EFETIVIDADE DA TERAPIA COMPORTAMENTAL DIALÉTICA PARA O TRATAMENTO DO TRANSTORNO DE PERSONALIDADE BORDERLINE: UMA REVISÃO DA LITERATURA

Autores

  • Leonardo da Cunha Guimarães
  • Jenifer Nunes Simões
  • Leandro Alencastro Santos

Resumo

A terapia Comportamental Dialética foi proposta inicialmente para o manejo de pacientes com ideação e tentativas de suicídio, apresentando bons resultados para esta finalidade. Diante de sua eficácia, alguns autores começaram a propor o uso de tal intervenção para o tratamento de indivíduos com diagnóstico de Transtorno de Personalidade Borderline, tendo em vista as limitações das abordagens terapêuticas para este transtorno. O objetivo do presente estudo foi avaliar a efetividade da Terapia Comportamental Dialética para o Transtorno de Personalidade Borderline. Trata-se de uma Revisão da Literatura, conduzida nas bases de dados PubMed e SciELO. A busca encontrou 9 estudos dentro dos critérios de inclusão estipulados, todos relatando eficácia de tal abordagem para o tratamento do Transtorno de Personalidade Borderline. Os principais sintomas a apresentar remissão foram abuso de substâncias, tentativa de suicídio, descontrole emocional e prejuízos ocupacionais. Contudo, a efetividade requer um segmento longitudinal após a conclusão da intervenção, e somente 2 estudos relataram tal segmento. Ambos sugerem efetividade de forma satisfatória, pois consistem em estudos com amostras expansivas. Ainda assim, cabe mencionar que a literatura apresenta mais dados assegurando a eficácia do que a efetividade da Terapia Comportamental Dialética para o Transtorno da Personalidade Borderline. Destaca-se a importância de mais estudos nesta área para que a efetividade de tal intervenção possa ser assegurada com maior índice de confiabilidade.

Referências

Ades, T., & Santos, E. F. (2012) Borderline: criança interrompida - adulto borderline. 2a. ed. São Paulo: Editora Isis.

Abreu, P., & Abreu, J. (2016). Terapia comportamental dialética: um protocolo comportamental ou cognitivo? Revista Brasileira de Terapia Comportamental e Cognitiva, 18(1), 45-58.

Agugila, Andrea et al. (2018). Asenapine in the management of impulsivity and aggressiveness in bipolar disorder and comorbid borderline personality disorder: an open-label uncontrolled study. Int Clin Psychopharmacol., 33(3), 121-130.

American Psychiatric Association. (2014). Manual Diagnóstico e Estatístico de Transtornos Mentais. 5a. ed. Porto Alegre: Artmed.

Axelrod, Seth R. (2011). Emotion regulation and substance use frequency in women with substance dependence and borderline personality disorder receiving dialectical behavior therapy. Am J Drug Alcohol Abuse., 37(1), 37-42.

Barbosa, A.S., Terroso, L.B., & Argimon, I.I.L. (2014). Epistemologia da terapia cognitivo-comportamental: casamento, amizade ou separação entre as teorias?. Bol. - Acad. Paul. Psicol., 34(86), 63-79.

Borst, A. W., & Gelder, B. (2016). Clear signals or mixed messages: inter-individual emotion congruency modulates brain activity underlying affective body perception. Soc Cogn Affect Neurosci., 11(8), 1299-1309.

Brink, C., Harte, J.M., & Denzel, A. D. (2018). Men and women with borderline personality disorder resident in Dutch special psychiatric units in prisons: A descriptive and comparative study. Crim Behav Ment Health., 28 (4), 324-334.

Bruno, A., Riganello, D., & Marino, A. (2009). Treatment with aripiprazole and topiramate in an obese subject with borderline personality disorder, obsessive-compulsive symptoms and bulimia nervosa: a case report. Cases J., 2, 7288-7293.

Burget, Melanie et al. (2015). Pain Processing after Social Exclusion and Its Relation to Rejection Sensitivity in Borderline Personality Disorder. PLoS One., 10 (8), e0133693.

Carvalho, A.F., Stracke, C.B. & Souza, F.G.M. (2004). Tratamento farmacológico do transtorno de personalidade limítrofe: revisão crítica da literatura e desenvolvimento de algoritmos. R. Psiquiatr. RS, 26 (2), 176-189.

Cunha, P.J., & Azevedo, M.A.S.B. (2001). Um caso de transtorno de personalidade borderline atendido em psicoterapia dinâmica breve. Psic.: Teor. e Pesq., 17(1), 5-11.

Dalgalarrondo, P., & Vilela, W.A. (1999).Transtorno borderline: história e atualidade. Rev. latinoam. psicopatol. fundam., 2(2), 52-71.

Dimeff, L. A., & Koerner, K. (2007). Overview of dialectical behaviour therapy. In: Dimeff, L. A.; Koerner, K. (Orgs.). Dialectical behavior therapy in clinical practice: applications across disorders and settings. New York: The Guilford Press, p. 1-18.

Einsenberger, N. I., Liberman, M.D. & Williams, K.D. (2003). Science, 302 (43), 290-292.

Eizirik, M., & Fonagy, P. (2009). Mentalization-based treatment for patients with borderline personality disorder: an overview. Rev. Bras. Psiquiatr., 31(1), 72-75.

Frías, A. et al. (2017). Differential symptomatology and functioning in borderline personality disorder across age groups. Psychiatry Res., 258(1), 44-50.

Gawda, B., & Czubak, C. (2017). Prevalence of Personality Disorders in a General Population Among Men and Women. Psychol Rep., 120(3), 503-519.

Goodman, Marianne et al. (2014). Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder. J Psychiatr Res., 57(1), 108-116.

Hiraoka, Regina et al. (2016). Borderline personality features and emotion regulation deficits are associated with child physical abuse potential. Child Abuse Negl., 52(1), 177-84.

Kim, Bo-Ram et al. (2014). Infant Emotion Regulation: Relations to Bedtime Emotional Availability, Attachment Security, and Temperament. Infant Behav Dev., 37(4), 480-490.

Kolla, Nathan J. et al. (2017). Trait Anger, Physical Aggression, and Violent Offending in Antisocial and Borderline Personality Disorders. J Forensic Sci., 62(1), 137-141.

Law, Mary K. et al. (2016). Using negative emotions to trace the experience of borderline personality pathology: Interconnected relationships revealed in an experience sampling study. J Pers Disord., 30(1), 52-70.

Linehan, Marsha M. et al. (1991). Cognitive behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48 (1), 1060-1064.

Linehan, Marsha M. et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry., 72(5), 475-82.

Mcmain, Shelley F. et al. (2012). Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up. Am J Psychiatry., 169 (6), 650-61.

Neacsiu, Andrada D. et al. (2014). Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder. Behav Res Ther., 53 (2), 47-54.

Niedtfeld, Inga et al. (2017). Pain-mediated affect regulation is reduced after dialectical behavior therapy in borderline personality disorder: a longitudinal fMRI study. Soc Cogn Affect Neurosci., 12 (5), 739-747.

Nunes, Fábio Luiz et al. (2015). Eventos traumáticos na infância, impulsividade e transtorno da personalidade borderline. Rev. bras.ter. cogn., 11 (2), 68-76.

Portela, M.C. (2000). Avaliação da qualidade em saúde. In: ROZENFELD, S., org. Fundamentos da Vigilância Sanitária [online]. Rio de Janeiro: Editora FIOCRUZ, p. 259-269. ISBN 978-85-7541-325-8. Disponível em: SciELO Books: <http://books.scielo.org>.

Ripoll, L. H. (2013). Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci., 15(2), 213-224.

Rizvi, Shireen L. et al. (2017). Can trainees effectively deliver dialectical behavior therapy for individuals with borderline personality disorder? Outcomes from a training clinic. J Clin Psychol., 73 (12), 1599-1611.

Santangelo, P. S. et al. (2018). Affective instability across the lifespan in borderline personality disorder – a cross‐sectional e‐diary study. Acta Psychiatr Scand., 138 (5):409-419.

Schmahl, Christian et al. (2014). Mechanisms of disturbed emotion processing and social interaction in borderline personality disorder: state of knowledge and research agenda of the German Clinical Research Unit. Borderline Personal Disord Emot Dysregul., 1 (12), 102-118.

Shen, Cheng-Che, Hu, Li-Yu, & Hu, Ya-Han. (2018). Comorbidity study of borderline personality disorder: applying association rule mining to the Taiwan national health insurance research database. BMC Med Inform Decis Mak., 17(1), 8-17.

Soloff, P. H., & Chiappetta, L. (2018). 10-Year Outcome of Suicidal Behavior in Borderline Personality Disorder. J Pers Disord., 22 (1), 1-19.

Stanely, B., & Siever, L.J. (2010). The interpersonal dimension of borderline personality disorder: toward a neuropeptide model. Am J Psychiatry., 167(1), 24-39.

Varghese, Bidu S. et al. (2010). Topiramate for anger control: A systematic review. Indian J Pharmacol., 42 (3), 135-141.

Vest, Noel A., Murphy, Kyle T., & Tragesser, Sarah L. (2018). Borderline personality disorder features and drinking, cannabis, and prescription opioid motives: Differential associations across substance and sex. Addict Behav., 87 (1), 46-54.

Wiggins, Jillian L. et al. (2014). Age-related effect of serotonin transporter genotype on amygdala and prefrontal cortex function in adolescence. Hum Brain Mapp., 35 (2), 646-658.

Wainer, Ricardo et al. (2016). Terapia cognitiva focada em esquemas. Porto Alegre. Artmed.

Winter, D. et al. (2017). Neural correlates of distraction in borderline personality disorder before and after dialectical behavior therapy. Eur Arch Psychiatry Clin Neurosci., 267(1), 51-62.

Yen, Shirley et al. (2015). Borderline Personality Disorder in Transition Age Youth with Bipolar Disorder. Acta Psychiatr Scand., 132(4), 270-280.

Downloads

Publicado

2020-07-31

Edição

Seção

Artigos