Rep36 Understanding Personality Disorder



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Further Reading
Hyler, S., Reider, R.O. & Oldham, J.M. (1992). Validity of the Personality Diagnostic Questionnaire Revised: A
replication in an out-patient sample. C
omprehensive Psychiatry, 33
, 73–77.
Beck, A.T. (1996). 
The Beck Depression Inventory
(2nd edn). New York: Harcourt Brace and Company.
Young, J.E. (1990). 
Schema Questionnaire.
New York: Cognitive Therapy Centre of New York.
Spielberger, C.D. (1983). 
Manual for the State-Trait Anxiety Inventory
. Palo Alto, California: Consulting Psychologists Press.


41
provide the therapeutic model that best fits each
individual’s needs.
In relation to important therapeutic
ingredients, research suggests that treatments
with people with personality disorder are most
successful when they are intensive, long term,
theoretically coherent, well structured, well
integrated with other services and where follow
up to residential care is provided. Also when care
is taken to engage personality disordered clients
in treatment, and keep them engaged (Bateman
& Fonagy, 2000; Rawlings, 2001). 
Therapeutic alliance is a strong predictor of
outcome in psychotherapy (Luborsky &
Auerbach, 1985), and the quality of the working
relationship that an individual with personality
disorder forms with their therapist is likely to be
of particular importance, as this group of
individuals have significant relationship problems.
Paying particular attention to ways of forming
and maintaining a good working alliance is,
therefore, likely to improve treatment outcome.
References
Bateman, A.W. & Fonagy, P. (1999). Effectiveness of
partial hospitalization in the treatment of borderline
personality disorder: A randomised controlled trial.
American Journal of Psychiatry, 156
, 1563–1569.
Bateman, A.W. & Fonagy, P. (2000). Effectiveness of
psychotherapeutic treatment of personality disorder.
British Journal of Psychiatry, 177
, 138–143.
Bateman, A.W. & Fonagy, P. (2001). Treatment of
borderline personality disorder with psychoanalytically
oriented partial hospitalisation: An 18-month follow-
up. 
American Journal of Psychiatry, 158
, 36–42.
Byford, S., Knapp, M., Greenshields, J., Ukoumunne,
O.C., Jones, V., Thompson, S., Tyrer, P., Schmidt, U.
& Davidson, K. (on behalf of the POPMACT Group)
(2003). Cost-effectiveness of brief cognitive
behaviour therapy versus treatment as usual in
recurrent deliberate self-harm: A rational decision-
making approach. 
Psychological Medicine, 33
, 977–986.
Chiesa, M. & Fonagy, P. (2000). Cassel personality
disorder study: Methodology and treatment effects.
British Journal of Psychiatry, 176
, 485–491.
Chisea, M., Fonagy, P., Holmes, J., 
et al
. (2002). Health
service use costs by personality disorders following
specialist and non-specialist treatment: A
comparative study. 
Journal of Personality Disorders, 16
,
160–173.
Chiesa, M., Iccoponi, E. & Morris, M. (1996). Changes in
health service utilisation by patients with severe
borderline personality disorder before and after
inpatient psychosocial treatment. 
British Journal of
Psychotherapy, 124
, 501–512.
Copas, J.B., O’Brien, M., 
et al
. (1984). Treatment
outcome in personality disorder: The effect of social,
psychological and behavioural variables. 
Personality
and Individual Differences, 5
, 565–73.
Davidson, K., Scott, J., Schmidt, U., Tata, P., Thornton,
S. & Tyrer P. (2004). Therapist competence and
clinical outcome in the Prevention of Parasuicide
by Manual Assisted Cognitive Behaviour Therapy
Trial: The POPMACT study. 

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