الفهرس 
Introduction and Aim of the StudyOnly 14 pages are availabe for public view
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Abstract
Borderline personality disorder is the most commonly diagnosed PD. It is characterized by a pattern of dysfunctional behaviors including impulsivity, affective instability, interpersonal or intrapersonal conflict or have difficulties in establishing a coherent sense of self or identity. Also, they often exhibit high levels of co-morbidities such as depression, anxiety as well as substance abuse. Individuals with BPD have higher rates of hospital admissions than individuals with other disorders, because of their higher rate of self-injurious or suicidal behavior.
The present study was conducted aiming to investigate the effectiveness of DBT intervention program among female BPD patients. Also, to adapt, implement and assess the effectiveness of the intervention program in decreasing self-injurious and suicidal attempts among female BPD patients.
To fulfill this aim, one group pre-test/post-test study design was carried out on a sample of 60 female BPD patients attending the outpatient clinic in El-Maamoura Psychiatric Hospital, Alexandria Governorate.
For the execution of this work, the BPD patients were subjected to:
• A pre-designed structured interviewing questionnaire designed by the researcher and reviewed by the supervisors to collect the following data:
a) Sociodemographic data: including age, education, occupation, residence, marital status, family size and household conditions.
b) History of abuse whether physical, emotional or sexual abuse.
c) Types of patients’ relationships; with friends, emotional relationships and relationship between parents.
d) History of psychiatric illness/drug abuse: including type of psychiatric disorders, previous medications, previous hospitalization or rehabilitation.
e) Family history of psychiatric illness/substance abuse, including patient’s knowledge about the presence of illness, diagnosis by a psychiatrist, compliance on medication if present.
• A self-report scale was used as an initial screening measure to identify BPD patients using the Arabic version of the PDQ-4+ questionnaire. The researcher confirmed the diagnosis of all the identified cases according to DSM-5 diagnostic criteria.
• The selected BPD patients (n=60) were assigned to six groups, each group consisted of ten members of female BPD.The duration of DBT intervention program was 13 weeks (one session weekly). Each group session lasted around 90-110 minutes.
• Self-injurious behavior was assessed using ISAS questionnaire three times; before, immediately and three months after implementation of the DBT program. The ISAS questionnaire was translated into Arabic language and the internal consistency was done using cronbach’salpha, which was found to be 0.842. Also, content validity of the questionnaire was tested by obtaining the opinion of three experts in psychiatry having Doctorate Degree and more than ten years in practice.
• Psychological support was provided throughout the group sessions through individual sessions and phone consultation whenever needed.
Results of the current study revealed the following:
The age of the study group (60 BPD female patients) ranged between 25-35 years. They were mostly single (76.7%), not working (56.6%) and the family monthly income was stated to be not enough or not enough and borrows in 77% of cases. The number of family members was more than five in 50% of the sample.
Living with either mother or father or both was found in 70% of cases. The relation between parents was described as bad in 90% of cases, whether still together in 65% of cases, separated in 10% of cases or divorced in 25% of cases.
All female BPD patients stated that they were subjected to different types of abuse (physical, emotional and sexual). Emotional abuse was present in 100% of cases, followed by sexual abuse (86.7%) then physical abuse in 78.3% leading to escape from home in nearly two thirds of the sample.
Nearly 68% of them had relationships with friends but it was bad or unstable in 87.8% of cases, nearly 92% had emotional relationships but the ending of emotional relationships was bad in 94.6% of cases.
A wide range of psychiatric symptoms was reported by 100% of the study sample. Smoking was present in 83.3% of cases, substance abuse in 43.3%, self-injurious behavior in 100% of cases, while suicidal attempts were mentioned by 75% of cases and 55% of cases had family history of psychiatric illness/substance abuse.
The social, relational and occupational functioning of the studied BPD patients showed evident dysfunction according to GAF score before enrolling in the program.
The following significant results were encountered:
There was a positive relation between many studied variables and some of the functions of NSSI according to ISAS scale. These variables are:
• Completing preparatory/secondary education and peer bonding subscale as a function of NSSI (KW p =0.034, post hoc=0.031).
• Having three or more friends and the self-care subscale (KW p=0.034, post hoc=0.020).
• Living with mother/father alone and self-care, sensation seeking and autonomy subscales (KW p= 0.021, 0.049, 0.025, post hoc= 0.030, 0.001, 0.034 respectively).
• Ending the emotional relationship (with opposite sex) with many problems and autonomy subscale (p=0.046).
• Escape from home once/twice and peer bonding (KW p=0.001, post hoc=0.030) and escape three times or more and peer bonding and interpersonal influence subscales (KW p=0.001, 0.037, post hoc=0.001, 0.035 respectively) as functions of NSSI.
• History of psychiatric illness/substance abuseof the BPD patients and functions of NSSI. There was a positive relation between regular smoking and autonomy subscale (KW p = 0.011, post hoc= 0.019), recent drug abuse and marking distress subscale (KW p=0.036, post hoc= 0.014), presence of psychiatric illness and interpersonal influence subscale (KW p= 0.032, post hoc=0.050). Also, there was a relation between past suicidal attempts and peer bonding as a function of NSSI (p=0.020).
• Lack of knowledge (i.e. patient does not know) about family history of psychiatric illness and interpersonal influence and autonomy subscales (KW p=0.032, 0.035, post hoc= 0.027, 0.001 respectively).
After DBT intervention program implementation:
• The BPD patients enrolled in the DBT program experienced significant decline in all borderline symptoms according to the PDQ-4+ in the total score from before to immediately and three months after implementation of DBT program (p≤0.05).
• Functions of NSSI showed marked decline in all subscales of ISAS questionnaire as well as their means, immediately and three months after implementation of the DBT program (p≤0.05).
• There were no cases of attempted suicide during, immediately and three months after implementation of the program.
• The GAF scale showed marked improvement in all scores immediately and three months after implementation of the DBT program.