Interpersonal and Emotional Problem Solving Skills and Parasuicide among Women with Borderline Personality Disorder

Constance A. Kehrer · Marsha Marie Linehan

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Personality Disorders and Psychopathology Suicide and Self-Harm Studies Problem Solving Skills Development

Abstract

This study examined the predictive relationship between interpersonal and emotional problem solving skills and parasuicide in a sample of 33 chronically parasuicidal outpatient women meeting criteria for borderline personality disorder. Subjects were assessed initially and at 4-month intervals for 1 year using a revised version of the Means-End Problem Solving Procedure (MEPS) and the Parasuicide History Interview. Inappropriate problem solving measured at the 4- and 8-month assessment points was a significant predictor of subsequent parasuicide. Both suicidal and nonsuicidal inappropriate responses predicted parasuicidal behavior. Active, passive, and self-soothing problem-solving strategies failed to predict. Results suggest the usefulness of differentiating interpersonal from emotional problem-solving and provide predictive validity for the modified MEPS Procedure. It appears that patient progress may be monitored by tracking MEPS problem-solving scores, and that treatment may benefit from directly targeting the reduction of maladaptive response patterns.

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References

1993Cognitive-Behavioral Treatment of Borderline Personality Disorder 1988Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) American Psychiatric Association (1987). American Psychiatric Press, Inc., 1400 K Street, NW, Washington, DC 20005. 567 pp., $39.95 hardcover; $29.95 softcover.1991Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients 1990Time-related predictors of suicide in major affective disorder 1993Naturalistic Follow-up of a Behavioral Treatment for Chronically Parasuicidal Borderline Patients 1987Problem-solving skills in suicidal psychiatric patients.1987Dialectical behavior therapy for borderline personality disorder. Theory and method.1990Cognitive-Behavioural Problem Solving in the Treatment of Patients who Repeatedly Attempt Suicide a Controlled Trial

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