Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

The relation between locus of control and coping in two contexts: age as a moderator variable

We examined the relation between locus of control and coping as moderated by age and context. A total of 96 adolescents, young adults, middle-aged adults, and older adults were administered Lazarus's Ways of Coping questionnaire, a situation-specific controllability measure, a defensive coping questionnaire, and Levenson's Internality, Powerfulness of Others, and Chance global locus of control scales for challenging and threatening contexts. Age moderated the relation between locus of control and coping. Internality was positively related to escape-avoidance, hostile reaction, and self-blame for younger individuals and negatively related for older adults. A belief in powerfulness of others was positively related to planful problem-solving and self-controlling in older adults and negatively related for younger individuals. Finally, a belief in chance was positively related to distancing and self-controlling for older adults and negatively related for younger individuals. The implication that dimensions of control vary with age is discussed.