214-5 |
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