Does personal agency matter? This study followed 57 people over 12 months when they were involved in DBT group therapy for BPD. Although treatment lead to improvements, those who started with higher personal agency did better. Having an internal locus of control leads to being an active agent in change. Treatments for BPD may be improved through enhancing personal agency in the early phase of therapy.
How best should we assess adolescents? A short 15 item scale was developed that measured self and interpersonal functioning in young people. Two main dimensions were a general factor on the integration of self-identity with other-interpersonal functioning, and a second factor that included information on aggression, reality testing and moral functioning. The short scale showed good validity in measuring severity and identifying diagnostic groups, and aligned with the ICD-11 framework.
What does personal recovery really look like? Although participants in treatment all began with the same severity of difficulties, those who recovered in their symptoms after 12 months shared important life features: living stability, contribution to work or study, and maintaining a relationship. These findings point to the importance of therapists seeking to help patients 'to love and work' in achieving remission.
A randomised controlled trial that using stepped care for personality disorders produces significant benefits for consumers and reduces health costs, including fewer inpatient bed-days and lower re-presentations for emergency departments.
How does pathological narcissism affect others? Relatives in close relationships (partners, family) with people with pathological narcissism were asked to describe everyday interpersonal interaction patterns. Interactions demonstrated high rejecting, subjugating and attacking behaviours. Relatives reported frequently detaching from their feelings and withdrawing from conflict. The risk of health services and therapists also withdrawing from people with narcissism is discussed. Day NJ, Townsend ML, Grenyer BF. Living with pathological narcissism: core conflictual relational themes within intimate relationships. BMC Psychiatry. 2022 Dec;22(1):1-1.
How should we help children who are starting to self-harm? Families are at the forefront of seeking help for their children who are struggling with self-harm. At times this can seem like a journey into the dark unknown, but connecting with psychiatrists, psychologists and friends is important. Ensuring practical support and validation for the whole family is a priority. Townsend ML, Jain A, Miller CE, Grenyer BFS (2022) Prevalence, response and management of self‐harm in school children under 13 years of age: a qualitative study. School Mental Health.
What do we know about people who find it hard to improve? The examination of many studies across different real-world settings (N = 2,436 participants) revealed an unexpected finding: approximately half the people who receive psychotherapy for BPD do not respond to treatment regardless of therapy type or treatment length. What is missing from the literature is an understanding of what contributes to non-response. Many of the best and highest quality studies simply don't report any details about those who didn't improve - keeping us in the dark about the challenges faced by many in therapy. Woodbridge J, Townsend ML, Reis S, Singh S, Grenyer BFS (2021). Non-response to psychotherapy for borderline personality disorder: A systematic review.Australian and New Zealand Journal of Psychiatry.
Impact of personality disorder compared to schizophrenia and depression: People with personality disorder represented 20.5% of emergency and 26.6% of inpatient mental health presentations with high risks for readmission - meaning providing effective treatments quickly is a priority.
Read how living with a person with pathological narcissism can be challenging, including experiencing how the person goes through large fluctuations in affect, oscillating attitudes and contradictory needs.
What is 'emptiness' in Borderline Personality Disorder? Read our new systematic review to understand how to work with emptiness in treatment.
Cochrane systematic review of Psychological therapies for Borderline Personality Disorder. Psychological therapies designed for BPD were superior to treatment as usual approaches, and evidence supports both behavioural (e.g. DBT) and psychodynamic (e.g. MBT) therapies. Common factors require more study, but all approaches emphasise the importance of a structured framework, good therapeutic alliance, an active therapist stance, and therapist support.
What are the priorities for improving personality disorder services?
Ng, F., Townsend, M. L., Jewell, M., Marceau, E. M., & Grenyer, B.F.S. (2020). Priorities for service improvement in personality disorder in Australia: Perspectives of consumers, carers and clinicians. Personality and Mental Health.
Does parenting style influence the development of narcissism in young people?
van Schie, C.C., Jarman, H.L., Huxley, E., Grenyer, B.F.S. (2020). Narcissistic traits in young people: understanding the role of parenting and maltreatment. Borderline Personality Disorder and Emotion Dysregulation 7, 10.
Read an update on evidence-based skills and strategies for working with people with Narcissistic Personality Disorder. King, R.M., Grenyer, B.F.S., Gurtman, C.G., Younan, R. (2020). A clinician's quick guide to evidence‐based approaches: Narcissistic personality disorder. Clinical Psychologist, 24, 91-95
Read new findings on parenting with personality disorder from our laboratory that synthesises research from over 84,000 participants and provides recommendations when considering parenting within clinical practice and policy. Key areas of focus include attachment enhancement, appropriate and timely diagnosis, and provision of evidence based treatment. Steele KR, Townsend ML, Grenyer BFS (2019) Parenting and personality disorder: An overview and meta-synthesis of systematic reviews. PloS ONE, 14(10): e0223038.
