Unified Protocol vs Mentalization‐Based Therapy for Adolescents With Borderline Personality Disorder: A Randomized Controlled Trial.

Background: Despite several treatments, e.g., mentalization‐based therapy (MBT) and Unified Protocol (UP), being adapted to treat adolescents with borderline personality disorder (BPD), there exists a dearth of literature regarding their relative efficacy. In this study modified forms of MBT and UP – MBT‐A and UP‐A respectively—were compared in their ability to reduce borderline symptoms in a sample of 91 Iranian adolescents (two‐thirds female) with a BPD diagnosis. Methods: Individuals randomly allocated to one of two treatment groups, MBT‐A (N = 45) or UP‐A (N = 46) were followed up across 36 months following treatment. A MIXED ANCOVA was applied to compare the effectiveness of these interventions in reducing severity of borderline symptoms (the primary outcome), impulsivity, self‐harm, emotion dysregulation and anger (secondary outcomes). The trial was retrospectively registered at IRCT20231106059970N1. Results: Both primary outcomes and secondary outcomes decreased significantly following both MBT‐A and UP‐A. In comparison with MBT‐A, UP‐A was more effective in reducing emotional dysregulation, but levels of remission declined progressively up to 36 months of follow‐up following both treatments. Conclusions: UP‐A appears to be more effective than MBT‐A in reducing emotional dysregulation in adolescents with BPD, despite being a shorter and less intensive treatment. An important caveat is that the treatment induced changes were largely limited to the emotion dysregulation aspect of BPD; other aspects (interpersonal and identity disturbances) were largely unchanged by either treatment. [ABSTRACT FROM AUTHOR]