Personality Disorders
Personality Disorders (DSM-5-TR)
Enduring patterns of inner experience and behavior that deviate from cultural expectations, are pervasive and inflexible, and cause distress or impairment. BPD is best-studied; DBT, MBT, TFP, and Schema Therapy have strongest evidence. Treatment typically longer-term.
Prevalence: ~10% general population; ~40-60% of clinical populations
24 Therapeutic Approaches
Sorted by evidence tier: guideline-recommended first, then RCT-supported, then emerging/limited evidence.
Guideline-Recommended (4)
Cognitive-Behavioral
DBT
Marsha Linehan · 1993
Effect: d = 0.54
~50-60% clinically significant change
NICE: recommended for BPD. APA Div 12: Strong Research Support for BPD
Psychoanalytic
Mentalization-Based Tx (MBT)
Fonagy / Bateman · 2004
Effect: d = 0.47
~40-50% no longer meet BPD criteria
NICE: recommended for BPD (CG78)
Cognitive-Behavioral
Schema Therapy
Jeffrey Young · 1990
Effect: d = 0.73
~52% full recovery (BPD)
NICE: considered for BPD alongside DBT and MBT
Psychoanalytic
Transference-Focused (TFP)
Otto Kernberg · 1999
Effect: d = 0.80
~50-60% BPD symptom reduction
APA BPD practice guideline references TFP
RCT-Supported (14)
Humanistic
Interpersonal Process Group Therapy
Irvin Yalom · 1970
Psychoanalytic
Psychoanalysis
Sigmund Freud · 1895
Cognitive-Behavioral
REBT
Albert Ellis · 1955
Psychoanalytic
Short-Term Psychodynamic
Davanloo / Sifneos / Malan · 1968
Somatic
Character-Analytic Vegetotherapy
Wilhelm Reich · 1933
Cognitive-Behavioral
Compassion-Focused Therapy
Paul Gilbert · 2005
Cognitive-Behavioral
Compassionate Mind Training
Paul Gilbert · 2005
Cognitive-Behavioral
DBT for Adolescents
Alec Miller, Jill Rathus, Marsha Linehan · 2007
Cognitive-Behavioral
Functional Analytic Psychotherapy
Robert Kohlenberg / Mavis Tsai · 1991
Family Systems
IFS
Richard Schwartz · 1995
Psychoanalytic
ISTDP
Habib Davanloo · 1980
Existential-Humanistic
Process Group Therapy
Irvin Yalom · 1970
Cognitive-Behavioral
RO-DBT
Thomas Lynch · 2018
Psychoanalytic
Supportive Psychotherapy
Various (Rockland, Winston) · 1950
Emerging / Limited Evidence (6)
Psychoanalytic
Lacanian Psychoanalysis
Jacques Lacan · 1953
Integrative
Multimodal Therapy
Arnold Lazarus · 1976
Somatic
NARM
Laurence Heller · 2012
Expressive
Psychodrama
Jacob Moreno · 1921
Psychoanalytic
Relational Psychoanalysis
Stephen Mitchell / Lewis Aron · 1988
Integrative
Transactional Analysis
Eric Berne · 1958
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