Psychological Interventions for Self-harm Behaviour and Suicide Attempts in Borderline Personality Disorder: A Systematic Review

Abstract

Self-harm behaviour and suicide attempts are considered maladaptive coping mechanisms by individuals with a diagnosis of borderline personality disorder (BPD). Numerous studies have demonstrated that individuals with BPD are at a heightened risk for self-harm behaviour and suicide. Therefore, there is a need for intervention efforts aimed at reducing self-harm and suicide attempts in this population by promoting more functional coping strategies. No systematic review has been conducted to explore the effectiveness of such interventions. A systematic review was performed to identify randomized controlled trials of interventions to reduce self-harm and suicide attempts among individuals with BPD, published between 2012 and 2022. PsycARTICLES, PubMed, Web of Science, Science Direct, and Taylor & Francis databases were examined in the review. A total of 6,760 studies were initially screened, only 13 were selected for review based on the inclusion and exclusion criteria. The results indicated that the standard dialectical behaviour therapy protocol, with the addition of psychological intervention components such as skills training, exposure and acceptance, statistically significantly increased recovery. Statistically significant results have been obtained from various psychotherapeutic intervention groups such as schema therapy, cognitive behavioural therapy and emotion regulation therapy However, it was noted that existing protocols might be inadequate in preventing relapse and addressing potential negative outcomes such as premature termination of therapy.

Keywords

• borderline personality disorder
• self-harm
• suicide
• psychological intervention