4 - (SYM 4) Suicidal, Self-injurious and Mental Health Outcomes from an Uncontrolled Trial of Sage: A Couple Therapy for Borderline Personality Disorder

Borderline personality disorder (BPD) is a life-threatening public health crisis. Ten percent of individuals with BPD die by suicide. Interpersonal stressors are known precipitants of self-injurious and suicidal thoughts and behaviours for people with BPD but frontline BPD treatments often do not directly target interpersonal processes that lead to these behaviours. People with BPD also have highly disrupted intimate relationships, and their partners report elevated mental health problems but little access to treatment. Incorporating partners into BPD interventions may optimize suicidal and self-injurious outcomes and improve partner mental health without added resource investments. Sage is a brief 12-session conjoint intervention for people with BPD and their intimate partners that targets BPD, relationship conflict, and partner mental health. In this symposium we present the results of the first uncontrolled trial of Sage. We focus on outcomes related to suicidal and self-injurious thoughts and behaviours of people with BPD and broader mental health outcomes of both partners. Sixteen people with BPD who engaged in recent and chronic suicidal or self-injurious behaviors or had elevated suicidal ideation and their partners were enrolled in Sage and completed measures related to suicidal ideation, the frequency of suicidal and self-injurious behaviours, depression, anxiety, shame, positive affect, negative affect, and quality of life outcome measures at pre-, mid-, and post-intervention, and at a three-month follow-up. Intent-to-treat multilevel modelling revealed significant improvements from baseline to 3-month follow up in self-reported suicidal ideation (g = 1.26, p = .023), shame (g = 1.01, p = .034), anxiety (g = 1.17, p = .045), positive affect (g = 1.03, p = .032), and quality of life (g = 1.10, p = .025). Results on changes in frequency of suicidal and self-injurious behaviours will be available by the time of the convention. No changes were observed in partner mental health outcomes. Findings suggest that Sage may be efficacious in improving suicidal, self-injurious and broader mental health outcomes of people with BPD. Partners generally reported low mental health symptoms at baseline which could have created floor effects in these outcomes. As such, the impact of Sage on partner mental health requires further study. By harnessing the interpersonal context of intimate relationships as a therapeutic process, Sage may be an efficient and effective method of addressing the broader mental health correlates of BPD.