Association between schema and schema modes and DSM-5 criteria for BPD
Research type
Research Study
Full title
Exploration of the association between schema and schema modes and DSM-5 diagnostic criteria for Borderline Personality Disorder
IRAS ID
350275
Contact name
Sarah Neale
Contact email
Sponsor organisation
The University of the West of England (UWE)
Duration of Study in the UK
1 years, 10 months, 27 days
Research summary
Borderline Personality Disorder (BPD) is a heterogenous disorder which poses significant challenges in diagnosis and treatment. To receive a diagnosis, individuals must meet any 5 or more of the 9 criteria according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA 2013), entailing a potential 256 symptom combinations for this one diagnostic label.
Prevalence varies but is thought to be between 0.7% and 2% within the general population. However, approximately 3.8% meet 3-4 of the criteria and can present as significantly impaired. These individuals may not qualify for entry to more specialist services that support those with the diagnosis, and regularly present in other types of NHS services which do not necessarily meet their needs (Barber et al 2021). This has negative implications for individuals and societal systems.
Schema therapy is thought to be one effective treatment approach for individuals demonstrating symptoms consistent with BPD (Arntz 2020) and in part consists of focussing on Early Maladaptive Schemas (EMS) and Schema Modes (SM’s). EMS are similar to traits or beliefs about the world around us and SM’s demonstrate more reactive and intense emotional states in which an individual may regress to a more child-like mode where needs were unmet (Arntz, Klokman & Sieswerda, 2005). Inclusion of EMS and SM’s could allow us to understand not only more stable traits but the more reactive features, or modes, associated with a BPD style presentation among individuals, how this relates to diagnostic criteria, and how this might differ between clinical and non-clinical populations.
Literature suggests potentially large numbers of individuals who present to services may not meet criteria for more focussed interventions, such as those in specialist services. This suggests benefit in understanding how EMS and SM’s correlate with diagnostic criteria to enable exploration into perhaps adapting therapeutic approaches available to those who hold a diagnosis, such as schema therapy, for those who do not meet diagnostic thresholds.
Adults (18-65) who have experienced 1 or more of the diagnostic criteria from Primary Mental Health Therapy Services and specialist services in Swansea Bay University Health Board will be eligible to participate as well as a student population from The University of the West of England.
The study employs a quantitative approach where all participants would answer a series of questionnaires.REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
25/WM/0027
Date of REC Opinion
25 Feb 2025
REC opinion
Further Information Favourable Opinion