Manualised psychotherapies for borderline and/or antisocial personality disorder in offender populations – a narrative synthesis

A narrative synthesis examining the evidence for the effectiveness of various, manualised psychological therapies for BPD and/or ASPD in forensic settings. This included original research studies conducted within an adult forensic setting (community/probation, secure hospital and custody/prison environments). Participants in these studies had a clinical diagnosis of BPD and/or ASPD. Interventions were recognised manualised psychological therapies, with an evidence base for the treatment of PD, provided on an individual and/or group basis. All included studies measured change pre- and post-intervention. Specific outcome measures for each study were examined by intervention, setting, specific PD symptoms, violence/offending behaviours, self-harm behaviours, and other non-specific symptoms/outcomes. A comprehensive methodology was applied to assess risk of bias to each study’s internal validity. Twelve studies were included, with a mixed gender population, in varied forensic settings, with diverse delivery of different psychological therapy modalities, from sixteen weeks to three years’ duration. Most studies reported statistically significant reductions in at least one category of symptoms/behaviours. The quality of included studies was variable, with several describing no control group and all studies having a serious risk of bias in at least one domain. This would suggest that such inferences regarding the validity of outcome measures should be interpreted with caution.