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Background:

Borderline personality disorder (BPD) is a major public health problem. This study aims to delay the onset of or reduce the severity of subsequent BPD in a sample of adolescents at risk of BPD.

Method:

Eighty-six 15-to 18-year-old participants were drawn from an adolescent psychiatric service. They had one or more childhood risk factors for BPD and met criteria for two or more current DSM-IV BPD features, using rigorous diagnosis. Participants were randomly allocated to 24 sessions of either cognitive analytic therapy [CAT; Ryle 1997] or manualized ‘good clinical care’(GCC). A third, nonrandomized comparison group (n= 30), which received ‘treatment as usual’(TAU), was collected prior to implementation of the study. Outcome measures completed at baseline, 6, 12 and 24 months included BPD score, internalizing and externalizing psychopathology and social and occupational functioning.

Results:

At …