Systems Training for Emotional Predictability and Problem Solving for older adults with borderline personality disorder symptoms

Abstract

Objective:Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a 20-week group treatment program for patients with borderline personality disorders (BPD). STEPPS is an evidence-based treatment to reduce BPD symptoms. However, the mean age of patients studied thus far is 33 years. Studies evaluating STEPPS in older adults are lacking. Aim of this study was to investigate the feasibility of STEPPS in older adults with BPD symptoms.Method:A naturalistic, pre- vs post-treatment pilot study design. Twenty-four patients (mean age 64 years) completed the Dutch version of the STEPPS program. Primary outcome was BPD symptoms and secondary outcome was psychological distress and maladaptive personality functioning.Preliminary results of the ongoing study:The STEPPS pilot in older adults demonstrated a significant decrease in BPD symptoms (Cohen’s d = 1.6), improved self-control of emotions and impulses (r = 0.58), and improved identity integration (Cohen’s d = 0.5). No significant differences were found for psychological distress.Conclusion:STEPPS is feasible for older adults with BPD symptoms. The treatment program led to a decreased in BPD symptoms and improvement of emotion regulation skills in older adults.Future perspectives:To further improve the feasibility of STEPSS in older adults a Delphi study was performed with seven experts in the field. The results of this Delphi study will additionally be discussed in this presentation. Most important recommendations were the addition of age-specific topics to the STEPPS program, e.g., changing social roles, life review, and/or physical limitations.