Targeting Elevated Borderline Features in Adolescents Using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A)

Niza A. Tonarely, Jamie A. Sherman, Rebecca A. Grossman, Jill Ehrenreich-May

Research output: Contribution to journalArticlepeer-review

Abstract

Youth with elevated borderline features (BF) exhibit significant emotional dysregulation and high impulsivity. Borderline Personality Disorder (BPD) and BF have been historically difficult to treat for various reasons. Individuals with BPD are prone to high rates of premature treatment dropout, despite displaying greater treatment-seeking behaviors than other clinical populations. Given the potential barriers to the attainment and implementation of more intensive treatments targeting BPD among adolescents, particularly for those with less severe BF presentations, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) may be a practical, time-limited, and less resource-intensive treatment option that still targets core emotion regulation processing deficits characteristic of BPD or its developmental sequalae. A case study describes usage of the UP-A with an adolescent female exhibiting elevated BF. This adolescent presented with comorbid anxiety, depressive disorders, and oppositional defiant disorder, as well as elevated BF at pre-treatment. Clinically significant decreases in anxiety and depressive symptom severity were noted during the course of the intervention, as well as a reliable decrease in BF. Adaptations to the existent core modules of the UP-A are described and guidance for identifying cases with elevated BF appropriate for the UP-A is discussed. Although more systematic evaluation is needed, this case illustration provides preliminary insight into the clinical strengths and limitations of this treatment protocol for targeting BF in adolescents.

Original languageEnglish (US)
Pages (from-to)47-64
Number of pages18
JournalEvidence-Based Practice in Child and Adolescent Mental Health
Volume6
Issue number1
DOIs
StatePublished - 2021

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health

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