Review Of Efficacy Research

The treatment of patients with PDs is hampered by the lack of a broad empirical base. The most well-explored disorder is BPD, with special emphasis on self-harm and parasuicidal behavior (Davidson et al., 2006; Weinberg, Gunderson, Hennen, & Cutter, 2006) Self-harm is a clear, targeted therapeutic goal. Attempts to mount similar studies for other PDs are hindered by the very nature of the disorders. For example, how does one go about obtaining a group of patients with NPD or HPD? Advertising or seeking referrals from inpatient units, or from acute care facilities, is not feasible.

Until the field develops a recruitment and screening program for the other PDs, we are unable to support empirically the cognitive-behavioral treatment for disorders other than BPD. We will be in the same bind that plagued the early psychoanalysts: Treating those patients who sought treatment, then extrapolating their clinical findings and insights to all persons—a problem that remains in some quarters even today.

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