CLINICAL UNIT BASED RESEARCH
Personality and Psychosocial Research Program
Collaborative Longitudinal Personality Disorders Study (CLPS)
Since 1996, Drs. Gunderson and Zanarini have collected data on 733 treatment-seeking subjects diagnosed with one of four DSM-IV personality disorders (PDs): schizotypal, borderline, avoidant, and obsessive-compulsive, and/or Major Depressive Disorder (MDD). The Collaborative Longitudinal Personality Disorders Study (CLPS) is funded by the National Institute of Mental Health (NIMH) and is a naturalistic, prospective, study conducted in conjunction with Columbia University and the New York State Psychiatric Institute, Yale University and Yale Psychiatric Research, Brown University, and Texas A & M.
The study's findings to date document that PDs show consistency as syndromes over time, but rates of improvement that are far greater than previously known. The CLPS project has developed a hybrid model of PDs that consists of more stable personality traits linked to intermittently expressed, symptomatic behaviors. The study's goal for the future is to use our new knowledge to alter the classification system, to explore underlying phenotypes and mechanisms of change, and to develop of new targets for treatment.
A Family Study of Personality Traits and their Relationship to Psychiatric Disorders
Repeated efforts to identify borderline personality disorder (BPD) as a "spectrum" variant of other psychiatric disorders reflect the congruence in these patients of maladaptive traits from four domains which are traditionally separated in psychopathology, i.e., affective, cognitive, behavioral, and interpersonal traits. Each domain is also considered core for other psychiatric disorders, i.e., mood, psychotic, substance abuse, and other personality disorders respectively.
This study, which began on July 1, 2005, will provide the first methodologically rigorous test of whether BPD is familial, as well as whether personality traits from the four domains are familial. The traits selected for study are each thought to be phenotypes, meaning that they are observable subsyndromal traits that may represent vulnerabilities for psychiatric disorders, and for which there is evidence of significant genetic heritability.
The department is also presently working on three other studies. The first is entitled "Evaluating the Effectiveness of the Borderline Center in the Treatment of Borderline Personality Disorder." It assesses the effectiveness of the interventions offered through the Borderline Center. This study has demonstrated significant benefits in many areas of outcome by three months. The second study entitled "Manual Assisted Cognitive Treatment for deliberate self-harm in BPD patients: Pre-Post treatment comparisons." This study has shown that a six-session intervention can significantly reduce self-harm. The third study entitled "Patients' reactions to receiving a borderline personality disorder diagnosis" explores whether the usual practice of withholding this diagnosis is justified.
- John G. Gunderson, M.D. â€“ Program Director, Personality and Psychosocial Research; Professor of Psychiatry, Harvard Medical School, McLean Hospital
- Mary C. Zanarini, Ed.D. â€“ Director, Laboratory for the Study of Adult Development; Associate Professor of Psychology, Harvard Medical School, McLean Hospital
- Lois Choi-Kain, M.D. â€“ Clinical Research Fellow, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
- Angela Howell â€“ Project Coordinator, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
- Igor Weinberg, Ph.D. â€“ Clinical/Research Fellow, BPD Treatment and Research Center, McLean Hospital, Harvard Medical School
- Alex Young â€“ Clinical Research Assistant, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
- Joe Lewko â€“ Data Manager, McLean Hospital
- Linda DeVito -ï€ Administrative Assistant, Personality and Psychosocial Research, McLean Hospital
- Gratz KL, Gunderson JG. Preliminary Data on an Acceptance-Based Emotion Regulation Group Intervention for Deliberate Self-Harm among Women with Borderline Personality Disorder. Behavior Therapy, 37(1):25-35, 2006.
- Paris J, Gunderson JG, Weinberg I. The interface between borderline personality disorder and bipolar spectrum disorders. Compr Psychiatry. 48(2):145-54, 2007.
- Gunderson JG:Â Disturbed relationships as a phenotype for borderline personality disorder: A commentary.Â Am J Psychiatry 164:11, 1637-1640, 2007
- Weinberg, I, Gunderson JG, Hennen J, Cutter CJ:Â Manual Assisted Cognitive Treatment for Deliberate Self-Harm in Borderline Personality Disorder Patients.Â J Pers Disord, 20(5): 482-492, 2006
- Gunderson JG, Weinberg I, Kueppenbender KD, Daversa M, Zanarini MC, Shea MT, Skodol AE, Sanislow CA, Yen S, Grilo CM, McGlashan T, Morey LC, Stout RL, Dyck I:Â Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder.Â Am J Psychiatry 2006; 163:1173-1178
- McGlashan TH, Grilo CM, Sanislow, CA, Ralevski E, Morey LC, Gunderson JG, Skodol AE, Shea MT, Zanarini MC, Bender DS, Stout RL, Yen S, Pagano ME: Two-year prevalence and stability of individual criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders. Am J Psychiatry, 162(5):883-889, 2005.
- Shea MT, Stout RL, Yen S, Pagano ME, Skodol AE, Morey LC, Gunderson JG, McGlashan TH, Grilo CM, Sanislow CA, Bender DS, Zanarini MC: Associations in the course of personality disorders and axis I disorders over time. J Abnorm Psychol, 113(4) 499-508, 2004.
- Gunderson JG, Morey LC, Stout RL, Skodol AE, Shea MT, McGlashan TH, Zanarini MC, Grilo CM, Sanislow CA, Yen S, Daversa MT, Bender DS. Major deprerssive disorder and borderline personality disorder revisited: longitudinal interactions. J Clin Psychiatry, 65(8): 1049-1056, 2004.
- Zanarini MC, Frankenburg FR, Yong L, Raviola G, Reich DB, Hennen J, Hudson JI, Gunderson JG.Â Borderline psychopathology in the first-degree relatives of borderline and Axis II comparison probands.Â J Pers Dis, 18(5) 439-447, 2004
- Gunderson JG, Bender D, Sanislow C, Yen S, Bame Rettew J, Dolan-Sewell R, Dyck I, Morey L, McGlashan TH, Shea MT, Skodol AE. Plausibility and possible determinants of sudden "remissions" in borderline patients. Psychiatry 66:111-119, 2003.
- Gunderson JG, Shea MT, Skodol AE, McGlashan TH, Morey LC, Stout RL, Zanarini MC, Grilo CM, Oldham JM, Keller MB: The Collaborative Longitudinal Personality Disorders Study: development, aims, design, and sample characteristics. J Personal Disord 2000; 14:300-315.