Baseline correlates of functional impairment at 12 months in young people with borderline personality disorder: findings from the MOBY trial.

Abstract

No studies have investigated baseline predictors of functioning among young people receiving treatment for BPD. The current study aimed to identify the baseline demographic, psychopathological and treatment correlates of interpersonal problems and social adjustment at 12-month follow-up among young people with BPD, who received early intervention in the Monitoring Outcomes of BPD in Youth (MOBY) randomised controlled trial. Of 139 randomised young people (aged 15 to 25 years) who completed interview and self-report measures at baseline (pre-treatment), 98 (M_age = 18.7, SD = 2.7) provided data on the same measures at 12 months (primary endpoint). Adjusting for other demographic, clinical and treatment characteristics, hierarchical regression analyses revealed that fewer interpersonal problems at 12 months were predicted by fewer interpersonal problems (β = 0.41, p = 0.02), fewer co-occurring personality disorder diagnoses (β = -0.31, p = 0.04), and lower BPD severity (β = -0.31, p = 0.04) at baseline (F² = 0.52). Higher social adjustment score at 12 months was predicted by having at least one caregiver engaged in employment at baseline (β = -0.25, p = 0.04, F² = 0.41). These findings suggest that young people presenting with lower severity of BPD, fewer interpersonal problems at baseline, and at least one caregiver in employment are more likely to have better functional outcomes following early intervention. Suicide attempts (SA) and self-harm (SH) were not found to be predictors of functional outcome, suggesting that early intervention programs reconsider the disproportionate influence of SA and SH upon decisions about entry or exclusion into treatment programs or clinical trials. Future research should focus upon individual or household indicators of social disadvantage as moderators of outcome in early intervention for BPD.