Abstract：
BACKGROUND: Psychological treatments for young people with sub-threshold or full-syndrome borderline personality disorder (BPD) are found to be effective. However, little is known about the age at which adolescents benefit from early intervention. This study investigated whether age affects the effectiveness of early intervention for BPD.
METHODS: N = 626 participants (M age = 15 years, 82.7% female) were consecutively recruited from a specialized outpatient service for early intervention in BPD in adolescents aged 12- to 17-years old. DSM-IV BPD criteria were assessed at baseline, one-year (n = 339) and two-year (n = 279) follow-up.
RESULTS: Older adolescents presented with more BPD criteria (χ2(1) = 58.23, p < 0.001) and showed a steeper decline of BPD criteria over the 2-year follow-up period compared with younger adolescents (χ2(2) = 13.53, p = 0.001). In an attempt to disentangle effects of early intervention from the natural course of BPD, a parametrized regression model was used. An exponential decrease (b = 0.10, p < 0.001) in BPD criteria was found when starting therapy over the 2-year follow-up. This deviation from the natural course was impacted by age at therapy commencement (b = 0.06, p < 0.001), although significant across all ages: older adolescents showed a clear decrease in BPD criteria, and young adolescents a smaller decrease.
CONCLUSIONS: Early intervention appears effective across adolescence, but manifests differently: preventing the normative increase of BPD pathology expected in younger adolescents, and significantly decreasing BPD pathology in older adolescents. The question as to whether developmentally adapted therapeutic interventions could lead to an even increased benefit for younger adolescents, should be explored in future studies.
METHODS: N = 626 participants (M age = 15 years, 82.7% female) were consecutively recruited from a specialized outpatient service for early intervention in BPD in adolescents aged 12- to 17-years old. DSM-IV BPD criteria were assessed at baseline, one-year (n = 339) and two-year (n = 279) follow-up.
RESULTS: Older adolescents presented with more BPD criteria (χ2(1) = 58.23, p < 0.001) and showed a steeper decline of BPD criteria over the 2-year follow-up period compared with younger adolescents (χ2(2) = 13.53, p = 0.001). In an attempt to disentangle effects of early intervention from the natural course of BPD, a parametrized regression model was used. An exponential decrease (b = 0.10, p < 0.001) in BPD criteria was found when starting therapy over the 2-year follow-up. This deviation from the natural course was impacted by age at therapy commencement (b = 0.06, p < 0.001), although significant across all ages: older adolescents showed a clear decrease in BPD criteria, and young adolescents a smaller decrease.
CONCLUSIONS: Early intervention appears effective across adolescence, but manifests differently: preventing the normative increase of BPD pathology expected in younger adolescents, and significantly decreasing BPD pathology in older adolescents. The question as to whether developmentally adapted therapeutic interventions could lead to an even increased benefit for younger adolescents, should be explored in future studies.
摘要：
背景：发现对亚阈值或完全综合征边缘性人格障碍（BPD）的年轻人进行心理治疗是有效的。然而,关于青少年从早期干预中受益的年龄知之甚少。这项研究调查了年龄是否影响BPD早期干预的有效性。
方法：N=626名参与者（M岁=15岁，82.7％的女性）连续从专门的门诊服务中招募，以对12至17岁的青少年进行BPD的早期干预。在基线时评估DSM-IVBPD标准，1年（n=339）和2年（n=279）随访。
结果：年龄较大的青少年表现出更多的BPD标准（χ2（1）=58.23，p<0.001），并且在2年的随访期内，BPD标准的下降幅度与年龄较小的青少年相比（χ2（2）=13.53，p=0.001）。为了从BPD的自然过程中解开早期干预的影响，使用参数化回归模型。在2年随访期间开始治疗时，发现BPD标准呈指数下降（b=0.10，p<0.001）。这种与自然病程的偏差受治疗开始时年龄的影响（b=0.06，p<0.001），尽管在所有年龄段都很重要：年龄较大的青少年在BPD标准方面表现出明显的下降，青少年的下降幅度较小。
结论：早期干预在整个青春期似乎是有效的，但表现不同：防止青少年预期的BPD病理的规范性增加，并显著降低老年青少年的BPD病理。关于适应发展的治疗干预措施是否可以为年轻青少年带来更大的益处的问题，应该在未来的研究中探索。
方法：N=626名参与者（M岁=15岁，82.7％的女性）连续从专门的门诊服务中招募，以对12至17岁的青少年进行BPD的早期干预。在基线时评估DSM-IVBPD标准，1年（n=339）和2年（n=279）随访。
结果：年龄较大的青少年表现出更多的BPD标准（χ2（1）=58.23，p<0.001），并且在2年的随访期内，BPD标准的下降幅度与年龄较小的青少年相比（χ2（2）=13.53，p=0.001）。为了从BPD的自然过程中解开早期干预的影响，使用参数化回归模型。在2年随访期间开始治疗时，发现BPD标准呈指数下降（b=0.10，p<0.001）。这种与自然病程的偏差受治疗开始时年龄的影响（b=0.06，p<0.001），尽管在所有年龄段都很重要：年龄较大的青少年在BPD标准方面表现出明显的下降，青少年的下降幅度较小。
结论：早期干预在整个青春期似乎是有效的，但表现不同：防止青少年预期的BPD病理的规范性增加，并显著降低老年青少年的BPD病理。关于适应发展的治疗干预措施是否可以为年轻青少年带来更大的益处的问题，应该在未来的研究中探索。
