Harvard Department Of PsychiatryHarvard Medical School

STUDIES OF THE PHENOMENOLOGY, COURSE, AND TREATMENT OF BORDERLINE PERSONALITY DISORDER

Laboratory for the Study of Adult Development, McLean Hospital

Mary C. Zanarini, Ed.D., Frances R. Frankenburg, M.D., Bradford Reich, M.D., Margaret F. Marino, Ph.D., Shawna Dowden, Ph.D., John Hennen, Ph.D.

This program is designed to expand the knowledge base concerning borderline personality disorder (BPD). Current projects include the McLean Study of Adult Development (MSAD), an NIMH-funded study of the longitudinal course of borderline personality disorder. This study, which is now in its tenth year, has demonstrated that BPD is a good-prognosis disorder. It assesses the symptomatic and psychosocial course of BPD as well as the course of comorbid disorders, psychiatric treatment, and medical health and services utilization. We also have a supplement from NIMH to study HIV-related risk factors in this sample of patients.

A second project, the McLean Study of Child Development, is a high risk study for BPD involving the children of the adult MSAD patients. At this point in time, only a quarter of the children have exhibited psychiatric symptoms of any severity.

Another area of investigation is the pharmacotherapy of borderline patients. We have conducted double-blind, placebo-controlled trials of olanzapine, valproate acid, and omega-3 fatty acids in samples of criteria-defined borderline patients. Currently, we are conducting a double-blind, placebo-controlled trial of olanzapine vs. fluoxetine vs. the combination of the two.

Yet another area of study is the psychoeducation of borderline patients. It is hypothesized that this psychosocial treatment will lead to more informed decisions concerning mental health services and more thoughtful life choices. We are also in the process of developing a screening instrument for BPD as well as a change measure of borderline pathology for use in treatment studies.

Key Words: Borderline personality disorder, childhood abuse, self-harm, suicide, dissociation, longitudinal course and outcome, physical health, psychotropic medications, psychosocial treatment

Grant Support: NIMH MH62169, American Society for the Prevention of Suicide, Eli Lilly, Abbott Laboratories, and NARSAD

Program Site: Laboratory for the Study of Adult Development, McLean Hospital

Project Director: Mary C. Zanarini, Ed.D., Laboratory for the Study of Adult Development, McLean Hospital, 115 Mill Street, Belmont, MA 02478. Email: zanarini@mclean.harvard.edu

Contact Person: Anna Vujanovic, Project Coordinator. Phone: 617-855-3589; Fax: 617-855-3580

Training Opportunities: Both pre- and post-doctoral training positions are available.

Representative Publications:

Zanarini MC, Frankenburg FR, Marino MF, Reich DB, Haynes MC, Gunderson JG. Violence in the lives of adult borderline

patients. J Ner Ment Dis 1999;187:65-71

Zanarini MC, Frankenburg FR, Reich DB, Marino MF, Lewis RE, Williams AA, Khera GS. Biparental failure in the

childhood experiences of borderline patients. J Personal Disord 2000; 14:264-273

Zanarini MC, Ruser T, Frankenburg FR, Hennen J. The dissociative experiences of borderline patients. Compr Psychiatry

2000; 41:223-227

Zanarini MC, Ruser T, Frankenburg FR, Hennen J, Gunderson JG. Risk factors associated with the dissociative experiences

of borderline patients. J Ner Ment Dis 2000; 188:26-30

Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind,

placebo-controlled pilot study. J Clin Psychiatry 2001; 62:849-854

Zanarini MC, Frankenburg FR, Khera GS, Bleichmar J. Treatment histories of borderline inpatients. Compr Psychiatry

2001; 42:144-150

Department Of Psychiatry Harvard Medical School - 2 West - Room 305 - 401 Park Drive - Boston, MA 02215