The Role of Psychodynamic Assessment in Diagnosis and Treatment of Personality Disorders: Reliability and Validity of the Developmental profile

__Abstract__ The aim of this thesis is to improve our understanding of the role of psychodynamic models, and their assessment procedures, in diagnosis and treatment of patients with personality disorders. In this introduction we briefly describe the current status of personality disorders and their treatment; diagnostic strategies for personality disorders ; the Developmental Profile as the instrument for psychodynamic personality diagnosis in study; a comprehensive model for establishing reliability and validity by empirical research; and the treatment center where we conducted our research. Finally, we present the aims of this thesis and the research questions involved, and briefly outline the contents of this thesis

Indicatoren voor de zorgtoewijzing bij persoonlijkheidsstoornissen: resultaten van een concept map analyse

Using the concept map method, this study revealed patient characteristics that are important for treatment selection decisions in patients with personality disorders. Concept mapping is a specific type of structured conceptualization process and describes the underlying structure of specific phenomena. The method uses qualitative and quantitative methods. In this study, we integrated a literature investigation with the opinions of 29 experts in the field of treatment allocation and/or personality disorders. Our goal was to reduce and describe the number of patient characteristics that are important for treatment allocation in personality disorders. The concept map procedure resulted in eight patient characteristics: (1) severity of symptoms, (2) severity of personality pathology, (3) ego-adaptive capacity, (4) motivation and capacity for a therapeutic alliance, (5) patient’s social system, (6) social demographic variables, (7) traumata, (8) treatment history and physical examination. This report describes in detail the concept mapping procedure and the outcomes are discussed

Marine Omega-3 Fatty Acid Supplementation for Borderline Personality Disorder: A Meta-Analysis

Objective: Several promising studies investigated marine omega-3 fatty acids (ie, fish oil) in borderline personality disorder (BPD), but overall effects remain unclear. The aim of this study was to obtain estimates of effectiveness of omega-3 fatty acids in BPD using meta-analysis, with a priori differentiation of affective, impulsive, and cognitiveperceptual symptom domains. Data Sources: We performed a literature search in PubMed, EMBASE, PsycINFO, and MEDLINE, using terms related to BPD and omega-3 fatty acids. Publication date was not a restriction. Study Selection: We included randomized controlled trials (RCTs) that compared omega-3 fatty acids to placebo or any active comparator and pooled data using meta-analysis. Five studies were included in the meta-analysis, describing 4 RCTs testing effects of omega-3 fatty acids in 137 patients with BPD or BPD-related behavior. Data Extraction: Using a pre-piloted data extraction form, we obtained data including intervention dose, duration, and BPD symptom scale scores, differentiating affective, impulsive, and cognitive-perceptual symptom domains. Results: Random effects meta-analysis showed an overall significant decreasing effect of omega-3 fatty acids on overall BPD symptom severity (0.54 standardized difference in means [SDM]; 95% CI = 0.91 to 0.17; Z = 2.87; P = .0041), without heterogeneity (I2 = 0.00; Q = 2.63; P = .45). A priori differentiation of relevant symptom domains showed significant effects on affect dysregulation (0.74 SDM; 95% CI = 1.21 to 0.27; Z = 3.11; P = .002) and impulsive behavior (0.45 SDM; 95% CI = 0.84 to 0.059; Z = 2.26; P = .024). However, effects on cognitive-perceptual symptoms did not reach the significance threshold. Conclusions: Available data indicate that marine omega-3 fatty acids improve symptoms of BPD, particularly impulsive behavioral dyscontrol and affective dysregulation. Marine omega-3 fatty acids could be considered as add-on therapy