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.

Personnel

John G. Gunderson, M.D. – Program Director, Personality and Psychosocial Research; Professor of Psychiatry, Harvard Medical School, McLean Hospital
Mary C. Zanarini, Ed.D. – Director, Laboratory for the Study of Adult Development; Associate Professor of Psychology, Harvard Medical School, McLean Hospital
Lois Choi-Kain, M.D. – Clinical Research Fellow, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
Angela Howell – Project Coordinator, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
Igor Weinberg, Ph.D. – Clinical/Research Fellow, BPD Treatment and Research Center, McLean Hospital, Harvard Medical School
Alex Young – Clinical Research Assistant, Personality and Psychosocial Research, Harvard Medical School, McLean Hospital
Joe Lewko – Data Manager, McLean Hospital
Linda DeVito - Administrative Assistant, Personality and Psychosocial Research, McLean Hospital

Representative Publications